Massachusetts

With all the concern over the rapidly spreading coronavirus epidemic and how uninsured people in particular can be expected to pay for testing and treatment of the disease, Andrew Sprung and Dave Anderson have reminded me that uninsured residents of California, the District of Columbia and Maryland may still be able to get covered via their respective ACA exchanges.

CALIFORNIA: You have until April 30th: (June 30th...see update below)

New Special-Enrollment Period Announced

Covered California also announced that effective Feb. 18 it will establish a special-enrollment period for those who were unaware of the state penalty or the new financial help. Consumers who fall into those categories, or who are currently insured off exchange (directly through an insurer) and want to switch to Covered California to benefit from the new state subsidies, will have through April 30 to sign up for coverage.

via the Massachusetts Health Connector:

Massachusetts Health Connector offers extended enrollment for uninsured individuals to ease coronavirus fears

BOSTON – March 11, 2020 – To ensure everyone who wants access to covered coronavirus services has it, the Massachusetts Health Connector announced today that uninsured residents can apply and get into coverage through a 45-day window running until April 25.

On March 6, the Division of Insurance announced that Massachusetts health insurers are now required to cover the cost of testing and treatment for members who may be affected by the Coronavirus (COVID-19), including not charging co-pays or deductibles for those services. The Health Connector’s decision to open enrollment to anyone without coverage ensures Massachusetts residents concerned about contracting coronavirus can access necessary services without cost barriers.

Last March I wrote an analysis of H.R.1868, the House Democrats bill that comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or make improvements in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

I just received the final 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):

Here’s where we are:

  • We have 290,105 January enrollments
  • 22,493 February and March enrollments
  • 7,014 plans selected
  • For a total of 319,612

New enrollments currently total 57,044.

I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for January vs. February or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).

Here's what's truly impressive: Massachusetts is the only state to increase their ACA exchange enrollment each and every year for six years running:

via the Massachusetts Health Connector:

On Wednesday, January 15, 2020, the Massachusetts Health Connector embarks on a one-day, multi-city tour that includes stops at six locations along the North and South Shore to remind Massachusetts residents there is still time to get 2020 health coverage before Open Enrollment ends January 23.

On Wednesday, January 15, 2020, the Massachusetts Health Connector holds its “Day of Coverage” featuring activities across the Commonwealth designed to help people #GetCovered with health insurance for the new year.“Day of Coverage” activities will be held in Boston, Hyannis, Lawrence, New Bedford, and Lowell.

Open Enrollment is happening now and runs through January 23, 2020. Massachusetts residents who want to enroll in coverage or switch plans to start February 1, must sign up through the Health Connector by January 23rd.

Residents can sign up for coverage at www.MAhealthconnector.org, over the phone at 1-877-MA-ENROLL (1-877-623-6765), or in person through a local navigator organization.

I just received the following 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):

Here are numbers as of yesterday:

  • We have 290,769 members enrolled in January coverage
  • We have 4,444 members enrolled in February or March coverage
  • We have 5,270 plans selected (1st premium not paid yet)
  • That’s a total of 300,483 people
  • We have 41,477 new enrollments.

I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for January vs. February or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).

via the Massachusetts Health Connector:

Massachusetts Health Connector Open Enrollment Continues through January 23, Offering High-Quality and Affordable Coverage to Residents

BOSTON – December 9, 2019 – Open Enrollment for health insurance through the Massachusetts Health Connector continues through January 23, 2020, providing residents time to find affordable coverage that delivers a wide range of benefits to make it easier and less costly to get health care.

Uninsured residents have until December 23 to apply, pick a plan and make a payment in order to have coverage starting January 1, and they have until January 23 to apply for coverage starting February 1. In contrast, Open Enrollment in other states served through the federal marketplace ends as early as December 15.

I just received the following 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):

It looks like we’ve pretty much wrapped up auto-renewal, how about an update on 2020 enrollment:

As of Nov. 29, we had a total of 286,640 people enrolled in Jan. 1 coverage, 6 with February or March enrollments, and 10,852 who had selected plans and had not yet paid to enroll. So, by the CMS definition, we are at 297,498. That includes about 17,000 new enrollments from people who did not have coverage as of Nov. 4 with the Health Connector.

I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for Januar vs. Feb. or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).

via the Massachusetts Health Connector:

Open Enrollment begins through Massachusetts Health Connector

BOSTON – Nov. 1, 2019 – The Massachusetts Health Connector started Open Enrollment this morning, making affordable coverage available to anyone in Massachusetts without health insurance, including lower-income people who can take advantage of low premiums and co-pays through the ConnectorCare program.

The Health Connector is Massachusetts’ state-based health insurance exchange, and provides health insurance to residents who do not get coverage through their employer. More than 97 percent of Massachusetts residents have health insurance, a result of the state’s 13-year old law which sought to ensure everyone in the Commonwealth has coverage.

Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has ten different carriers participating in the individual market. MA (along with Vermont and the District of Columbia) has merged their Individual and Small Group risk pools for premium setting purposes, so I'm not bothering breaking out the small group market in this case.

Getting a weighted average was a bit tricky. On the one hand, only one or two of the rate filings included actual enrollment data. On the other hand, the Massachusetts Health Connector puts out monthly enrollment reports which do break out the on-exchange numbers by carrier. This allowed me to run a rough breakout of on-exchange MA enrollment. I don't know whether the off-exchange portion has a similar ratio, but I have to assume it does for the moment.

*(Yes, I know, the District of Columbia isn't actually a state, and Vermont's mandate is...well, read on...)

As the 2020 Open Enrollment Period rapidly approaches (it starts November 1st nationwide...except for California, where open enrollment is starting on October 15th), it's time to start getting the word out about some important things to keep in mind this fall.

One of the most critical things to remember for residents of California, the District of Columbia, Massachusetts, New Jersey, Rhode Island and Vermont is that each of these states* has reinstated an individual healthcare coverage mandate law/ordinance to replace the federal ACA mandate penalty which was zeroed out by Congressional Republicans back in December 2017. This means that if you live one one of them, unless you receive an affordability, hardship or other type of acceptable exemption, you'll be charged a financial penalty when you file your state/district taxes for 2020 in spring 2021 if you don't have qualifying healthcare coverage.

MLR rebate payments for 2018 are being sent out to enrollees even as I type this. The data for 2018 MLR rebates won't be officially posted for another month or so, but I've managed to acquire it early, and after a lot of number-crunching the data, I've recompiled it into an easy-to-read format.

But that's not all! In addition to the actual 2018 MLR rebates, I've gone one step further and have taken an early crack at trying to figure out what 2019 MLR rebates might end up looking like next year (for the Individual Market only). In order to do this, I had to make several very large assumptions:

Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has ten different carriers participating in the individual market. MA (along with Vermont and the District of Columbia) has merged their Individual and Small Group risk pools for premium setting purposes, so I'm not bothering breaking out the small group market in this case.

Getting a weighted average was a bit tricky. On the one hand, only one or two of the rate filings included actual enrollment data. On the other hand, the Massachusetts Health Connector puts out monthly enrollment reports which do break out the on-exchange numbers by carrier. This allowed me to run a rough breakout of on-exchange MA enrollment. I don't know whether the off-exchange portion has a similar ratio, but I have to assume it does for the moment.

This press release is mostly of interest because it came from the Governor's office, not the MA Health Connector itself:

Baker-Polito Administration Announces Health Connector Completes Successful Open Enrollment with Highest-Ever Membership, Covering 282,000 People with Health Insurance

Governor Baker announced today that the Massachusetts Health Connector completed Open Enrollment with the highest membership in the 13-year history of the state’s health insurance exchange, covering 282,000 people with health insurance.

Heh. "13-year history" took a moment to register...but of course Massachusetts has had a health insurance exchange website since 2006, when "RomneyCare" went into effect.

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