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2017 Rate Changes

Mississippi remains one of only two states which still don't have their 2017 Rate Filings posted over at HC.gov's Rate Review database. In addition, while Mississippi does use the SERFF system for other types of insurance, major medical doesn't appear to be among them. Finally, while the MS Dept. of Insurance does include a special website specifically designed for searching/comparing rate changes for health insurance policies...it doesn't appear to have been updated in awhile (the only recently listings are for obscure carriers which seem to be mostly offering short-term plans and other "mini-med" types of policies, not full ACA-compliant plans.

The point is that I don't have the actual rate filings to go on for now...but thanks to commenter farmbellpsu for bringing my attention to this (corrected) news article which escaped my radar last week:

Massachusetts' total individual market was only around 72,000 people in 2014, but their ACA exchange had disastrous technical problems during the first ACA open enrollment period, causing tens of thousands of Baystaters to enter a sort of "limbo" status healthcare coverage-wise (the first version of the exchange couldn't properly confirm which enrollees qualified for APTC assistance, so only those paying full price were actually enrolled in exchange QHPs; those claiming APTC status were temporarily transferred over to state-based coverage until it could be sorted out, which took nearly a year in most cases). Fortunately, in 2015, the state got their act together and enrolled nearly 214,000 people in exchange-based policies this year.

New Hampshire has only 5 carriers offering individual market policies, all 5 of which will still be participating in the NH market next year as well. Two of the five (Community Health Options and Minuteman Health) are among the 7 surviving ACA-created Co-Ops.

Even so, NH is proving to be a very tricky state to estimate, because only one of the 5 carrier rate filings includes their actual current rate-impacted enrollment data. As a result, I've had to take my best shot at estimating the market share of the other four. The only way I could think of to do this was to look up the latest NH DOI 2016 QHP Monthly Membership Report. New Hampshire, to their credit, is one of the only states without their own state-based ACA exchange which still actually posts regular reports about how many residents are enrolled in ACA exchange policies. Furthermore, they even break these numbers out by metal level and carrier, making the relative market share easy to calculate.

North Dakota's total individual market was 49,000 people in 2014. Assuming a 25% increase since then, it should be roughly 61,000 today, some portion of which is composed of transitional/grandfathered enrollees. I'm going to assume (based on hard numbers from a few other states) that GF/TR enrollees make up perhaps 10% of the total, or 6,100. They enrolled 21,604 people in exchange plans this year, of whom 20,536 were still enrolled as of the end of March. Last year, Blue Cross Blue Shield of ND held roughly 29,000 enrollees total, with Medica making up another 4,800 or so.

All of the above numbers are important when attempting to estimate the weighted average rate hikes requested by ND carriers, because of the 3 operating on the individual market (BCBS, Medica and Sanford), only one of them, Medica, has provided their actual 2016 enrollment tally (7,329).

Just as I'm wrapping up calculating the weighted average rate hikes requested in all 50 states, New York just became the second state (after Oregon) to release their approved rates:

Shout-out to Zachery Tracer for the heads up for this press release from the New York Dept. of Financial Services:

DEPARTMENT OF FINANCIAL SERVICES ANNOUNCES 2017 HEALTH INSURANCE RATES

As of 2014, South Carolina's total individual market was roughly 201,000 people, including grandfathered & transitional enrollees. 205,000 people were enrolled in exchange policies as of the end of March 2016; when you add off-exchange enrollees, it's likely closer to 250K, of which I'd imagine 225K or so are ACA-compliant. The enrollment numbers below therefore should reflect roughly 70% of the ACA-compliant market.

To calculate the Blue Cross Blue Shield average percentage, I had to do a bit of guesswork as to the proportion of their 116,000 enrollees between the 3 different types of plans (BlueEssentials, Multistate and Catastrophic). BlueEssentials is the highest of the three (14.74%), but also likely holds the vast majority (I'd guess 95% or more); usually very few people select Catastrophic plans, and I don't think many go for Multistate either. Therefore, I'm eyeballing the overall average at around 14.4%.

Last month I noted that while South Dakota hadn't posted their ACA-compliant 2017 rate filings yet, they had posted their grandfathered/transitional filings, and decided to take a look at those. While GF/TR plans are down to a pretty nominal number in most states (and about half the states don't have any transitionals at all at this point), SD still has a huge portion of their individual market enrolled in them (over 1/3, from what I can tell).

Only 4 carriers appear to be participating in the ACA-compliant individual market in South Dakota next year: Aetna, Sanfrod, SD State Medical and Welmark. I only have the enrollment numbers for 3 of the 4, but the requested rate hike for the fourth one (Sanford) is pretty close to the average of the other three anyway, so it shouldn't really impact the overall average by much:

As I noted Monday morning, I believe that August 1st was the deadline for every state to submit their 2017 rate filings, meaning that the 14 states missing from my Requested Rate Hike Project are finally available to be plugged into the spreadsheet. I'll also be going back through the other states I've been tracking since as early as April to see which ones require updates due to carriers dropping out, joining in or resubmitting their rate requests.

Wisconsin's total individual market was around 260,000 people in 2014 and is likely up to around 300,000 today (not including grandfathered/transitional enrollees), with about 224,000 enrolled on ACA exchange policies as of March 2016, plus an unknown number off-exchange. That means that the table below is likely missing around 1/3 of the total ACA-compliant market.

As I noted Monday morning, I believe that August 1st was the deadline for every state to submit their 2017 rate filings, meaning that the 14 states missing from my Requested Rate Hike Project are finally available to be plugged into the spreadsheet. I'll also be going back through the other states I've been tracking since as early as April to see which ones require updates due to carriers dropping out, joining in or resubmitting their rate requests.

As I noted Monday morning, I believe that August 1st was the deadline for every state to submit their 2017 rate filings, meaning that the 14 states missing from my Requested Rate Hike Project are finally available to be plugged into the spreadsheet. I'll also be going back through the other states I've been tracking since as early as April to see which ones require updates due to carriers dropping out, joining in or resubmitting their rate requests.

As I noted Monday morning, I believe that August 1st was the deadline for every state to submit their 2017 rate filings, meaning that the 14 states missing from my Requested Rate Hike Project are finally available to be plugged into the spreadsheet. I'll also be going back through the other states I've been tracking since as early as April to see which ones require updates due to carriers dropping out, joining in or resubmitting their rate requests.

There are only two insurance carriers participating in Hawaii's individual market next year: The Hawaii Medical Service Association (HMSA) and the Kaiser Foundation Health Plan.

As I noted Monday, I believe August 1st was the deadline for every state to submit their 2017 rate filings, meaning that the 14 states missing from my Requested Rate Hike Project are finally available to be plugged into the spreadsheet. I'll also be going back through the other states I've been tracking since as early as April to see which ones require updates due to carriers dropping out, joining in or resubmitting their rate requests.

In 2014, New Jersey's total individual market was estimated at around 261,000 people, including off-exchange, grandfathered and transitional enrollees. Assuming 25% growth, this should be around 325,000 today.

As I noted Monday, I believe August 1st was the deadline for every state to submit their 2017 rate filings, meaning that the 14 states missing from my Requested Rate Hike Project are finally available to be plugged into the spreadsheet. I'll also be going back through the other states I've been tracking since as early as April to see which ones require updates due to carriers dropping out, joining in or resubmitting their rate requests.

The most recent ACA/healthcare news out of Illinois was the ugly announcement that Land of Lincoln Health is the latest ACA-created Co-Op to go belly-up, leaving 49,000 people (39,000 on individual plans and 10,000 in the small group market) having to scramble to find new coverage in the middle of the year. This was on top of recent news that UnitedHealthcare is pulling out of dozens of states including Illinois (Humana is also dropping out of a bunch of states, but I don't think Illinois is among them).

Well, nature (and the market) abhors a vacuum, so guess what?

One of the nation's largest health insurance companies plans to enter the Obamacare marketplace in the Chicago area for the first time, bringing new competition as other insurers exit or go out of business.

(Originally Posted 6/09/16)

Every year, Republicans insist that the ACA is guaranteed to cause a rate hike "death spiral" as increasing premiums cause healthier people to drop out of the individual exchange market, causing higher medical expenses, causing even higher premiums, causing more healthy people to drop out and so forth...and every year, for three years in a row so far, this has failed to be the case nationally. While premiums have obviously continued to increase for many people, the individual insurance market has grown each year, from around 11 million in 2013 to 15.6 million in 2014, around 17 million last year and up to 19-20 million or so today.

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