Illinois

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.

(Note: I've had to re-work some of this entry thanks to clarifications from Adam Cancryn about the RBC rule; too many little edits to document each one).

Last week I posted about the latest ugly Co-Op meltdown, this time Land of Lincoln Health (LoL) of Illinois.

As pointed out in my follow-up entry, given the precarious financial state LoL was already in last year, it made little sense that they only asked for fairly nominal rate hikes:

Now, since LoL went belly-up mid-year regardless, obviously even those massive rate hikes weren't enough to save them, so the question is, what would have happened if LoL had gotten their nominal increases as requested?

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.

Commenter "M E" just asked an important question about the Land of Lincoln debacle:

Likely stupid question here, but if they were doing this bad financially that they couldn't even make it though all of 2016, then how come when requesting their 2016 rates last year they (apparently) asked for less than a 10% bump?

I mentioned this yesterday in my "back from vacation" post, but it's important enough to deserve a separate follow-up post...especially given the clarification about the coverage cut-off date:

Land of Lincoln coverage will end Oct. 1 for individual enrollees

Land of Lincoln Health's insurance coverage for its individual enrollees will end Oct. 1, according to the Illinois Department of Insurance.

The agency posted the news on Land of Lincoln's website. A green banner now greets visitors to the website with the headline, "Important notice to all members" with a link taking them to information about the Chicago-based insurer's impending shutdown. The notice comes a week after the agency moved to seize control of the financially troubled Chicago-based insurer.

All last fall I documented the saga of the Risk Corridor Massacre, which helped to wipe out a dozen ACA-created co-ops and put many of the remaining ones (along with some private carriers) on shaky ground.

Earlier this week I noted that one of the remaining co-ops, HealthyCT of Connecticut, is the latest to go belly-up...due in large part to a different program, "Risk Adjustment". The irony in both cases is that both programs were supposed to be designed specifically to help ensure that "little guy startups" such as the co-ops would be protected from dissolution during the unstable first few years of the ACA exchanges. Instead, developments in both programs have served to help destroy them.

As I noted the other day, the Risk Adjustment program seems to be backfiring:

As Richard Mayhew noted a few days ago over at Balloon Juice:

A couple of weeks ago Adam Cancryn reported that several of the 11 remaining ACA-created Co-Ops had actually reported small profits for the first quarter of 2016.

Today, I'm afraid Cancryn says that this is not the case for Land of Lincoln Mutual Health Insurance Co., the Illinois Co-Op...although they are hoping to take advantage of the announcement made just over the weekend which now allows the Co-Ops to seek outside funding:

Land of Lincoln Mutual Health Insurance Co. plans to look for outside investors to boost its financial resources after federal regulators indicated they would loosen funding restrictions on consumer operated and oriented plans.

I admit that given the carnage of the past couple of weeks, I'm almost afraid to post this entry...but I had to write something positive about the CO-OP situation.

With the ACA-created CO-OPs seemingly dropping like flies due to the #RiskCorridorMassacre, I thought this would be a good time to flip things around and look at which CO-OPs are doing well (or at least not badly).

This isn't much, but it'll do for now:

Wisconsin's insurance department says it has no intention of shutting down its #ACA co-op, which appears it will remain solvent next year.

— Bob Herman (@MHbherman) October 22, 2015

@charles_gaba and at this point, other than Maine, it's difficult to expect many others will last beyond risk corridors.

— Bob Herman (@MHbherman) October 22, 2015

IMPORTANT: See this detailed explanation of how I've come up with the following estimated maximum requested weighted average rate increases for Illinois

As explained in the first link above, I've still been able to piece together rough estimates of the maximum possible and most likely approved average rate increase for the Illinois individual market:

Again, the full explanation is included in the Missouri estimate linked at the top of this entry, but to the best of my knowledge, it looks like the companies with rate increases higher than 10% come in at a weighted 32.7% increase, but only make up about 57% of the total ACA-compliant individual market, with several other companies with approved increases of less than 10% (decreases in some cases) making up the other 43%.

Hot on the news that HHS Secretary Sylvia Burwell decided to channel the Bridgekeeper from Monty Python & the Holy Grail ("Right! Off you go then!!") when it came to Pennsylvania and Delaware's "state-based exchange" requests, here's what's going on in three other states facing possible tax credit loss from an adverse King v. Burwell decision:

ILLINOIS: Hospital group says Illinois could lease Healthcare.Gov

A hospital group in cash-strapped Illinois says the state might be able to set up a health insurance exchange at a lower cost by "leasing" the federal government's technology, an option that could appeal to as many as 34 states where subsides could be jeopardized by an unfavorable U.S. Supreme Court decision.

OK, this one is a bit vague, but for the moment I'll take it. "Land of Lincoln Health" is an insurance CO-OP which operates, as you'd imagine from the name, in Illinois. I'm fairly certain that's the only state they operate in, so this number should be restricted to IL:

Land of Lincoln has enrolled “several hundred people” since open enrollment began this past Saturday, and the plan is already receiving payments from consumers, said Dorgan, who is in charge of finding and renewing members. About 6,000 people visited Land of Lincoln's website over the weekend with no apparent technology issues—an auspicious start for a plan that hopes to have 50,000 covered lives for 2015.

For the moment I'll assume "several hundred" means "300 - 400" and will go with 350 until better data comes out.

This is excellent news for another reason as well: Land of Lincoln only scored about 2,500 enrollees for 2014 open enrollment, so they're at something like 14% of their entire 2014 number in just 2 days.

At the end of August, Illinois' Medicaid expansion program was up to around 452,000 people (including 93,000 transferred over from the existing CountyCare program). As of the end of September, that total was up another 16,000:

The video also coincides with the release Tuesday of new data by Quinn’s administration that showed 468,000 people enrolled in the expanded Medicaid program since last year, more than double original forecasts.

Of course, the larger point of the article in question is that if Democratic Illinois Gov. Quinn's Republican opponent had been calling the shots, he would have told all 468,000 of his fellow Illinoisians (?) to go pound sand:

SPRINGFIELD — Newly surfaced video of Republican Bruce Rauner obtained by the Chicago Sun-Times shows him telling conservative activists in Lake County last year that, as governor, he would have blocked Gov. Pat Quinn’s 2013 expansion of Medicaid.

My in box is once again flooded with ACA-related stories which are interesting but which I just don't have time to do full write-ups on...

ILLINOIS: Clock Ticking For Illinois To Form State-Run Obamacare Exchange

Unless Illinois acts quickly, it will leave hundreds of millions of federal dollars on the table that would go toward building its own health insurance marketplace, potentially upping the cost of coverage for nearly 170,000 Illinois residents. State lawmakers, unable to break a years-long standoff, have not passed a law authorizing a state-based exchange, the marketplaces created under the Affordable Care Act that allow consumers to compare and buy health coverage, often with the help of federal tax credits. As a result, Illinois was one of 36 states that relied on the federal government to host its marketplace on HealthCare.gov, the website that survived a disastrous launch late last year to enroll about 217,000 Illinoisans, 77 percent of whom received federal help.

Holy smokes! This may seem a bit anticlimactic after this morning's surprise announcement by CMS Administrator Marilyn Tavenner, but it's still just as important in other ways:

@JeffYoung @philgalewitz I can tell you there are now roughly 450,000 newly eligibles who enrolled so far in Medicaid in Illinois.

— Peter Frost (@peterfrost) September 18, 2014

When I inquired, he explained:

@charles_gaba @JeffYoung @philgalewitz Sure. Those are the figures from @CoveredIllinois. They say total is now 670,000 (mktplc + Medicaid)

— Peter Frost (@peterfrost) September 18, 2014

When I asked for a link for confirmation, Jonathan Ingram helpfully chimed in:

Last October, at the height of the botched HC.gov rollout, I repeatedly commented over at Daily Kos:

 I still don't know why they didn't roll it out one state per day; if they'd gone alphabetically, they would have had a solid week to work the kinks out with a (relatively) low volume before hitting a big state:

  • Alabama, Alaska, Arizona and Arkansas are all relatively low-population.
  • California, Colorado, Connecticut and Delaware* are all state-run exchanges.
  • That means they wouldn't have hit Florida on the federal site until tomorrow.

I know that the system still would have had serious software issues, but at least they wouldn't have to deal with the massive overload of traffic at the same time that they were trying to fix the issues.

*(Obviously I was mistaken at the time about Delaware running their own exchange, but it's still a low-population state so my point was still valid...and of course the District of Columbia does run their own exchange).

Well, obviously it was too late for that at the time, and they've since scrambled to get their act together on the individual exchange side.

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