UPDATED 6/22/18: Added Indiana and Iowa to the table.
UPDATED 6/25/18: Added Florida, Kentucky, Ohio and Texas* to the table *(Texas only has about 1/3 of the total ACA individual market accounted for, so it could easily change) UPDATED 7/3/18: Added Montana and Georgia to the table UPDATED 7/13/18: Added Tennessee, updated Texas to add BCBSTX UPDATED 7/16/18: Added Colorado UPDATED 7/17/18: Added Nevada UPDATED 7/19/18: Added California UPDATED 7/20/18: Added Connecticut
Well this is a nice surprise! Yesterday the Minnesota ACA exchange, MNsure, issued a press release a day ahead of the public posting of requested 2019 individual market insurance rate changes, advising people of the various ways they have to keep their premiums down via ACA tax credits, shopping around and so forth. I was immediately concerned that they might know something I didn't...perhaps they were expecting a batch of double-digit rate hikes as has happened in so many other states the past few years?
NOTE: I originally missed two carriers (McLaren and Molina); thanks to Louise Norris for calling attention to my error. The entire post, along with the table, has been updated to reflect the updated numbers including all 11 carriers.
Also note that while the headline originally reflected what the average rate change would be without the CSR load sabotage factor introduced in 2017, I've decided to be consistent with other states and only include 2018 sabotage impact.
My home state of Michigan just posted their preliminary requested rate changes for the 2019 Open Enrollment Period, and unlike most of the other states which have released their early requests so far, Michigan is a pleasant surprise: An overall average requested premium increase of just 1.7%!
Also noteworthy: According to the filings, eight of the carriers are specifically projecting exactly a 5% mandate repeal factor, which is remarkably consistent (usually the projections are all over the place). HAP is slightly lower (4.4%) while Molina is higher (7.2%). Priority Health didn't mention this at all, but it's safe to assume it'd be roughly 5% for them as well.
Private insurance companies set premium prices, and the Minnesota Department of Commerce regulates those companies. Final, approved 2019 premium rates will be available by October 2, and the 2019 open enrollment period begins on November 1. Minnesotans shopping for health insurance through the individual market may be able to reduce premium costs in three ways:
1. See if you are eligible for tax credits only available through MNsure
The simplest explanation of how Risk Corridors worked is this:
The ACA made dramatic changes to how the individual insurance policy market worked.
Since it was so disruptive, it included several provisions to help stabilize the market.
One of these programs, called "Risk Corridors", was a temporary (3 year) program which acted as sort of an insurance policy for insurance carriers.
In a nutshell: Carriers which earned excessive profits on ACA policies had to place a chunk of those profits into a pool of money. Carriers which took excessive losses on ACA policies were supposed to be reimbursed for a chunk of those losses.
If the profits exceeded the losses, the government got to keep the difference, so it was theoretically possible they'd actually profit off the system.
If, however, the losses exceeded the profits, the government was supposed to pay out the difference.
(As an aside: For those claiming "government bailout! picking winners and losers!" etc etc, the ACA's risk corridor program is actually very similar in many ways to the permanent Medicare Part D risk corridor program, although there are some key differences between the two).
Scott started what was first Columbia in 1987, purchasing two El Paso, Texas, hospitals. Over the next decade he would add hundreds of hospitals, surgery centers and home health locations. In 1994, Scott’s Columbia purchased Tennessee-headquartered HCA and its 100 hospitals, and merged the companies.
Rate filings were due in New Mexico by June 10, 2018, for insurers that wish to offer individual market plans in 2019. Insurers that offer on-exchange coverage have been instructed by the New Mexico Office of the Superintendent of Insurance (NMOSI) to add the cost of cost-sharing reductions (CSR) only to on-exchange silver plans and the identical versions of those plans offered off-exchange (different silver plans offered only off-exchange will not have the cost of CSR added to their premiums).
AHIP Issues Statement Regarding TX v. United States of America
WASHINGTON, D.C. – America’s Health Insurance Plans (AHIP) issued the following statement regarding the latest developments in TX v. United States of America:
“Millions of Americans rely on the individual market for their coverage and care, and they deserve affordable choices that deliver the value they expect. Initial filings for 2019 plans have shown that, while rates are higher due to the zeroing out of the individual mandate penalty, the market is more steady for most consumers than in previous years, with insurance providers stepping in to serve more consumers in more states.
For those of you just coming to the case, this is from my earlier recap:
In their complaint, the states [including Texas and other red states] point out (rightly) that the Supreme Court upheld the ACA in NFIB v. Sebelius only because the individual mandate was a tax and (rightly) that Congress has now repealed the penalty for going without insurance. As the states see it, the freestanding requirement to get insurance, which is still on the books, is therefore unconstitutional. Because it’s unconstitutional, the courts must invalidate the entire ACA—lock, stock, and barrel.
Welp. The idiotic #TexasFoldEm lawsuit against the ACA...or more specifically, the Trump Administration's decision to lay down and even join the lawsuit against it--appears to be doing even more damage to the U.S. Justice Department than I had thought:
A highly respected career lawyer at the Justice Department has decided to resign just days after the Trump administration backed a controversial lawsuit that would wreck part of the Affordable Care Act.
About 90% of my focus here at ACASignups.net is on the two biggest sections of the ACA: The Individual Market (3-legged stool, exchanges, subsidies, etc.) and Medicaid expansion. I tend not to write much about Medicare, "traditional" Medicaid or the Employer-Sponsored Insurance (ESI) market, which mainly consists of the Large Group Market (companies with 50 employees or more) and the Small Group Market (companies with fewer than 50 employees). As it happens, the ESI market covers nearly half the U.S. population (roughly 155 million Americans, give or take).
Under the ACA, individual market policies have to include the following "Blue Leg" provisions to be considered ACA-compliant:
By far, the most popular provisions of the Affordable Care Act is that it mandates Guaranteed Issue (GI) and Community Rating (CR) rules to all major medical healthcare insurance policies in most of the United States (all 50 states, plus DC...most ACA provsions don't apply in Puerto Rico, Guam and other U.S. Territories). These provisions state, quite simply, that insurance carriers can no longer discriminate against enrollees based on their physical or mental health status or history, their gender and so on, and can therefore no longer use medical underwriting to either cherry-pick who their enrollees are or how much they're charged in premiums for a given policy.
It's time once again to talk about stools. Not step stools, but the Three-Legged Stool.
I posted this video explainer about the Affordable Care Act's "Three-Legged Stool" works last winter. The first 9 minutes or so covers why it exists, how it's supposed to work, how well it's actually working, the most obvious problems with it and the basics of how to fix them. The second half goes into the details of the half-dozen different awful repeal/replace bills that Congressional Republicans tried to push through throughout 2017.
Below is a condensed transcript version of the first half of the slideshow.
First of all, who is in the Individual Market? Well, what you're looking at right now is something a friend of mine dubbed The Psychedelic Donut. It's actually a depiction of the healthcare coverage, by type, of the entire U.S. Population...all 320 million or so of us.
One of the big stories over the past few months has been the Trump Administration's attempts to strip away regulations on non-ACA compliant "Short-Term, Limited Duration" plans (by making them neither short-term nor of limited duration) and "Association Health Plans" (by recategorizing them from state-regulated, Small Group plans to mostly unregulated Large Group plans).