File this one under "Be Careful What You Wish For".
Just a couple of days ago I reported that the New York Dept. of Financial Services had issued their approved 2018 rate changes for the 15 insurance carriers participating in the state's individual and small group markets...and, in some welcome news, they whittled down the rate increases by a bit, from 17.7% on average to 14.5% on average in the individual market, and from 11.7% to 9.3% in the small group market.
Back in early June, the New York Dept. of Financial Services posted the requested 2018 rate hikes for the individual and small group markets. In most states, the CSR reimbursement issue is a much bigger factor than whether or not the Trump Administration enforces the individual mandate, but in New York it's the exact opposite: According to the NY DFS, loss of CSR payments would only tack on 1.3 points to the total, while "a full repeal of the federal individual mandate would increase rates by an additional 32.6%".
The reason for the fairly nominal CSR factor is that the vast majority of NY's CSR-eligible population (those earning 138-200% FPL) is instead enrolled in the state's Basic Health Program. As a result, only 26% of New York's exchange enrollees receive CSR assistance, and the 200-250% FPL recipients only receive a fairly skimpy amount of CSR help anyway. At the opposite end of the spectrum, the 32-point mandate factor is far higher than most carriers are indicating (more like 4-5 points), but there's a big difference between the administration "not enforcing" the penalty and outright repealing it, which NY DFS is talking about.
In any event, this means that NY's requested average increases boiled down to: 15.0% if CSRs are paid/mandate enforced, 16.6% if CSRs aren't paid/mandate is enforced, or a whopping 50.5% if CSRs aren't paid and the mandate was repealed.
This chart sets forth the average premium rate adjustments that health insurers have requested from the New York State Department of Financial Services (DFS). There are 16 insurers that have submitted individual rates and 20 insurers that have submitted small group rates for 2018. These are the rates insurers have requested and are not the final premium rates DFS will approve. Under the Insurance Law, the Superintendent may deny or modify the requested rates if she finds that the insurer's request is unreasonable, excessive, discriminatory or inadequate based on sound actuarial assumptions and methods (Insurance Law §§ 3231(e)(1), 4308(c)). From the date DFS posts insurer rate applications on the DFS website, the public will have 30 days to submit comments to DFS on the proposed rates. The total percentage requested rate increase for individual and for small group on the chart below represent a weighted average that accounts for the relative share of overall enrollment for each insurer.
So, I got back from my trip to the NIHCM awards dinner in DC late last night, and am groggily attempting to bone up on all the healthcare stuff which happened while I was gone (ironic, of course, given that I was attending a healthcare-related event filled with other healthcare wonks/reporters).
There are so many stories I could be writing right now about the fallout, potential fallout, next steps and so forth of yesterday's House vote on the AHCA. But this one in particular really says it all.
Watch: Chris Collins admits he didn't read health care bill
WASHINGTON – Rep. Chris Collins told CNN that he didn't read the entire Republican health care bill that the House passed Thursday.
And then he told The Buffalo News that he was unaware of a key provision in the bill that decimates a health plan that serves 635,000 New Yorkers.
Asked by CNN's Wolf Blitzer if he had read the entire health bill, Collins, R-Clarence, said: "I will fully admit, Wolf, that I did not. But I can also assure you my staff did. We have to rely on our staff. ... I'm very comfortable that we have a solution to the disaster called Obamacare."
I'm actually a bit surprised that NY State of Health is the first state exchange out of the gate with final enrollment numbers, but good for them:
Press Release: NY State of Health Announces Enrollment Surges: More Than 3.6 Million New Yorkers Secure Health Coverage
Feb 1, 2017
Nearly 50,000 sign up during final two days of Open Enrollment
An additional 800,000 New Yorkers enroll through the Marketplace since January 2016
ALBANY, N.Y. (February 1, 2017) -- NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.6 million New Yorkers enrolled in comprehensive health coverage through NY State of Health, a 28 percent increase from 2016.
“New York continues its commitment to bring affordable, comprehensive health coverage to New Yorkers” said NY State of Health Executive Director, Donna Frescatore. “New Yorkers now have access to affordable health insurance coverage, giving hundreds of thousands of previously uninsured individuals economic and healthcare security.”
With the GOP Congress still obsessed with repealing the ACA and Donald Trump doing everything in his power to sabotage the law whether it gets repealed or not, the final 5 days of the 2017 Open Enrollment Period, which would normally see a spike in enrollments regardless, is going into a bit of a panic mode. Trump and his Republican cohorts are doing whatever he can to discourage people from enrolling before the deadline, while the insurance carriers, healthcare advocates and everyone else is doing whatever they can to encourage it.
New York State of Health, the NY ACA exchange, just announced that with the 1/31 final deadline rapidly approaching next Tuesday, they're extending their customer service hours on Saturday and Sunday.
Back in mid-December, just about all of the ACA exchanges bumped out their enrollment deadlines for January 1st coverage by a few days. I was mildly surprised because improvements in the bandwidth, coding, layout and support staffing have meant a smoother process towards the big last-minute surge. Still, I wasn't blown away by the development or anything, as mid-December has always seen a massive spike in enrollment.
New Yorkers Now Have Until January 18 to Enroll in or Renew Health Insurance Coverage Beginning February 1
Consumer Demand Remains High Prompting Deadline Extension
ALBANY, N.Y. (January 12, 2017) – NY State of Health, the state's official health plan Marketplace today announced that consumers now have three additional days to enroll in a health plan with coverage starting February 1. The deadline has been extended through 11:59 p.m., January 18. The previous deadline was January 15.
22 Percent Increase Over Last Year • New Yorkers Show Demand for Quality, Affordable Healthcare
ALBANY, N.Y. (January 6, 2017) – NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.4 million people have enrolled in health insurance through December 24, 2016.
With almost a month to go until the end of the 2017 Open Enrollment period, participation in the NY State of Health Marketplace has already increased more than 22 percent since the last Open Enrollment period ended, January 31, 2016. Enrollment has increased in all 62 counties of the state. The overall share of New Yorkers now enrolled through the NY State of Health has reached nearly 18 percent of the state’s population.
Over 2.7 Million New Yorkers Would Lose Coverage Estimated State Budget Impact of $3.7 Billion
Counties Across New York Would Lose Over $595 Million in Direct Spending
New York Residents Would Lose $250 Million in Health Care Savings Tax Credits
New York is a little different: For one thing, they haven’t actually released any 2017 Open Enrollment data yet (other than a cryptic “55K enrolled over a 3-day period", which isn't very useful). They should be up to around 200K w/out auto-renewals by now. More significantly, they're one of only 2 states (Minnesota's the other) which features the ACA's Basic Health Plan. Unlike QHPs, which are divided into subsidized and unsubsidized enrollees, the BHP program is entirely dependent on ACA financing, so if the law is repealed, all BHP enrollees are kicked to the curb, just like Medicaid expansion enrollees would be.
Oof. I've been compiling a lot of charts and graphs the past week or so based on what I thought were the most comprehensive 2017 enrollment numbers available to date. The biggest data gaps are Vermont and New York, neither of which has released any enrollment data yet...or so I thought.
In the past three days, more than 55,000 New Yorkers have enrolled or renewed coverage through NY State of Health. The Customer Service Center has answered more than 1,000,000 calls since the start of Open Enrollment on November 1 and an average of 46,000 calls a day this week. The NY State of Health website has also experienced high traffic reaching 12,000 users in peak hours.
...This is also the first time this enrollment period that NYSoH has released any actual enrollment data: 55,000 renewals + new signups. Unfortunately, that number only includes 12/12 - 12/14...no earlier numbers are included. Still, I'll take what I can get...
NY State of Health Deadline Extended! New Yorkers Now Have Until December 17 to Enroll in or Renew Health Insurance Coverage Beginning January 1, 2017
High Enrollment Activity Prompts Deadline Extension
ALBANY, N.Y. (December 15, 2016) - NY State of Health, the state’s official health plan Marketplace today announced that the deadline to enroll or renew coverage for a health plan effective January 1 has been extended through December 17. The previous deadline was December 15. Consumers have two additional days to enroll in a plan with coverage starting January 1.
“NY State of Health is having the busiest open enrollment period yet and we want consumers to have a little more time to select a health plan for January 1, 2017.” said NY State of Health Executive Director, Donna Frescatore.