Minnesota

When I crunched the numbers for Minnesota's requested rate hikes, the results were pretty scary-looking; based on partial data, I estimated that the weighted average was something like a 37% overall requested increase:

Note that there were several crucial missing numbers: I didn't know the actual market share for several companies (I made a rough guess based on an estimate of the total missing enrollments), nor did I know what the requested increases were for Medica or PreferredOne, other than thinking that both were under 10%.

Just moments ago, however, the Minnesota Insurance Commissioner released the approved rate changes...and it's admittedly not pretty:

Individual Market

Minnesota's troubled MNsure exchange continues to quietly roll along through the off-season...

Cumulative QHP selections are up 1,093 since July 14 (42 per day), 2,937 since June 14 (52 per day), 5,059 since May 14 (58 per day) and 9,355 since the end of Open Enrollment on 2/21/15...or about 55 per day). Things have gradually slowed during the off-season, but not by much.

In just the last month they've also beefed up their Medicaid enrollment tally by over 16,800 and added 3,800 more to MinnesotaCare.

This report also gives some important additional stats, such as:

(sigh) Just 2 days ago there was excellent news on the 2016 rate increase front from the largest state (California, 4% weighted average) and one of the smaller ones (Maine, just 0.7%). Today brings the other side of the coin: Assuming the requested rate hikes are approved, Minnesota is looking at some pretty unpleasant increases next year:

A team of actuaries at the Minnesota Department of Commerce are currently scrutinizing the proposed rates that have been filed for 2016, and final rates will be announced on October 1. But for now, four MNsure’s individual market carriers have proposed the following rate changes for coverage effective January 1, 2016 (market share is as of the end of the 2015 open enrollment period):

Minnesota's troubled MNsure exchange continues to quietly roll along through the off-season...

Cumulative QHP selections are up 1,844 since June 14 (61 per day), 3,966 since May 14 (65 per day) and 8,262 since the end of Open Enrollment on 2/21/15...or about 58 per day; they've been pretty consistent during the off-season.

In just the last month they've also beefed up their Medicaid enrollment tally by nearly 17,800 and added over 3,500 to MinnesotaCare.

The Minnesota ACA exchange, MNsure, held their June board meeting yesterday and released some new enrollment numbers:

Cumulative QHP selections are up 2,122 since May 14, while Medicaid and MinnesotaCare are (combined) up 24,296 people in just a month.

Hot off the presses, the Minnesota ACA exchange, MNsure, just held their monthly board meeting and released some new enrollment numbers:

That precise 64,000 QHP number is up 2,126 since April 13, while Medicaid and MinnesotaCare are (combined) up a whopping 34,538 people, which is pretty impressive.

Hmmm...this is a bit surprising. The last report out of MNsure stated that they had added 1,405 QHP selections in the 15 days from 2/21 - 3/08, or 94 per day. I assumed that as today's tax filing deadline approached, this rate would increase as procrastinators scrambled to get their taxes filed under the wire. Instead, however, this is their latest report:

61,874 - 61,109 = Just 765 people enrolling over the 36 days since the prior report, or just 21 people per day. ACA exchange enrollments have actually slowed down substantially over the past month compared to the prior 2 weeks (which were after open enrollment ended). If this slowdown is representative of the whole country, then instead of several hundred thousand #ACATaxTime enrollees, we might be looking at fewer than 100K. However, this isn't nearly enough to draw any conclusions from yet.

The impending King v. Burwell Supreme Court decision will cast an even larger shadow over the ACA over the next 2 months (the decision is expected to be announced in June), as exchanges in 6 of the 14 states running their own (State-Based Marketplaces, or SBMs) are at risk of either being abandoned, dissolved or otherwise moved over to the federally-run Healthcare.Gov exchange:

The federal government is threatening to take over Hawaii's health insurance exchange within months and has restricted grant money to support operations of the Hawaii Health Connector.

Jeff Kissel, the Connector's executive director, told lawmakers at a briefing Thursday that if the exchange created by the Affordable Care Act does not get state funding soon, the federal government will abolish Hawaii's marketplace and run it directly.

The good news is that MNsure is continuing to provide off-season enrollment reports. The only bummer is that they appear to have switched to monthly reports, but I guess I can live with that:

Latest Enrollment Numbers

March 12, 2015

MNsure provides a robust enrollment metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. This page will be updated on board meeting days.

Health Coverage Type Cumulative Enrollments
Medical Assistance 90,839
MinnesotaCare 31,070
Qualified Health Plan (QHP) 61,109
TOTAL 183,018

Unlike today's DC update, which seems highly questionable due to the "...since Oct. 2013" wording, MNsure's report only includes 2015 enrollments, and the numbers, while still impressive, are much more reasonable.

Now that the King v. Burwell Supreme Court oral arguments are out of the way (with radio silence expected until they announce the decision sometime in June) , the next Big Development to keep an eye on ACA-wise is...Tax Season! There will be plenty of stories about how many people have to pay back some/all of their 2014 tax credits, how many will receive additional tax credits...and, most germane to this site, how many additional people enroll via the exchanges to avoid having to pay (most) of the higher tax penalty next year for not being covered in 2015 during the Tax Filing Season Special Enrollment Period (SEP), or #ACATaxTime as I prefer to call it.

This isn't an exact apples-to-apples comparison, since the Massachusetts number includes the "overtime" extension period while the other 5 states only run through 2/15/15, but I thought it would be useful to see how the 6 exchanges which had widespread technical issues last year fared this time around. Obviously  other states like Washington and California had some snafus, but these are the ones which were seriously hosed last year to the point of requiring massive overhauls or which were completely scrapped in favor of a new platform (I'm not including HC.gov itself here since everyone already knows what massive technical improvements they've made).

The chart below refers specifically to QHP selections only (whether paid or not), and compares the 2015 open enrollment period (11/15/14 - 2/15/15...or 2/26 in the case of MA) against the 2014 open enrollment period (10/1/13 - 4/19/14). I've also included some notes for context.

Three more updates to the #ACAOvertime Deadline Extension Roundup:

  • First, as noted this morning, California has tacked on an extra 2 days to their "In Line by Midnight" period (previously ending on 2/20; now extended to 2/22)

But by February 18, the exchange was offering an extension to people who tried to enroll by February 15 but were unable to do so by the deadline.  This has not been published on the exchange website, but an exchange representative confirmed that the extension runs through February 23, and that the call center (855-899-9600) will help enrollees complete the process between now and then.

MNsure just joined 46 other states (+DC)...that just leaves Kentucky, Vermont and Hawaii without an official extension policy of some sort or another:

MNsure Announces Special Enrollment Period for Consumers "In Line" to Enroll at Midnight February 15
Special Enrollment Period planned to ensure all Minnesotans have the ability to get covered

ST. PAUL, Minn.—Today MNsure announced a plan to ensure all Minnesotans “in line” have the ability to obtain affordable, comprehensive coverage. The Special Enrollment Period will make certain that Minnesotans who were “in line” to enroll—those who began the enrollment process but experienced difficulty, preventing enrollment in time to beat the February 15 deadline—will have their enrollments processed during a special enrollment period.  

“In line” is defined as anyone who took any of the following steps with the MNsure system:

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