Way back in April (a lifetime ago, I realize), I noted that my prediction from over a year ago regarding the massive Medical Loss Ratio rebates which would likely be paid out this year to 2019 individual market enrollees was dead on target:

If you use Anderson's 7% and assume the final, national weighted average for 2020 comes in at around 0.5%, that means roughly 6.5% of that $93.2 billion could end up having to be rebated to enrollees....or potentially 1/3 of up to $6 billion.

The three-year rolling average means that the actual amount paid out would be 1/3 of that...perhaps $2 billion in September 2020.

Back in March & April, I wrote a lot about COVID-19 Special Enrollment Periods...and especially about the fact that the largest ACA exchange of all, HealthCare.Gov, kept refusing to do so in spite of massive pressure from governors, members of Congress and nearly every advocacy group under the sun, as well as the U.S. Chamber of Commerce and even the health insurance industry itself...which is especially remarkable given that it was BCBSA & AHIP who insisted on cracking down on Special Enrollment Periods in the first place a few years earlier.

On March 31st, I posted the following:

As I just noted with my Arizona post, the federal Rate Review database website heavily redacts the rate filing forms submitted by insurance carriers, making it impossible to run a weighted average even when all of the individual and small group market carrier rate change requests are readily available.

Fortunately, in the case of Florida, the Office of Insurance Regulation has at least provided the weighted average for me in each market, even though they still hide the actual enrollment numbers for each carrier:

The good news is that the federal Rate Review database has now posted the preliminary avg. 2021 rate filings for the individual and small group markets for every state. This makes it very easy to plug in the average requested rate changes in 2021 for every carrier participating in both markets.

The bad news is that most of the underlying filing forms are heavily redacted, meaning I can't use the RR database to acquire the other critical data I need in order to run a proper weighted average: The number of people actually enrolled in the policies for each carrier.

This means that in cases where this data isn't available elsewhere (either the state's insurance department website, the SERFF database or otherwise), I'm limited to running an unweighted average. This can make a huge difference...if one carrier is requesting a 10% increase and the other is keeping prices flat, that's a 5.0% unweighted average rate hike...but if the first carrier has 99,000 enrollees and the second only has 1,000, that means the weighted average is actually 9.9%.

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.

Here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, August 29th (click image for high-res version):

via the New Hampshire Insurance Dept:

Large Decreases in 2021 Premium Rates Expected in Individual Market

CONCORD, NH – The federal government has published information on proposed rates for New Hampshire’s health insurance exchange (https://ratereview.healthcare.gov/) in 2021.

The New Hampshire Insurance Department is reviewing 2021 forms and rates for individual health plans. For 2020, the second lowest cost silver plan was $404.60. The 2021 second lowest cost silver plan proposed premium rate is $318.95. This represents a 21.2% decrease.

It's important to note that the 21.2% decrease only refers to the difference between the 2020 benchmark and the 2021 benchmark plans. They aren't necessarily from the same carrier, and even if they are, that's not the same as the weighted average rate changes for all policies at all metal levels from all carriers.

Back in late June, I noted that the Maine Insurance Dept. had issued the preliminary 2021 rate filings for the state's individual and small group market carriers. At the time, the individual market carriers were averaging rate reductions of around 4% while the small group carriers were looking to raise premiums by around 6.2%.

It was recently brought to my attention that revised rate filings have been submitted by Maine carriers for 2021...and while these still aren't the final/approved rates, they're significantly lower than the original filings.

Two of the three indy market carriers (Anthem and Harvard Pilgrim) have reduced their rates dramatically. The third (CHO) only reduced theirs by a couple of points, but the net result is that they're now averaging a 13% reduction...9 points lower than the 4 points they were already being knocked down.

The small group market carriers didnt' change their requests by as much, but they're still lower: A 4.4% average increase instead of 6.2%.

Virginia is usually the first state to publicly post their preliminary annual individual/small group market health insurance premium rate filings; historically they've published them as early as mid-April. This year, however, due primarily to the COVID-19 pandemic, I presume, they didn't actually post them until mid-August.

The average premium changes for 2021 on the individual market range from a 13% drop to a 7.7% increase, with the statewide weighted average coming in at around a 7.2% reduction. For the small group market, premiums are increasing by around 3.6% on average, ranging from a 2.4% drop to a 10.9% increase.

Two other noteworthy items: First, Optimum Choice is expanding into VA's individual market (this isn't the same as Optima Health); secondly, VA's indy market has dropped from over 300,000 last year to around 256,000 this year, presumably due to the lingering effects of Medicaid expansion enrollees shifting over from subsidized private plans.

Nolan Finley is the conservative editorial page editor of The Detroit News.

On July 29th, he tweeted this out in response to criticism of the COVID-19 policy recommendations by himself and Michigan Republican legislative leadership:

Florida 20 million population, 6100 deaths. Michigan 10 million population, 6400 deaths. https://t.co/O1tNoyWwB0

— Nolan Finley (@NolanFinleyDN) July 29, 2020

Let's take a look at the data, shall we? Here's a graph of official COVID-19 positive test cases and fatalities per capita for both Michigan and Florida. Cases are per 1,000 residents; deaths are per 10,000 in order to make the trendlines more visible:

this just in via Covered California:

Covered California Opens New Paths to Coverage for Wildfire Victims and Those Who Lose Their Job or Income During the Pandemic and Recession

  • Covered California establishes a new special-enrollment period to benefit victims of the 500+ wildfires raging across the state.
  • In addition, Covered California announced new paths to coverage that will run through the end of 2020, for Californians who have lost employment or income due to the pandemic and resulting recession.
  • The moves come during ongoing uncertainty in the lives of Californians caused by the wildfires and the continuing fight against COVID-19.
  • More than 271,000 people have signed up for coverage through Covered California since the exchange’s initial announcement of a special-enrollment period in response to the pandemic.
  • La versión en español de este Comunicado puede ser descargada en este enlace.

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.

Here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, August 22nd (click image for high-res version):

The Delaware Insurance Dept. has posted the preliminary 2021 rate filings for the individual and small group health insurance markets.

The Indy market is about as simple as it gets since there's only a single carrier offering ACA policies either on- or off-exchange (Highmark BCBS). They're actually cutting premiums on average slightly next year, by half a percent. They state in their summary that "Covid19 is expected to increase claim costs in 2021"...but that's all they have to say about it. The full actuarial memo includes an extensive section about the COVID-19 impact factor...but the numbers/percentages are all redacted:

The Idaho Insurance Dept. has posted the preliminary rate filings for the 2021 Individual and Small Group markets:

The Department of Insurance receives preliminary health plan information for the following year from insurance carriers by June 1 and reviews the proposed plan documents and rates for compliance with Idaho and federal regulations. The Department of Insurance does not have the authority to set or establish insurance rates, but it does have the authority to deem rate increases submitted by insurance companies as reasonable or unreasonable. After the review and negotiation process, the carriers submit their final rate increase information. The public is invited to provide comments on the rate changes. Please send any comments to Idaho Department of Insurance.

Back in April, in the midst of the earlier stages of the COVID-19 pandemic sweeping through much of the nation, there was a loud outcry for the various ACA health insurance exchanges, including the federal exchange at HealthCare.Gov which hosts enrollment for over 3 dozen states, to re-open enrollment to anyone who missed the official Open Enrollment Period which had ended several months earlier.

Eventually, twelve of the thirteen state-based exchanges did just that, launching COVID-19-specific Special Enrollment Periods of varying time periods for any resident who would normally be eligible to enroll during Open Enrollment to do so. Many of those SBEs would go on to extend the deadlines of their SEPs by a month...or two months...or even more. As of this writing, in fact, California, Maryland, New York and the District of Columbia are are still offering "open" COVID-19 SEPs.

Way back in May (a lifetime ago), Vermont was among the first states to publicly post their preliminary 2021 rate filings for their combined individual & small group market. At the time, the carriers were requesting an average 6.8% rate increase, and noted that they had no clue how much to tack on to cover themselves for the COVID-19 factor...or to even reduce rates because of it.

This week, the Vermont insurance regulatory board issued their final decisions about both BCBS of Vermont and MVP Health Plan, and cut down on each of their requested increases by several points (h/t Louise Norris for the links):

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