Maryland

2018 MIDTERM ELECTION

Time: D H M S

In addition to the big HC.gov Week 4 Snapshot released about an hour ago, the Maryland exchange has also updated their numbers:

With two weeks to go before the Dec. 15 deadline for full 2016 health coverage, 31,740 people have enrolled in private health plans through Maryland Health Connection as of Dec. 1.

About 71 percent, or 22,477, were enrolled in silver plans, which provide savings in the form of advance premium tax credits and cost-sharing reductions for those eligible to lower their cost..

In total, 139,244Marylanders have enrolled in coverage through the state’s health insurance marketplace since open enrollment began on Nov. 1. That includes 107,504 enrolled in Medicaid, which accepts applicants year-round.

Also, 8,880 individuals have enrolled in dental plans which are available for the first time through MarylandHealthConnection.gov for 2016. Of those, 4,022 people enrolled in dental along with a qualified health plan (QHP), 2,756 enrolled in dental along with Medicaid and 2,102 enrolled in a stand-alone dental plan.

The Maryland Health Benefit Exchange has released a new updated tally:

Nearly 25,000 people have enrolled in private qualified health plans (QHP) through Maryland Health Connection for 2016.

As of Nov. 23, 19,675 Marylanders had enrolled in private coverage with some or most of their premium costs next year to be offset by advance tax credits. Another 5,310 enrolled in qualified health plans without tax credits. Nearly 72 percent, or 17,960, were enrolled in SIlver plans.

That's 24,985 QHPs total in 23 days, or 1,086 per day.

In addition, 1,708 people have enrolled in stand-alone dental plans and 5,235 more have enrolled in dental along with health coverage for a total of 6,943 with dental coverage next year.

Also, 87,941 were enrolled in Medicaid since Nov. 1 through Maryland Health Connection.

Busy Day today! From the Maryland Health Connection:

More than 57,000 people enrolled in health coverage through MarylandHealthConnection.gov during the first nine days of 2016 open enrollment, more than double the enrollment traffic during a comparable span a year ago.

Of the 57,213 who enrolled from Nov. 1 through Nov. 9, 10,867 were in private qualified health plans; 45,402 were in Medicaid and 944 were in stand-alone dental plans. The large Medicaid total included previous Medicaid enrollees who were in Maryland's former legacy system and were "redetermined" into the new web-based system. 

Wow!

Through yesterday, 8537 people have already enrolled in private health plan coverage for 2016 at https://t.co/GpASXcJbQN Is it your turn?

— MD Health Connection (@MarylandConnect) November 4, 2015

And https://t.co/GpASXcJbQN now offers dental coverage for 2016 too. 1705 Marylanders enrolled in dental through yesterday. Makes us smile!

— MD Health Connection (@MarylandConnect) November 4, 2015

Just to be certain that the 8,537 figure doesn't include Medicaid or the dental figure mixed in with it, I asked and they confirmed:

@charles_gaba Correct. That's all QHP. Dental's in the other tweet.

— MD Health Connection (@MarylandConnect) November 4, 2015

Boy, that was fast! From today's Baltimore Sun:

The start of open enrollment on the state's online marketplace for health insurance went smoothly Sunday, officials said, with almost 780 people signing up by late afternoon and many others calling for information or meeting in person with professional advisers.

The Maryland health exchange launched free of the technical problems that disrupted enrollment in the first enrollment season beginning in the fall of 2013.

Performance improved in 2014. Consumers this time were promised a user-friendly website, a simpler application and better access to knowledgeable brokers to help them choose plans, exchange officials said.

Those moves were expected to help the state reach a goal of signing up 150,000 people in private plans, up from 115,000 last year.

"It was a good first day," said Andrew Ratner, exchange spokesman. "Especially being a Sunday."

By 4 p.m., 779 people had enrolled, including 461 in private plans and 136 in Medicaid, and 182 in dental plans.

When I updated my #OE3 state-level enrollment projections yesterday, I came across this official projection for #OE3 from Your Health Idaho's Sept. 18th board meeting minutes:

Rep. Rusche asked what our target enrollment is for this cycle and what barriers we see in making those targets. Mr. Kelly said the team is focused on the 80% goal of 92,000 as our enrollment target.Premium increases are a potential barrier. Net premium is a relatively small increase for most consumers, and each consumer will experience something different depending Page 5 of 14 on their plan, their location, their carrier, etc. We feel that while the premiums are increasing the relatively small net premium increase will mitigate this barrier to a large degree.

When I asked for clarification, they informed me that:

We currently have 86,659 effectuated enrollments with Your Health Idaho, as of September 15. The 92,000 would also refer to effectuated enrollments.

In my most recent Maryland exchange update, I noted that after months of ACA exchange enrollments increasing during the off-season (if slowly), net policy cancellations finally started to outweight off-season additions starting in August:

As of Aug. 13th, 606,226 Marylanders have enrolled in quality, affordable health coverage for 2015 through Maryland’s state-based insurance marketplace.

That includes 123,673 people enrolled in private Qualified Health Plans (QHP) and 482,553 people enrolled in Medicaid through the marketplace since open enrollment for the year began on Nov. 15, 2014. Nearly 94 percent of all Marylanders who have enrolled through Maryland Health Connection for coverage this year received financial assistance.

Today, the exchange tweeted out a quickie update ahead of the 2016 Open Enrollment period:

A couple of days ago I noted that Covered California is adding a very good feature this year: They're opening up 2016 enrollment nearly 3 weeks early...for those who are already currently enrolled. Starting this monday, Oct. 12, current enrollees will be able to renew or switch to a different CoveredCA plan, 19 days ahead of he official Nov. 1st Open Enrollment launch.

Today I discovered that at least one other state-based exchange (Kynect, in Kentucky) is doing this as well...sort of:

I clicked through and saw this listed under the Frequently Asked Questions:

1. How do I enroll in kynect?
Simply visit kynect.ky.gov or talk to your insurance agent. If your insurance plan is up for renewal, you may be eligible to enroll through kynect today. You can also call Customer Service at 1-855-4kynect (459-6328).

With the 2016 Open Enrollment Period quickly approaching (it launches on November 1st), the Maryland Health Connection has already officially launched 2016 Window Shopping!

They even whipped up a simple video stepping you through the process (oddly, the background music seems to have been lifted from "There's Something About Mary", which is either a good or bad omen depending on your POV):

MARYLAND:

In today's speech at the Howard University College of Medicine, HHS Secretary Sylvia Burwell started ramping things up for the 2016 Open Enrollment Season (which I'm gonna designate #ACA2016 unless someone else comes up with something better) by dropping some data points.

Among these was this one: 

Almost half of the uninsured individuals who are likely eligible for Marketplace plans are between the ages of 18 and 34.

This is really important, because only about 28% of those who enrolled in exchange-based policies this year fall into the 18-34 range, which is a problem from an actuarial/risk pool perspective. Younger people are generally healthier, so the insurance companies prefer to have a higher percentage of them in their risk pools in order to help keep premiums/deductibles from increasing too quickly.

If "almost half" of the 10.5 million uninsured people eligible for the ACA exchanges are in the 18-34 range, that's roughly 5 million young adults who the exchanges need to target.

Maryland was one of the first states to release their list of requested 2016 rate hikes, and caused quite a stir at the time due to the largest player in the state, CareFirst, asking for a whopping 30% rate hike. At the time, I didn't have much to go on in terms of hard enrollment numbers, but it looked like the weighted average request would be somewhat lower, perhaps around 22-23%.

Today, the Maryland Dept. of Insurance has released the final, approved rate changes, and while 5 of the 8 companies on the individual exchange saw reductions in their rate change (2 others were approved as is, and one, Kaiser Health Plan was actually increased from 4.8% to 10%), it's still difficult to lock down a fully weighted average due to some crucial enrollment data missing.

I was able to track down the "covered lives" data for 5 of the eight companies.

When I posted Maryland's July enrollment update, I noted that the effectuated exchange-based QHP number had actually gone up slightly from April through July (from 125,535 to 126,346). Not much of an increase, of course, but the fact that this number increased at all was significant since it indicated that, as I expected, new additions to the exchange QHP pool thanks to the "life event" options are slightly outpacing those dropping their policies during the off-season.

Last week the MD HealthBenefit Exchange released their August report and, as I've also been expecting, the tide is now starting to turn, with "drop-outs" finally starting to outpace the new additions:

BALTIMORE (Aug. 18, 2015) -- As of Aug. 13th, 606,226 Marylanders have enrolled in quality, affordable health coverage for 2015 through Maryland’s state-based insurance marketplace.

Long-time readers (and anyone from Maryland, I presume) know that the Old Line State (I have no idea whether that nickname is actually widely used?) was among those whose 2014 ACA exchange website turned out to be a huge technical mess. Oregon and Nevada received most of the headlines because they both ended up scrapping theirs completely and moving home to HealthCare.Gov this year (to be followed by Hawaii in 2016), but along with Massachusetts, Maryland went the "Try, Try Again" route.

Not sure how this one got by me, but the Maryland Health Benefit Exchange actually released some updated enrollment numbers over a week ago:

Nearly a half-million Marylanders — 493,346 — have enrolled in quality, affordable health coverage through Maryland Health Connection for 2015.

That includes 126,346 people enrolled in private Qualified Health Plans and 367,000 enrolled in Medicaid from Nov. 15, 2014 through July 5, 2015. About 92 percent of enrollees through the state’s health insurance marketplace are receiving some form of financial assistance.

Medicaid enrollments are year-round. And while open enrollment for private health insurance for 2015 coverage ended in February, people may still enroll if they have a qualified “life event.”

The "92% receiving financial assistance" bit is slightly misleading; that's true, but only because the Medicaid enrollees are lumped in. If you're talking about QHPs only, it's more like 69% (87.2K out of 126.3K). Whether that's a good or bad thing obviously depends on your POV.

Maryland's rate request website is an exercise in frustration. At first glance, it looks very cut and dried: A full table of each health insurance company, broken out by either individual or small group market, whether the filing is for policies sold on or off the ACA exchange, and the "average % change requested", along with direct links to the actual filing documents (where, presumably, I can dig up the crucial enrollment numbers, which are vital to determining the weighted average rate requests).

Unfortunately, once you get into the actual documents...they're completely scattershot. Some companies list the number of enrollees who would be impacted by the requested rate changes; some don't. That makes it impossible to determine the market share, which in turn means there's no way of weighting the average.

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