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When I first analyzed Vermont's 2019 ACA policy rate filings back in May, the state's two ACA carriers, Blue Cross Blue Shield and MVP Healthcare, were requesting average premium increases of 7.5% and 10.9% respectively.

Vermont's situation is unusual compared to most other states for a couple of reasons. First of all, VT is one of only two states (Massachusetts is the other one) which has merged their Individual and Small Group market risk pools into one to help stabilize both markets. This is something I wish every state would do, frankly, although it's probably a lot easier to do in deep blue states (and Vermont having such a small population probably made it easier as well).

A few weeks ago, I posted about New Jersey's preliminary 2019 ACA-compliant individual market rate filings. At the time, the official New Jersey Dept. of Banking & Insurance specifically stated that:

  • Because Congressional Republicans repealed the ACA's Individual Mandate Penalty, carriers were planning on increasing 2019 premiums by 12.6% on average, in part to account for the adverse selection which was expected to happen next year.
  • However, thanks to the Democratically-controlled New Jersey state legislature and Governor swiftly reinstating the ACA individual mandate, actual 2019 rate filings are only expected to increase rates an average of 5.8%, saving the average unsubsidized indy market enrollee around $470 apiece next year.
  • Finally, the NJ legislature also passed, and Governor Murphy signed into law, a robust reinsurance bill which, if approved by CMS, is expected to lower unsubsidized 2019 premiums by an additional 15 percentage points, for a final 2019 average premium reduction of around 9.2%.
  • It's also important to understand that New Jersey's portion of the funding for the proposed reinsurance program will be coming from the revenue generated by the reinstated mandate penalty itself.

 

(Note: I uploaded Livengood's video clip to YouTube because it's the only way I could embed it within the blog post)

VIDEO: Today, I attempted to pin down @SchuetteOnDuty today on whether he will keep @onetoughnerd’s expanded Medicaid program intact if he’s elected governor.
I think I’ll try again next week... pic.twitter.com/hu6ejM2vpt

— Chad Livengood (@ChadLivengood) August 15, 2018

Transcript:

Livengood: "Attorney General, if you're elected governor, are you gonna keep the Medicaid program that the governor's established, the Healthy Michigan plan?"

Over at The Hill, Nathaniel Weixel has a great roundup of some of the actions various states are taking to counteract Donald Trump's potentially illegal sabotage of the Affordable Care Act:

The Department of Health and Human Services is urging states to cooperate with the federal government, but instead, insurance commissioners are panning the new plans as "junk” insurance and state legislatures are putting restrictions on their sales.

State insurance officials argue that, despite being less expensive than ObamaCare plans, the short-term plans are bad for consumers and aren't an adequate substitute for comprehensive insurance.

“These policies are substandard, don’t cover essential health benefits, and consumers at a minimum don’t understand [what they’re buying], and at worse are misled,” California Insurance Commissioner Dave Jones (D) said.  

Hot on the heels of Anthem's announcement that they're significantly expanding their ACA market coverage throughout Virginia comes another piece of welcome news:

Gov. Ralph Northam’s administration will convene a new work group on Monday to consider options to stabilize soaring premiums in Virginia’s health insurance market.

The Virginia Market Stability Group will consider a wide range of options to lower insurance premiums expected to average more than $833 a month next year, making coverage unaffordable to people who don’t qualify for federal subsidies for premiums or out-of-pocket expenses in the marketplace established by the Affordable Care Act.

...But one option could trump all others — a state budget plan to request a federal waiver for a “re-insurance” program in Virginia that would help defray the costs for the most expensive patients and relieve the expense for others by lowering the risk.

Over at the New York Times, ACA-supporting University of Michigan law professor Nicholas Bagley (who I've quoted/cited here many times before) and Yale law professor Abbe R. Gluck (who's also a member of the conservative Federalist Society) have co-written an interesting op-ed piece which cuts to the heart of not only Donald Trump's relentless attempts to sabotage, undermine and otherwise stab the ACA through the heart, but the larger issue of the President's responsibility to "faithfully execute" the law of the land:

From the moment he took office, President Trump has used all aspects of his executive power to sabotage the Affordable Care Act. He has issued executive orders, directed agencies to come up with new rules and used the public platform of the presidency in a blatant attempt to undermine the law. Indeed, he has repeatedly bragged about doing so, making statements like, “Essentially, we are getting rid of Obamacare.”

I haven't really written much about the idiotic (but incredibly dangerous) #TexasFoldEm lawsuit in over a month, but it just jumped back into the news in a big way:

Oral arguments have been scheduled for Sept. 10 in a Texas lawsuit seeking to strike down Obamacare as unconstitutional.

The case was filed in February by 20 Republican state attorneys general. They’re seeking a preliminary injunction halting enforcement of the federal health care law.

The Trump administration has partly sided with the plaintiffs in seeking to strike down the Affordable Care Act’s insurance protections, including the prohibition on denying coverage to individuals with pre-existing medical conditions.

 

Back in the early 1990's, Bill and Hillary Clinton attempted an ambitious overhaul of the entire U.S. healthcare coverage system. Hillary was put in charge of the effort.

The backlash from the health insurance lobby was swift and furious, most infamously encapsulated in the form of the "Harry & Louise" attack ads, two of which I've posted above.

SIDENOTE: There's a lot going on here, especially in the 2nd ad:

In my Tennessee 2019 rate filing analysis last month, I noted the good, the bad and the ugly:

  • The good news was that average unsubsidized 2019 ACA individual market premiums were expected to drop by about 5.7% after years of double-digit rate hikes.
  • The bad news was that due specifically to various types of deliberate sabotage by the Trump Administration and Congressional Republicans (primarily repeal of the individual mandate and expansion of #ShortAssPlans), that 5.7% drop was still a good 12 points or so higher than it otherwise would have been.
  • The ugly news was that due specifically to the Trump Administration's utterly unnecessary decision to freeze Risk Adjustment fund transfers in response to a lawsuit out of New Mexico, 2019 premiums would be hundreds of dollars higher still than they should have been for Blue Cross Blue Shield of Tennessee's 113,000 enrollees:

UPDATE: As noted in the comments below, it looks like Anthem won't be expanding to cover the entire state after all. Even so, this is a major improvement in the situation.

Every year, Virginia is the first state out of the gate with their preliminary healthcare premium rate changes for the following year, posting the initial rate requests in early May. For 2019, it originally looked like the carriers were asking for a statewide average increase of 15.2%, but I later corrected this to 13.4%.

However, these were just preliminary numbers. The requests still have to go through the rate review process, and the carriers often make other changes as well before the final deadlines pass.

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