Florida

Back in late August, the Florida Office of Insurance Regulation posted preliminary 2021 individual & small group market rate filings. At the time, the weighted average increases were around 1.8% on the individual market and 3.3% for small group plans. Unfortunately, the actual enrollment data for each carrier is protected as a trade secret in Florida, but the FLOIR did post those weighted statewide averages.

Last month (I'm a bit behind) they posted the approved, final rate filings. The average individual market increases actually went up a bit, which is unusual (usually they're whittled down a few points), while the small group market average is exactly the same (oddly, they had it as 3.3% in August but say that the preliminary average was 3.4% now):

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

That was late July.

Let's take a look at mid-October, 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:

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:

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:

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

Two weeks ago, 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:

The graph below is a linear depiction of how COVID-19 has spread across the state of Florida every day since March 20th.

As you can see, the thick orange line shows the ramping up of testing, the thick blue line is the increase in cases and the thick red line is the (official) rate of fatalities. In order to fit all three measurements on the same graph in a presentable way, the scale is different for each: Tests are per 100 residents; cases are per thousand, and deaths are per ten thousand.

The thinner lines are for Orange County, Florida specifically...and there's a reason for that which I'll explain below.

Louisiana's 2020 Presidential primary was scheduled for April 4th, but the other day Democratic Governor John Bel Edwards and Republican Secretary of State Kyle Ardoin agreed to reschedule it for June 20th...which is actually later than the last previously-scheduled primary in the U.S. Virgin Islands on June 6th:

The presidential primary elections in Louisiana slated for April will be delayed by two months, the latest in a series of dramatic steps government leaders have taken to slow the spread of the new coronavirus.

Secretary of State Kyle Ardoin, Republican, and Gov. John Bel Edwards, a Democrat, both said Friday they would use a provision of state law that allows them to move any election in an emergency situation to delay the primary.

The presidential primary elections, initially scheduled for April 4th, will now be held June 20th. Ardoin said in a press conference he does not know of any other states that have moved elections because of the new coronavirus, or COVID-19.

This just in from the Florida Insurance Dept:

TO ALL HEALTH INSURERS AND HEALTH MAINTENANCE ORGANIZATIONS AUTHORIZED TO DO BUSINESS IN FLORIDA

~ INSURANCE COVERAGE FOR CORONAVIRUS (COVID-19) ~

In response to the Executive Order #2020-51 issued by Governor Ron DeSantis establishing COVID-19 response protocols and directing a public health emergency in Florida, the Florida Office of Insurance Regulation (OIR) is issuing this Informational Memorandum to all health insurers authorized to do business in Florida to help facilitate the state’s ongoing efforts to protect Floridians.

Heightened Communication and Customer Service

via Becker's Hospital Review:

Cigna extended its individual healthcare exchange products for the 2020 plan year, the insurer said Sept. 18.

For 2020, individuals can purchase individual health plans in 19 markets across 10 states. The expansions will take place in counties in Kansas, South Florida, Utah, Tennessee and Virginia. The other states include Arizona, Colorado, Illinois and North Carolina.

The plans will be available for purchase on the individual marketplace during the 2020 open enrollment period, which begins Nov. 1. Plans will take effect Jan. 1.

via Bruce Japsen of Forbes:

A few weeks ago, I posted a lengthy, in-the-weeds explainer about how the ACA's Medical Loss Ratio (MLR) provision works. The short version is that ever since the ACA went into effect in 2011 (3 years before newly-sold policies had to be ACA compliant), to help reduce price gouging, insurance carriers have been required to spend a minimum of 80% of their premium revenue (85% for the large group market) on actual medical claims.

Put another way, their gross margins are limited to no more than 20% (or 15% in the large group market). Remember, that's their gross margin, not net; all operational expenses must come out of that 20% (15%). The idea is that they should be spending as much of your premium dollars as possible on actual healthcare, as opposed to junkets to Tahiti or marble staircases in the corporate offices, etc. Anything over that 20% (15%) gross margin has to be rebated to the policyholder.

A few weeks ago I posted the preliminary 2020 ACA-compliant premium changes for Florida's Individual and Small Group markets. At the time, the requested rate hikes were only available for about 4 of the 10 carriers participating in the Individual Market, and just 10 of the 14 carriers on FL's Small Group market. However, the Florida Office of Insurance Regulation did provide the weighted average request: A 1.2% increase for the Indy Market and 6.4% for Small Group plans.

Today, FLOIR has released the approved rates for each, including the actual average changes for each carrier...and once again, they've whittled the rate changes down further yet on Indy plans (although they actually bumped them up a point on the Small Group market). From the press release:

OIR Announces 2020 PPACA Individual Market Health Insurance Plan Rates

I've now analyzed the preliminary average (weighted or, in a few unfortunate cases, unweighted) premium change requests for over 3 dozen states. Of the dozen or so left, the largest states unanalyzed are Georgia, Texas...and Florida.

Florida may be the third largest state, but it has the largest ACA Individual health insurance market. 18% more Floridians enrolled in ACA exchange policies this year than California, in spite of FL's total population being only 54% as large.

Two years ago I noted that for whatever reasons (demographics? state economy?), Florida's Individual market is twice as large as the rest of the country on a per capita basis. Today I found out that FL's indy market is actually larger than their large group market:

The bill started out on the right track...

Florida lawmakers approved a health insurance bill Wednesday that would require insurers keep covering pre-existing conditions if the Affordable Care Act disappears, though the bill would not keep protections in the federal law to control how much those patients can be charged.

...but quickly went off the rails after that:

The bill, Senate Bill 322, which the House approved by a 70-42 vote after the Senate passed it last week, would also expand short-term and association health plans and change requirements for “essential health benefits” covered by insurers, regardless of the status of the Affordable Care Act. It must be approved again by the Senate before it heads to Gov. Ron DeSantis for his signature.

"Medicaid Work Requirements" have been in the news a lot over the past two years as the Trump Administration has given states the go-ahead to start imposing increasingly draconian, humiliating and ineffective work requirements for low-income people to avoid losing healthcare coverage.

For the most part, though, the work requirement bills have at the very least been restricted to ACA expansion of the Medicaid program to "able-bodied" adults earning up to 138% of the Federal Poverty Line (roughly $17,000/year for a single adult or $23,300 for a couple without minor children).

Today, Joan Alker of the Georgetown University Health Policy Institute Center for Children & Famlies reports that the Florida House of Representatives is planning on taking the cruelty even further:

URGENT: On Thursday, the Florida House will take up the harshest Medicaid work reporting requirement bill that I’ve EVER seen. As many as 100,000, mostly mothers, could lose their health insurance. https://t.co/64uRz23Puk

The 2019 ACA Open Enrollment Period has finally officially ended nationally. HOWEVER...

  • GEORGIA residents in 69 counties (around 1.37 million people) who were impacted by last fall's hurricanes have until February 20th to enroll by calling HC.gov directly at 800-318-2596.
    • Counties Eligible: Appling, Atkinson, Bacon, Baker, Ben Hill, Berrien, Bleckley, Brooks, Bulloch, Burke, Calhoun, Candler, Chattahoochee, Clay, Coffee, Colquitt, Cook, Crawford, Crisp, Decatur, Dodge, Dooly, Dougherty, Early, Echols, Emanuel, Evans, Glascock, Grady, Hancock, Houston, Irwin, Jeff Davis, Jefferson, Jenkins, Johnson, Jones, Laurens, Lee, Macon, Marion, Miller, Mitchell, Montgomery, Peach, Pulaski, Putnam, Quitman, Randolph, Schley, Screven, Seminole, Stewart, Sumter, Tattnall, Telfair, Terrell, Thomas, Tift, Tooms, Treutlen, Turner, Twiggs, Washington, Webster, Wheeler, Wilcox, Wilkinson, Worth

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