Maryland

2018 MIDTERM ELECTION

Time: D H M S

I've ranted several times before about the importance of current Obamacare private policy enrollees making sure to actually visit the exchange website, shop aroundlog into your account and manually re-enroll for 2015, even if nothing has changed at your end (ie, no changes in income, dependents, residence etc).

There are many reasons NOT to auto-renew, most of which are financial in nature. The short version is, you could easily end up paying more than you thought next year by not switching (in addition to premium changes, your tax credit might drop even if your income hasn't changed due to how it's calculated), and you could pay substantially less next year if you do switch to another policy (premiums are actually dropping in many markets).

As promised, Maryland residents can start shopping around now for 2015 qualified health plan (QHP) policies on the all-new, completely overhauled Maryland Health Connection website:

Note that the actual enrollment capability won't be available until after November 15th (actually, they're rolling it out in stages this year, which strikes me as very wise given the technical problems MD had last time around:

Nov. 15 -- The first HealthConnectNow! sign-up event will be held. About 25 sign-up events are being scheduled throughout Maryland -- four times the number held during the first open enrollment. Details about times, dates and locations will be announced in the coming weeks.

Nov. 16 -- The call center opens to take phone applications at 855-642-8572 (TTY 855-642- 8573).

I have the press release as well, but this article from the Daily Record does a good job of summarizing the numbers:

More than 81,000 Marylanders had enrolled in private health insurance on the state’s health exchange as of Sept. 20, officials said Friday.

That’s an increase of 2,425 individuals since August.

At the end of September, 376,850 people had gained Medicaid coverage during 2014. That’s an increase of 21,569 over the past month.

However, over the past year, some people have been dropped from the Medicaid rolls. People can become ineligible for the public insurance program if their income increases or if they experience other changes, like in age or household status.

So, the net increase in Medicaid enrollment compared to December 2013 is 262,979 people, according to officials with the Maryland Health Benefit Exchange.

Like some other states, Maryland has made some poor decisions when it came to setting up their ACA exchange last year, necessitating scrapping the original platform and replacing it with a customized version of Connecticut's much better system. While it remains to be seen how well the 2nd attempt will function, this is a very smart move on their part:

BALTIMORE (Tuesday, Sept. 16, 2014) — The second year of Maryland’s health insurance marketplace for individuals and families begins on Nov. 9 when consumers will have access to a newly redesigned website that enables “anonymous browsing,” the ability to compare plans — without registering personal information — before enrolling. This feature is being launched earlier than originally planned to enhance the shopping experience for Marylanders.

...Starting November 9, the redesigned exchange will be rolled out with a series of events, including a more intensive campaign of in-person assistance to help consumers and businesses during the upcoming season of open enrollment: 

The Maryland Health Connection just issued their latest monthly enrollment report (running from 7/27 - 8/23). On the one hand, the QHP tally includes both new additions and dropped/cancelled enrollments this time around, making it useless for adding to my off-season enrollment projection chart...

Enrollment Data
As of August 23, 78,666 individuals have enrolled in qualified health plans.1

As of August 27, 2014, 355,281 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage. We have begun reporting the net changes in Medicaid enrollment. This figure takes into account that individuals lose Medicaid coverage because of changes in household, age and income, as well as redeterminations. Compared to December 31, 2013, the net change in Medicaid enrollment as of August 27, 2014 is +262,737. 

This Just In (busy day today)...

Commissioner Approves Premium Rates for 2015 Individual Market

(Baltimore) – Maryland Insurance Commissioner Therese M. Goldsmith today announced approved premium rates for individual health insurance plans to be offered in the State for coverage beginning January 1, 2015.

Premium rates for three of the six carriers currently participating in Maryland’s individual insurance market – All Savers Insurance Company, Evergreen Health Cooperative, and Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. − will drop by an average of 6.7 percent, 10.3 percent, and 14.1 percent, respectively. The other three carriers currently in the market, all CareFirst companies, received approval to increase premium rates by 9.8 percent (CareFirst BlueChoice, Inc.) or 16.2 percent (CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc.), on average − substantial reductions from the 22.8 percent and 30.2 percent increases those companies requested for 2015.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

MARYLAND: An Amazing Healthcare Revolution Is Happening In Maryland — And Almost No One's Talking About It

The Maryland ACA exchange has been one of the "middle-tier" models in my view; not an utter disaster like the ones in Oregon or Massachusetts, but still riddled with technical problems like the ones in Minnesota & Vermont. However, the state has apparently had a different healthcare-related initiative which has been a huge success so far:

Through innovative methods and a data-centric approach, Western Maryland Regional Medical Center, has become the cornerstone in Democratic Gov. Martin O'Malley's ambitious makeover of the state's healthcare programs.

Until this month, Maryland's reports were a bit irritating in two ways: First, they were running a month behind; second, the "thru dates" for the QHP numbers never quite lined up with the Medicaid number for some reason. With today's report, they've corrected both issues, bundling both June and most of July in and matching up the dates:

Enrollment Data
As of July 26, 2014, 332,504 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage.

Beginning this month, we will also report net changes in Medicaid enrollment. This figure takes into account the fact individuals lose Medicaid coverage because of changes in household, age, and income, as well as redeterminations. Compared to December 31, 2013, the net change in Medicaid enrollment as of July 26, 2014 is +273,245.

As of July 26, 78,930 individuals have enrolled in a qualified health plan.

The good news: While Maryland's enrollment numbers are still way below their expectations due primarily to a screwed-up exchange website, they're continuing to crank out smaller numbers of enrollees, and have now hit the 75K milestone:

Maryland enrolled about 75,000 people in private health plans, about half as many as the state initially aimed to sign up in private insurance plans. However, the state ended up enrolling about 300,000 people through Medicaid. The Connecticut health exchange technology was chosen largely because it was effective and preserves Medicaid enrollments.

The 300K Medicaid number is impressive, but I already have that number plugged in so no changes there.

On the down side, MD's move to an all-new exchange website platform (purchased from Connecticut), while a welcome move, will also require everyone who's receiving subsidies to re-enroll this November:

As I noted this morning, the Maryland Health Exchange has released an updated enrollment report running through the end of May (the June report will be out at the end of July):

As of May 31, 300,310 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage. 
 
As of May 31, 72,207 individuals have enrolled in a qualified health plan. 

Compared with the previous report, MD had a 4,300 QHP increase from 5/10 - 5/31, and an increase of 4,450 since the end of the open enrollment period. This means that they're averaging around 106 per day, or 31% of their average rate during open enrollment...which has had a significant impact on the Off-Season Projection Chart that I started posting yesterday (as you can see, MD had been only running 2% of the OE rate until now).

Don't let the snarky headline fool you; I'm still very much a single-payer guy. However, anyone who still claims that the ACA exchanges are "socialized medicine" doesn't have the slightest clue what they're talking about. In case you needed even more proof that the ACA is very much private-market friendly:

Illinois:

After sitting out the first year, UnitedHealth Group Inc. intends to offer individual policies on the Illinois health insurance exchange next year, according to sources familiar with the company's plans.

The decision by UnitedHealth, the nation's largest and the state's No. 2 insurer, has the potential to shake up the Illinois market, which was dominated in 2014 by Blue Cross and Blue Shield of Illinois, the state's dominant insurer.

...United's participation also could help lower rates for consumers, a key concern among the law's supporters.

While United would neither confirm nor deny its plans to offer policies in Illinois next year, a spokesman said the Minnesota-based insurer intends to increase its participation over time in exchanges nationwide.

Regular readers of this site know that the ACA Signups project started over at Daily Kos. This is the first time I can recall using dKos as a primary source for a story link. I'm sorry to say it's not exactly a flattering one as far as Maryland's ill-fated state exchange is concerned:

Maryland's health exchange website, which is best known for falling to pieces on Oct. 1, will be scrapped after $129 million in spending. In April, the Maryland Health Exchange board voted to adopt Connecticut's web application.

At the time officials refused to say they were junking the Noridian-designed system. It was a just revamping ... right.

However, the state can't transfer data from one system to the other.

The fix? Contact 275,000 Medicaid enrollees -- about 75% of the people on the exchange -- and have them log onto a new system and put their information in again.

A slight increase in exchange QHPs since mid-April (either via final data entry corrections or qualifying life events?), and a solid increase in Medicaid/CHIP enrollees:

As of April 29, 2014, 275,090 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage.

As of May 10, 2014, 67,907 individuals have enrolled in a qualified health plan.

This is really part of the actual HHS report, but I haven't had a chance to plug in the Medicaid numbers for every state yet so I'm including it here for now:

The state reports that nearly 263,000 Marylanders have gained Medicaid coverage in 2014.

It seems a bit odd to me that Maryland is issuing a formal press release today when their extension period doesn't end until tonight or tomorrow (why leave a couple days of stragglers?), but whatever; the increase in exchange QHPs from 4/09 to 4/14 was only 1,017, so I guess they figure that it won't be more than a few hundred from 4/15 - 4/18 anyway.

In any event, they say they aren't issuing any more updates until mid-May, so for all practical purposes, this closes the books on Maryland for now:

Please note, we will begin reporting on a monthly basis, on the third Friday of each month. Our next report will be May 16, 2014.

As of April 15, 2014, 262,619 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage.

As of April 14, 2014, 66,203 individuals have enrolled in a qualified health plan. 

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