OE7

When I ran the preliminary 2020 average unsubsidized premium rate change requests for Illinois in early August, I was frustrated because I had no idea what the actual enrollment numbers for the individual carriers were, making it impossible to run a weighted average change. I had to go with an unweighted average increase of 1.4% statewide.

Fortunately, since then, not only have the final rate changes been approved and posted, I've also acquired the enrollment data, allowing for a weighted average. In the end, average unsubsidized premiums are dropping ever so slightly (0.3%)...versus going up ever so slightly (0.1%) statewide.

Hawaii only has two carriers participating in the Individual health insurance market. For 2020, they're reducing unsubsidized premiums by 4%. This is a slight reduction from the preliminary unsubsidized rate change requests from back in August.

HMSA's average dropped from a 1.6% reduction to a 3.2% reduction, while Kaiser, which had been asking for a very slight increase, will actually be lowering rates by around 5.4% in 2020.

After several years with four carriers participating in their ACA individual market, the Peach State is gaining not one but two additional carriers this year: CareSource and Oscar are joining Alliant, Ambetter/Centene, Blue Cross Blue Shield and Kaiser.

When I ran the numbers for Georgia's preliminary 2020 unsubsidized premium rate changes back in August, they were averaging a 2.4% increase.

Today, however, CMS has posted the final/approved rate changes, and three of the four carriers already on the Georgia market (Alliant, Ambetter/Centene and Kaiser) are looking at slightly lower rates than they had requested. The fourth, Blue Cross Blue Shield, is bumping up their rates by an additional percentage point. Overall, Georgia carriers are dropping unsubsidized premiums by 0.9%.

When I ran the preliminary 2020 rate changes for unsubsidized ACA policies in Alaska back in August, it was pretty easy to do...there's only a single carrier offering ACA-compliant individual market policies for 2019, which means no weighting is required. Furthermore, Premera Blue Cross Blue Shield is basically keeping their rates flat for 2020 anyway.

Moda is re-entering the market for 2020, but there's no "rate change" for them since there's no base premiums to measure against year over year.

Anyway, CMS just posted the final, approved rate changes, and Premera's number is ever so slightly higher than it was: They went from a 0.05% reduction to...a 0.03% reduction.

When I first ran the preliminary 2020 ACA premium rate filing requests for Alabama in August, I came up with a weighted average increase of 3.9%.

CMS has just posted the final, approved rates for Alabama's 2 carriers (Blue Cross Blue Shield and Bright Health). Both carriers had their requested rate hikes approved without any changes, but the final weighted average for unsubsidized enrollees still dropped a bit to 3.3%...because I had the wrong market share ratios. It looks like Bright has an even smaller share of the market than I thought (less than 1%), bringing the weighted average down a bit.

I talked about this the other day, but re-reading my post, I don't think I emphasized it nearly enough:

It's also important to keep in mind that due to how the ACA's subsidy formula is structured (combined with Silver Loading and Silver Switching), a lower benchmark premium will actually result in higher net premiums for many subsidized enrollees (although it's still good news for those who are unsubsidized). Here's why:

  • Let's say the unsubsidized premiums for a given enrollee in 2019 is $400 for Bronze, $600 for the benchmark Silver and $700 for Gold.
  • Let's say that enrollee earns exactly $32K/year (256% FPL), meaning they only have to pay 8.54% of their income for the benchmark plan.
  • That means they qualify for ($7,200 - $2,733) = $4,467 in subsidies ($372/month).

This would leave them paying $228/month for the benchmark Silver...but they can apply that towards a Bronze plan if they wish so they'd only pay $28/month, or a Gold plan so they only pay $328/month.

A week or so ago I  noted that several of the 13 state-based exchanges (remember, Nevada split off of HC.gov this year) had opened up their ACA exchange websites for prospective enrollees to window shop for 2020 coverage. One of them, Covered California, actually started allowing people to enroll already; the rest were for comparison shopping only.

Well, as of today, residents of every state can window shop for 2020 healthcare policies, because HealthCare.Gov has followed suit and is now letting you plug in your household & income info to see what plans are available next year, what the unsubsidized premiums are, and (most importantly for a lot of people) what sort of financial assistance you may be eligible for.

There have been some interesting modifications to the interface and workflow of HC.gov this year:

FEDERAL HEALTH INSURANCE EXCHANGE 2020 OPEN ENROLLMENT 

I've been expecting this exact press release from Trump's HHS Dept. to drop for awhile now:

Premiums for HealthCare.gov Plans are down 4 percent but remain unaffordable to non-subsidized consumers

Today, the Centers for Medicare & Medicaid Services (CMS) announced that the average premium for the second lowest cost silver plan on HealthCare.gov for a 27 year-old will drop by 4 percent for the 2020 coverage year. Additionally, 20 more issuers will participate in states that use the Federal Health Insurance Exchange platform in 2020 bringing the total to 175 issuers compared to 132 in 2018, delivering more choice and competition for consumers. As a result of the Trump Administration’s actions to stabilize the market, Americans will experience lower premiums along with greater choice for the second consecutive year.

Back in early August, I ran the preliminary average unsubsidized 2020 individual market rate changes in Arizona. At the time, I had the requested rate changes for both the individual and small group markets, but not the actual enrollment numbers for each carrier, so I had no way of calculating the weighted average. I instead settled for a simple unweighted average, which came in at around a 2.4% reduction in premiums on the individual market and a 5.2% increase on the small group market.

A few days ago, the Arizona Insurance Dept. released the final/approved 2020 rate changes, and there was only one significant change: Health Net of AZ (dba Arizona Complete Health), which had requested a 2.9% rate reduction, will instead be keeping their premiums flat year over year on average. With Health Net holding over 50% of the market share, this meant that the statewide average is a bit higher than I had it previously.

Back in July, the Pennsylvania Insurance Dept. posted the preliminary/requested 2020 average premium rate changes for the individual and small group markets. The ACA-compliant individual market average increase was around 4.6%; for small businesses, the average was 9.6%.

Today they finally posted the approved rate changes for each...and the indy market average has dropped to a 3.8% increase, while the small group market has gone up just a hair to 9.7%.

I'm not sure how this slipped by me, but in addition to Covered California already having launched their 2020 Open Enrollment Period yesterday, five other state-based ACA exchanges are already partly open as well. That is, you can shop around, compare prices on next year's health insurance policies and check and see what sort of financial assistance you may be eligible for:

I'm not sure when the other 7 state-based exchanges will launch their 2020 window shopping tools, nor do I know when HealthCare.Gov's window shopping will be open for the other 38 states, although I believe they usually do so about a week ahead of the official November 1st Open Enrollment Period launch date.

 As I noted yesterday, while the 2020 Open Enrollment Period doesn't officially start until November 1st across the rest of the country, in California it already started on October 15th, two weeks earlier than everywhere else.

I also noted that there's two important points for CA residents to keep in mind starting this Open Enrollment Period:

  • First: The individual mandate penalty has been reinstated for CA residents. If you don't have qualifying coverage or receive an exemption, you'll have to pay a financial penalty when you file your taxes in 2021, and...
  • Second: California has expanded and enhanced financial subsidies for ACA exchange enrollees:

Until now, only CoveredCA enrollees earning 138-400% of the Federal Poverty Line were eligible for ACA financial assistance. Starting in 2020, however, enrollees earning 400-600% FPL may be eligible as well (around $50K - $75K/year if you're single, or $100K - $150K for a family of four). In addition, those earning 200-400% FPL will see their ACA subsidies enhanced a bit.

While the 2020 Open Enrollment Period doesn't officially start until November 1st across the rest of the country, in California it begins two weeks earlier, for whatever reason:

In most states, open enrollment for 2020 coverage will run from November 1, 2019 to December 15, 2019. But California enacted legislation (A.B.156) in late 2017 that codifies a three-month open enrollment period going forward — California will not be switching to the November 1 – December 15 open enrollment window that other states are using.

Instead, California’s open enrollment period (both on- and off-exchange) will begin each year on October 15, and will continue until January 15. Under the terms of the legislation, coverage purchased between October 15 and December 15 will be effective January 1 of the coming year, while coverage purchased between December 16 and January 15 will be effective February 1.

I posted Wisconsin's preliminary 2020 rate filings in early August. Yesterday the state insurance department posted this press release, which includes the final, approved rate changes. As far as I can tell, nothing has changed (the final statewide weighted average is a 3.2% average premium reduction over last year, thanks primarily to them implementing a fairly robust ACA Section 1332 reinsurance waiver:

​Gov. Evers Announces More Health Insurance Options for Wisconsinites in 2020 Ahead of Open Enrollment

Back in July, the Colorado Insurance Dept. announced the preliminary 2020 avg. premium rate changes for the individual and small group markets, including making the important point that their then-pending Section 1332 Reinsurance Waiver program, if approved, would cut down on unsubsidized premiums by over 18% on average (18.2%, to be precise, according to the CO DOI, although my own analysis based on the preliminary rate filings brought it in at a 17.5% reduction).

Today they announced the final, approved 2020 rate changes...and the average premium is expected to drop even lower yet:

Gov. Polis: 2020 ACA Premiums Going Down by an Average of 20.2%

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