Me, June 16th, after several months of various state-based ACA exchanges bumping out their COVID-19 Special Enrollment Period deadlines by a month, then another month, then another month:

At a certain point I'm guessing at least one of the state exchanges will just say "screw it" and open 2020 enrollment up for the full year.

The point of a deadline is a) to prevent people from trying to game the system by deliberately waiting until they're sick/injured before enrolling in coverage (thus driving up premiums for everyone else) and b) to goad people into actually taking action (deadlines do have a clear positive impact on enrollment). With the COVID-19 pandemic having thrown the entire healthcare system into disarray, neither of those seem to be much of a factor this year.

Maryland Connect, August 7th:

Back on July 31st, I wrote:

I've taken some amount of criticism from people who got the vapors and claimed that I was "politicizing" the pandemic, which is laughable in the Trump era, where everything has been politicized by the Trump Administration.

Cut to Vanity Fair, yesterday:

Six months into the pandemic, the United States continues to suffer the worst outbreak of COVID-19 in the developed world. Considerable blame belongs to a federal response that offloaded responsibility for the crucial task of testing to the states. The irony is that, after assembling the team that came up with an aggressive and ambitious national testing plan, Kushner then appears to have decided, for reasons that remain murky, to scrap its proposal.

 

This morning, U.S. Senator Gary Peters (D-MI) and his Republican opponent, John James, were interviewed online by Nolan Finley of the Detroit News and Stephen Henderson of DPTV & WDET. Here's the verbaitm transcripts of each of their healthcare/ACA Q&A sections, Peters first:

HENDERSON: "One of the things which has been made really manifest during the COVID-19 pandemic is the weakness of our healthcare system. We're now coming up on about a decade of life under the Affordable Care Act, which of course expanded access to insurance and made some other changes, but there are still obviously a lot of inefficincies...there are a lot of insufficiencies.

Give us an idea of what you would support in terms of changes to the healthcare system, changes to the Affordable Care Act, to get more people covered at lower costs and make the system work better."

I don't know if this is an industry trend, a state regulator trend or new policies being implemented by CMS, but it seems that either more health insurance carriers have been redacting their Actuarial Memos and/or not uploading their URRT files to the publicly-accessible SERFF database or the state insurance departments, SERFF database and/or CMS's Rate Review database aren't posting as many of them publicly.

Case in point, Wisconsin: I have the average requested 2021 premium rate filings for every carrier on the individual and small group markets...but the actuarial memos are all redacted and none of the URRTs are available at all, making it impossible for me to run a weighted average since I don't know how many enrollees each carrier has. Also, for the second year running, Compcare Health Services doesn't appear in CMS's Rate Review database at all for reasons unknown.

Missouri's preliminary avg. 2021 unsubsidized premium rate changes have been posted. There's one new entrant into the individual market this year (Blue Cross Blue Shield of Kansas City, which actually mostly pulled out of MO a couple of years back). Nothing too noteworthy--the average requested 2021 premium is going up 4.7% on the individual market and 9.3% on the small group market.

The Indiana Insurance Dept. has posted their 2021 individual & small group rate filings to the SERFF database. Nothing terribly noteworthy other than the average requested rate increase is unusually high for 2021 compared to most other states so far (10.2%, mainly via Celtic), and it looks like a second division of UnitedHealthcare is offering policies on the small group market next year:

The data below comes from the GitHub data repositories of Johns Hopkins University, execpt for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.

A reminder that I made two important changes to the spreadsheet last week:

  • First, the Johns Hopkins Github archive has finally started breaking out New York City's data into the five separate boroughs/counties
  • Second, I've finally gone through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.

With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, September 12th (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District

Back in July, the Connecticut Insurance Dept. posted the preliminary 2021 rate filings for the individual and small group market carriers. On average, they were seeking rate increases of 6.3% for the individual market and 11.3% for the small group market.

Today, the CT DOI issued their final rate change rulings, and the difference are pretty dramatic:

Insurance Commissioner Issues Decisions For 2021 Health Insurance Rates

Insurance Commissioner Andrew N. Mais today announced the Department has made final decisions on health insurance rate filings for the 2021 coverage year. As a result of these decisions, approximately 214,600 Connecticut consumers are projected to save $96 million.

The Department approved an average increase for individual plans of 0.01 percent, down from the average request of 6.29 percent. The average increase for small group plans is 4.1 percent, down from the requested average of just over 11.28 percent.

WATCH: Trump Fans Give CNN's Jim Acosta Jaw-Dropping Reasons Why They're Not Wearing Masks at Packed Rally https://t.co/hNcXv4KYfb pic.twitter.com/vuSEkPFO8s

— Tommy X-TrumpIsARacist-opher (@tommyxtopher) September 11, 2020

Around 5,500 Trump supporters showed up at an aircraft hanger in Freeland, Michigan (Saginaw County) to hear Donald Trump speak. The almost entirely white crowd may have been outside, but they were tightly packed and few were wearing masks. CNN's Jim Acosta (who did wear a mask properly, over both his nose and mouth) interviewed some of the attendees to ask why they weren't doing so, and the responses are...quite telling (click thru for the actual video):

Acosta: "Why are you guys not wearing masks?"

Me, June 16th, after several months of various state-based ACA exchanges bumping out their COVID-19 Special Enrollment Period deadlines by a month, then another month, then another month:

I admit that this is starting to get a bit silly. At a certain point I'm guessing at least one of the state exchanges will just say "screw it" and open 2020 enrollment up for the full year.

The point of a deadline is a) to prevent people from trying to game the system by deliberately waiting until they're sick/injured before enrolling in coverage (thus driving up premiums for everyone else) and b) to goad people into actually taking action (deadlines do have a clear positive impact on enrollment). With the COVID-19 pandemic having thrown the entire healthcare system into disarray, neither of those seem to be much of a factor this year.

Maryland Connect, August 7th:

Hmmm...on the one hand, this summary of the 2021 ACA individual market rate filings from the Ohio Insurance Dept. would appear to be pretty straightforward:

The sections below include a summary of Ohio’s individual market for 2021.  The data is based on product filings the Ohio Department of Insurance is currently reviewing.

Ohio’s Health Insurance Market 2021

For 2020, the department approved 10 companies to sell on the exchange. Based on the plan information the department approved, most counties had at least three insurers.  29 counties had two insurers, and just one county had only one insurer.

For 2021, the department approved those same 10 companies to sell on the exchange.  Based on those filings, all counties will have at least two insurers and all but 10 counties will have three or more insurers. 

Companies Who Have Filed to Sell in 2021

Exactly one month ago, I posted an analysis of the preliminary 2021 premium rate filings for Georgia's individual and small group market carriers. At the time, the requests from the individual market carriers ranged from a 22.8% reduction to as much as an 18.3% increase.

I've also repeatedly noted that estimates by the carriers of the impact of the COVID-19 pandemic is pretty much all over the place. While a few carriers have indeed baked in significant rate hikes in response to COVID, most either don't mention it at all in their preliminary filings or, if they do, state that they expect the net impact to be negligible. However, they also make sure to hedge their bets by reserving the right to re-file their 2021 requests with adjusted COVID impact.

Overall, as I noted way back in May, the consensus on COVID-19 impact seems to be a big old ¯\_(ツ)_/¯.

via the Oklahoma Insurance Dept:

Oklahoma Consumers to Have More Health Options for 2021 ACA Plans

OKLAHOMA CITY – Insurance Commissioner Glen Mulready announced today the 2021 preliminary rate filings for health insurance plans under the Affordable Care Act (ACA). Insurers that currently offer coverage through the Oklahoma Marketplace filed plans requesting average statewide increases of 2.7 percent.

The same three insurers that offered individual health plans on the 2020 Exchange will return for 2021 — Blue Cross Shield of Oklahoma (BCBSOK) , Bright Health and Medica Insurance Company. In addition, Oscar Health, UnitedHealthCare (UHC) and CommunityCare Oklahoma (CCOK) will join the marketplace in Oklahoma for 2021 allowing consumers to have more choices. BCBSOK and Medica offer statewide plans while Bright Health, CCOK, Oscar and UHC serve limited areas of the state.

Moderate rate increase requests and new insurers looking to offer plans in Oklahoma revealed that the Oklahoma insurance market is stable and able to offer multiple health insurance options for all Oklahomans.

I've written several times about how Republican Senator Cory Gardner of Colorado has repeatedly shown sickening levels of chutzpah and gaslighting when it comes to the Affordable Care Act:

In a pathetic attempt to gaslight Colorado voters, Gardner is now trying to paint himself as supporting healthcare expansion, going so far as to try to claim credit for passage and approval of last year's Section 1332 Reinsurance Waiver program which dramatically reduced premiums for unsubsidized individual market enrollees throughout Colorado...even though a) he didn't have a damned thing to do with it and b) the reinsurance program was only able to be developed thanks to the Affordable Care Act...which Gardner has repeatedly voted to repeal.

The data below comes from the GitHub data repositories of Johns Hopkins University, execpt for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.

This week there are two important changes to the list:

  • First, the Johns Hopkins Github archive has finally started breaking out New York City's data into the five separate boroughs/counties
  • Second, I've finally gone through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.

With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, September 5th (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District

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