Over the past few months, my Congressional District Breakdown tables estimating how many people would likely lose healthcare coverage if the ACA were to be "cleanly" repealed (with no replacement) have gotten a lot of attention. This was followed by the Center for American Progress (CAP) running their own estimates of how many would likely lose coverage if, instead of a "clean" repeal of the ACA as a whole, the ACA were to be partially left in place, with the GOP's AHCA (Trumpcare) bill, which dramatically changes the ACA, being signed into law instead.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
My standard methodology applies:
Plug in the 2/01/16 QHP selections by county (hard numbers via CMS)
Project QHP selections as of 1/31/17 based on statewide signup estimates
Knock 10% off those numbers to account for those who never end up paying their premiums
Multiply the projected effectuated enrollees as of March by the percent expected to receive APTC subsidies
Then knock another 10% off of that number to account for those only receiving nominal subsidies
Whatever's left after that are the number of people in each county who wouldn't be able to afford their policy without tax credits.
In the case of Georgia, assuming 567,000 people enroll in exchange policies by the end of January, I estimate around 396,000 of them would be forced off of their policy upon an immediate-effect full ACA repeal.
UnitedHealth Group Inc., the biggest U.S. health insurer, is scaling back its experiment in Obamacare markets as its Harken Health Insurance Co. startup withdraws from the two exchanges where it was selling plans.
Harken will not offer individual plans through Obamacare exchanges in Georgia and Chicago in 2017, the company said Thursday in an e-mailed statement. It will continue to offer individual plans off the exchange, Harken said.
About a month ago, when I first plugged in the average requested 2017 rate hikes for Georgia's ACA-compliant independent market, I came up with an overall weighted average of around 27.7%. However, there was one major gap in the data: I had trouble finding Ambetter/Peach State's enrollment numbers or even their average rate hike request, so I reluctantly left them out of the calculation completely.
When Aetna announced that they were dropping out of the Georgia exchange-based independent market, I went back and removed them from the mix. Since Aetna's request had been 15.5% on a substantial share of the market, this meant that the rest of the statewide average shot up to 32.0%.
Today I was able to track down the missing Ambetter/Peach State data--both the average requested rate hike (around 8.0%) as well as the number of current enrollees impacted...around 73,000:
IMPORTANT: This is really just a placeholder for Georgia's 2017 average rate hike requests, because it's extremely spotty and partial so far. I'll update it once I'm able to actually track down the bulk of Georgia's individual market enrollment and rate hike request numbers.
UPDATE 7/25/16: I've managed to acquire the additional filings; see update below
UnitedHealth Group will stop offering plans on Arkansas' health insurance exchange next year, a spokesman for the Arkansas Insurance Department said Thursday.
The Minnetonka, Minn.-based insurer offered plans this year for the first time, but it didn't submit plans to the department for 2017, department spokesman Ryan James said.
The deadline for insurers to submit such plans was April 1, he said.
This is hardly unexpected news for a couple of reasons. First, UHC made huge waves last November by making a big, dramatic announcement that they might very well drop out of the ACA exchanges altogether next year after taking large losses on exchange enrollees in 2015. As you may recall, this was a very oddly-timed announcement given that they had issued a glowing quarterly report just a month earlier which made it sound like everything was hunky-dory.
When I ran the numbers for Georgia's individual market in August, I didn't have a whole lot to work with. The requested rate changes were only publicly available for carriers representing around 222,000 enrollees, out of a state-wide individual market of (likely) around 750,000. The weighted average increase for the companies I had data for was around 18.3%; all I knew about the rest of them is that they had asked for hikes of under 10%. My best ballpark estimate was that Georgia residents were likely looking at roughly a 10-13% increase overall.
Today I ran across an article in the Rome News-Tribune which gives some of the final, approved rate hike numbers for 2016...but just bits and pieces, nothing to hang your hat on:
Many Georgians buying individual or family health insurance will see double-digit increases in their premiums for 2016.
IMPORTANT:See this detailed explanation of how I've come up with the following estimated maximum requested weighted average rate increases for this state.
As explained in the first link above, I've still been able to piece together rough estimates of the maximum possible and mid-range requested average rate increase for the Georgia individual market:
Again, the full explanation is included here, but to the best of my knowledge, it looks like the companies with rate increases higher than 10% come in at a weighted 18.3% increase, but only make up about 29% of the total ACA-compliant individual market, with several other companies with requested increases of less than 10% (decreases in some cases) making up the other 71%.
There are two threads of conventional wisdom heading into Tuesday's midterm election. The first is that the election doesn't much matter. Regardless which party controls the Senate, President Barack Obama will still occupy the White House, which means gridlock will remain, if not escalate. The second is that, when it comes to Obamacare, the status quo will remain in place for at least the next two years. Senate Republicans may push for repeal votes. But Obama will veto them. Smaller reforms may pass. But the law will mostly remain intact.
ATLANTA ‑ UnitedHealthcare, Coventry, Cigna and Time Insurance Company have each submitted plans with the state to offer insurance in the federally run health care exchange in Georgia next year.
They join the five holdovers from this year’s exchange that are also submitting rates for review: Alliant Health Plans, Blue Cross and Blue Shield of Georgia, Humana, Kaiser Permanente, and Peach State Health Plans.
Also, you may recall a nice graph by Dan Diamond from a couple of weeks back showing the states which are increasing their exchange competition for 2015; I've crudely updated it with new competition data from 4 additional states: Connecticut, Maryland, North Carolina and Georgia (plus one more added to Kentucky since he posted it):
My estimate for "woodworkers" in non-expansion Georgia has been around 63,000 people; this article pretty solidly places that number at about 1/3 higher: 91,000 to date:
As of Thursday, DCH has received more than 40,000 “account transfers” from the exchange, “with about 2,000 arriving every hour,’’ an agency spokeswoman, Kallarin Richards, told GHN.
These potential sign-ups in Georgia have been stalled for months due to technological snags.
Community Health said Friday that it’s waiting until all of the transfers have been received from the exchange before processing them. “This will ensure DCH is working from the most recent data and can identify any duplicative applications that may exist,” Richards said in an email.
Federal health officials recently reported that more than 91,000 Georgians were identified through the health insurance exchange as eligible for Medicaid or PeachCare.
“Let me tell you what we’re doing (about ObamaCare),” Georgia Insurance Commissioner Ralph Hudgens bragged to a crowd of fellow Republicans in Floyd County earlier this month: “Everything in our power to be an obstructionist.”
After pausing to let applause roll over him, a grinning Hudgens went on to give an example of that obstructionist behavior, this one involving so-called “navigators” who are being hired to guide customers through the process of buying health insurance on marketplaces, or exchanges, set up under the federal program.
This is a great article for several reasons. Not only is it the first Georgia-specific update I've received, but the numbers are quite good (daily average over 2x that of February) and very straightforward (they don't explicitly state that the 178K are QHPs only, but they include the 3/01 total of 139K and I alrleady checked the 3/01 Medicaid tally, which is quite a bit more than 38K, so it's definitely not included here).
As a surprise bonus, it includes the Paid/Unpaid data for Georgia...which is over 81%, within the 80-85 range that most insurers have been reporting of late. Finally, the data comes directly from the state insurance commissioner, so there should be no mistranslations going on.
State insurance officials said Wednesday that 177,668 Georgians have completed applications for coverage in the health exchange as of March 15.
That number, reported by health insurers in the state, reflects a recent surge in enrollees from the latest figures released by the federal government. As of the end of February, federal officials said, Georgia’s exchange enrollment totaled 139,371.
OK, as noted a little earlier, I underestimated the February HHS Report for Exchange-based Private QHP enrollment by about 4.2%:
My Projection: 902,800 (4.202 million total)
Actual Enrollments: 942,833 (4.242 million total)
I'm perfectly happy to have underestimated. As for where the extra 40,000 enrollments came from, my initial guess would be that California, in particular, started ramping up their big March blitz a bit earlier and more successfully than I figured, which, again, I'm absolutely fine with.Update: Nope, actually, California's numbers plummetted in the 2nd half of Feb due to that ugly technical outage; see below for details.
I'm busily plugging the new enrollment numbers into the spreadsheet even as I type this, and will be updating with various notes and observations, so keep checking in.
OK, I've entered the QHP data; a couple of things to note: