An analysis of potential premium changes in states across the nation shows increases of 16 to 30 percent likely in 2019 if federal steps are not taken.
While the Patient Protection and Affordable Care Act’s subsidies would largely insulate subsidized consumers from these costs, millions of unsubsidized consumers would pay the full price of these increases. Many would likely be priced out of coverage.
Continued policy and premium uncertainty risks further carrier withdrawals, leaving more consumers with only one health plan and even the prospect of “bare counties.”
The analysis reviews three federal policy options that could stabilize markets and mitigate the impact of premium increases in many states.
Covered California’s open-enrollment period is still underway and consumers have through Jan. 31 to sign up for coverage.
Covered California just announced their latest 2018 Open Enrollment Period numbers:
220,000 new enrollees as of 12/15 (10% higher than last year)
Extended Jan. start deadline to 12/22 to handle high demand
Final deadline still same as last year (1/31/18)
~1.2 million active or passive renewals
~1.4 million total enrollees (renewals + new enrollments)
Assuming the 1.2 million figure is very close to the exact number, that makes the total number around 1.42 million QHP selections.
This brings CoveredCA within 9% of last year's total, and within 10% of their all-time total set a year earlier.
The official total as of 12/17 last year (with an extra 2 days) was 1,437,150 enrollments, about 1% higher. Given that CoveredCA is keeping to the same January 31st deadline as prior years, I'm pretty sure they'll end up very close to last year's final total when the dust settles.
This just in from the California Insurance Dept...
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More than 48,000 new consumers selected a plan during the first two weeks of open enrollment, which is slightly ahead of last year’s pace.
New subsidized enrollees are using increased tax credit money to purchase coverage that is more comprehensive.
The majority of consumers signing up will be able to pay lower prices in 2018 than they would have for the same plans last year.
SACRAMENTO, Calif. — Covered California issued its first enrollment snapshot for the first two weeks of the current open-enrollment period. From Nov. 1 through Nov. 14, more than 48,000 new consumers signed up for coverage through Covered California, which is slightly ahead of last year’s pace when more than 39,000 consumers selected a plan during the first two weeks of November 2016.
As both the largest-population state in the country and the largest state-based exchange under the ACA, Covered California provides an important guideline for me when it comes to attempting to track national enrollment data. They hold over 12% of the total U.S. population and enrolled 12.7% of all ACA exchange enrollments for 2017, coming in second only to Florida's 14.4%.
Today I confirmed that on Day One of the 2018 Open Enrollment Period, CoveredCA signed up 5,979 people...around 25% more than they did on Nov. 1st last year.
Covered California Keeps Premiums Stable by Adding Cost-Sharing Reduction Surcharge Only to Silver Plans to Limit Consumer Impact
In the absence of a federal commitment to continue funding cost-sharing reduction (CSR) reimbursements through the upcoming year, Covered California health insurance companies will add a surcharge to Silver-tier products in 2018.
However, because the surcharge will only be applied to Silver-tier plans, nearly four out of five consumers will see their premiums stay the same or decrease, since the amount of financial help they receive will also rise. Those who do not get financial help will not have to pay a surcharge.
Financial help means that in 2018, nearly 60 percent of subsidy-eligible enrollees will have access to Silver coverage for less than $100 per month — the same as it was in 2017 — and 74 percent can purchase Bronze coverage for less than $10 per month.
California and individual markets across the nation still need a clear commitment that the federal government will continue to make CSR payments to promote lower premiums, save taxpayer money and ensure health insurance companies participate.
The fact that the Graham-Cassidy bill, like all of the prior Republican "replacement" healthcare bills, screws over people on both Medicaid and the individual market starting in 2020 is hardly news. A few provisions of the ACA are stripped out and/or bastardized immediately (and some, like the individual mandate penalty, are even repealed retroactively), but for the most part the pain doesn't start for another 2 years, well after the midterms are over.
However, JP Massar called something to my attention this morning:
Covered California Releases 2018 Rates: Continued Stability and Competition in the Face of National Uncertainty
Covered California remains stable, with an average weighted rate change of 12.5 percent. The change is lower than last year and includes a one-time increase of 2.8 percent due to the end of the health insurance tax “holiday.”
The competitive market allows consumers to limit the rate change to 3.3 percent if they switch to the lowest-cost plan in the same metal tier.
New Analysis Shows Potentially Significant Health Care Premium Increases and Drops in Coverage If Federal Policies Change
California’s premiums could rise by 28 to 49 percent in 2018, and up to 340,000 consumers could lose individual market coverage if changes are made to existing federal policies.
The potential rate increase would mean billions of dollars in additional federal spending. The 1.2 million consumers who do not receive subsidieswould bear the entire brunt of these increases.
The potential decrease of 340,000 insured consumers would not only represent many individuals losing access to potentially life-saving care, but it would result in a sicker risk mix in the individual market and higher premiums for everyone.
SACRAMENTO, Calif. — A new analysis shows the dramatic consequences facing Californians if federal policies are changed from the current structure and there is no longer direct federal funding of cost-sharing reduction (CSR) reimbursements and the individual shared responsibility payment is not enforced when a consumer chooses not to purchase coverage.
The analysis found that Covered California health plan premiums could rise up to 49 percent if two key elements that have been in place for the past four years are changed: Cost-sharing reduction reimbursements are no longer directly funded as reimbursements to carriers, and the shared individual responsibility payment is not enforced.
I noted a week or so ago that according to David Anderson of Balloon Juice, rumor has it that many insurance carriers are making their actuaries work overtime to put together multiple rate filings for 2018 based on several different outlooks:
Trump/Price/GOP quit screwing around, officially fund CSR reimbursements, enforce the mandate penalty and generally implement the ACA in good faith.
Trump/Price/GOP cut off CSR funding but otherwise enforce the law somewhat reasonably
Trump/Price/GOP cut off CSR, don't enforce the mandate, keep mucking around with half-assed repeal/replacement bills
If you can't hear it, here's the transcript of California Democratic U.S. Senator Diane Feinstein's response when asked how (not if, mind you...how) she would support moving to a Single Payer healthcare system:
She starts out by making an incredibly tone-deaf and inaccurate statement about single payer:
"If by ‘single payer’ you mean that it’s going to be a complete takeover by the government, of healthcare, then I am not there.
IMPORTANT: This is my county-level estimate for California. The congressional district breakout will be following soon.
Update 2/17/17: (SEE BELOW: CONGRESSIONAL DISTRICT BREAKOUT ADDED!!)
Regular readers know that I started out the "How Many Could Lose Coverage..." project at the state level, then moved into analyzing the county-level data, before finally tackling the hardest challenge: Breaking them out by Congressional District.
The state level table includes all 50 states (+DC), while I managed to break out the county level data for 34 states so far before moving into the Congressional District analysis by popular demand. There, I've managed to crunch the numbers for 43 states so far.
Covered California Finishes Fourth Open Enrollment With More Than 412,000 New Consumers and Strong Participation From Young Enrollees
New plan selections met enrollment projections for the fourth open-enrollment period.
Nearly 50,000 consumers signed up for health care coverage in the final two days before the Jan. 31 deadline.
Strong finish and overall enrollment are credited to effective work by Certified Insurance Agents and enrollers and robust television, digital, print and outdoor advertising that ran throughout the open-enrollment period.
The crucial demographic of young adults ages 18–34 accounted for 37 percent of enrollment, contributing to a healthy risk mix for 2017.
SACRAMENTO, Calif. — Covered California announced Monday that it finished the open-enrollment period with 412,105 new consumers signing up for health coverage.