I haven't written a single word about Maryland since early October. Last year their ACA exchange was very good about posting fairly regular enrollment updates; this year they've been dead silent about it so far, which is rather surprising (and no, I don't think it's because their numbers are bad...every other state I have data for seems to be doing pretty well or even better than last year so far).
Anyway, there's one bit of news out of the Old Line State (yes, I had to look it up to find out what their nickname is) today which is disappointing but not surprising when you understand the circumstances:
The Maryland Insurance Administration barred Evergreen Health from selling health insurance policies for individuals until federal and state regulators decide whether to allow the cooperative to convert to a for-profit insurer and receive a much-needed cash infusion.
With less than one month until open enrollment begins, we want you to be armed with the knowledge you need to sign up or choose a new plan for 2017. You can now browse and compare prices online at MarylandHealthConnection.gov or on your phone or tablet through our new mobile app, Enroll MHC. Find the free app in the Play Store for Android or Apple’s App Store.
Here’s how to get started:
Evergreen Health, Maryland’s version of the innovative nonprofit insurers created under the Affordable Care Act, decided Monday to become a for-profit company to avoid the possibility of a shutdown, according to its chief executive.
If the switch is approved as expected by federal and state officials, Evergreen’s unprecedented move will leave standing only five of the 23 co-ops, or Consumer Operated and Oriented Plans, which started nearly three years ago.
...Evergreen, which covers nearly 38,000 Marylanders, has been trying for the past year to forge an arrangement with federal health officials to stabilize its finances. It enlisted help from the state’s congressional delegation and in June filed suit against the federal government.
As noted below, only around 8,000 are on enrolled in individual ACA exchange policies; the rest are either off-exchange or small/large group coverage.
Every once in awhile I remember what I actually do for a living (I'm a website developer, for those who don't know). That's actually a major reason I started this project in the first place...the techical meltdown of HealthCare.Gov and many of the state-based exchange sites in October 2013 fascinated me, leading me to start trying to assess just how many people were actually enrolling in the plans using the messy websites, and it spread from there.
The cost of health insurance plans offered under the Affordable Care Act will jump 20 percent or more next year under rates to be announced Friday by Maryland regulators.
His remarks came as the Maryland Insurance Administration approved double-digit rate increases for the four companies that sell health plans through the state exchange, an online marketplace set up under the law for people who cannot buy coverage through their employer.
...CareFirst, which holds 68 percent of the market, received an average hike of 31.4 percent on its PPO plan and 23.7 percent on its HMO — the highest increases of any insurer.
...Rates in Maryland also have been typically lower than those nationally under the Affordable Care Act, so there could be some normalizing going on, said John Holahan, a fellow in the Urban Institute's Health Policy Center.
"Maryland rates have been lower than the rest of the nation so it seems some catching up should be expected," said Holahan.
BALTIMORE – Commissioner Al Redmer, Jr. will be conducting a second public hearing on Monday, August 15th from 11 am – 1 pm at the Maryland Insurance Administration located at 200 St. Paul Place, 24th floor Hearing Room, Baltimore, MD 21202 to receive public input on a revised filing made by CareFirst. On July 26, CareFirst refiled its 2017 proposed rates for the individual market and requested a 27.8% rate increase for HMO plans and a 36.6% rate increase for PPO plans. CareFirst previously requested a 12.0% and 15.3% rate increase, respectively.
However, they just posted the following market share breakdown, which shows that they currently have 148,403 Marylanders enrolled in exchange policies, a net drop of just 8.5%. Apparently they've added more people during the off season via SEPs than they've lost due to attrition since April.
Health insurers seek rate increases in Maryland as United Healthcare quits market
...United Healthcare, the nation's largest insurer but a bit player in Maryland, was not included on a list released Friday by state regulators of companies seeking rate increases for 2017.
Insurance Commissioner Al Redmer confirmed that the company was leaving the exchange created under the Affordable Care Act, as it has in most states across the country. It will continue to offer plans in the small-business market.
A couple of days ago I noted that after two years of nothing but doom & gloom (and coming just a week after UnitedHealthcare pulled the plug on the individual market in over two dozen states) there seems to finally be some positive developments, with companies like Centene and Anthem reporting better-than-expected results. They may not be making a profit yet, but at least they aren't losing money hand over fist the way they did the first couple of years.
I also made a brief mention of the Maryland Co-Op, Evergreen Health, which reported their first quarterly profit since launching 2 1/2 years ago.
Consumer operated and oriented health plans in Maryland, New Mexico and Massachusetts will report profits in the first quarter, in a sign that some of the remaining Affordable Care Act-created nonprofits could be finding their footing on the state exchanges.
A few months ago I noted that while UnitedHealthcare and some other carriers may be losing money hand over fist on the ACA exchanges, at least some of them are making a profit, breaking even or at least cutting their losses down to a reasonable level.
As a simple reminder, competitive markets should see some companies make money and some companies that offer more expensive and less attractive products lose money. I would be extremely worried if everyone was making money after three years, just like I would be extremely worried that everyone was losing money after three years of increasingly better data.
In a classic case of missing the forest for the trees, I posted two very wonky, detailed entries over the past couple of days about Minnesota and Connecticut's latest enrollment numbers...but completely missed one crucially important data point.
As of 2/1, total QHPs are 165,123 (49,377 new + 115,746 renewal-active and passive).
However, this number didn't include a few "overtime" days of enrollees, which padded the number a bit more...nor did it include the subtraction of unpaid QHP enrollees (ie, cancellations/purging of enrollees who didn't pay their January premiums in time, were transferred to Medicaid due to income changes and so forth).