Oregon

Also hot off the presses, Nick Budnick at the Oregonian reports that OR is the first state to approve final 2016 individual market policy rates. Since Oregon is not allowing "transitional" policies for 2016 (they gave a 1 year extension vs. the 2-3 that some states allowed), this should apply to all individual policies state-wide (as well as small group policies):

More than 220,000 Oregonians who buy their own health insurance will face higher premiums next year, and Portlanders could see some of the biggest hikes in the country.

State regulators have announced the 2016 rates for people who aren't covered by their employers or government programs.

The overall news is not good for consumers. Some insurers had asked the state to approve rates similar to last year's lowest. But many insurers lost money from unexpectedly high costs, so officials proposed raising many rates in preliminary decisions two weeks ago. The final decisions issued Wednesday resulted in a slightly better range of options for consumer.

Way back on April 30th I posted the first in a series of 2016 rate change request entries for Oregon. At the time, the initial news didn't look very good, with the weighted (by market share) average increase looking to be around 23%.

At the time, and since then, I've posted a whole bunch of stuff regarding the importance of keeping calm about these initial rate requests for a variety of reasons. One of those reasons is that none of the initial requests had actually been approved yet. Last year, many large rate increase requests were denied nationally, with only more modest increases being approved by state regulators, and the same is likely to happen in many cases this year.

THIS REMAINS LIKELY TO BE THE CASE OVERALL. However, there's another possibility which, while I always knew was possible, I wasn't aware of actually having happened until today:

OK, I admit this caught me by surprise; last year the first following-year rate increase requests didn't start popping up in the major media until late May (or perhaps they did but I didn't happen to notice until then). My first entry on the subject wasn't until May 17, 2014.

This year, the first state out of the gate with the proposed rate changes is Oregon. There's a reason why I'm emphasizing "requested" and "proposed" here...because it's very important for people to understand that in most states, anyway, the state insurance commissioner can veto rate increases which are out of line. An insurance company can ask for a 10,000% increase...that doesn't mean they're gonna get it.

For instance, last summer the insurance companies in Rhode Island asked for an average rate increase of 8.9%...but only ended up getting 4.5% approved.

OK, this was an unexpected update:

Here's which health insurers lost or gained market share in Oregon this year

The numbers are in: It appears that Oregon consumers were fairly price sensitive when it came to choosing health plans this year.

LifeWise had the lowest rates, at $222 a month for a 40-year-old Portlander on a silver plan. Probably not coincidentally, it more than doubled its individual membership in plans that comply with Affordable Care Act guidelines.

As of March 31, LifeWise has nearly 37,000 members in ACA-compliant plans, up from 4,735 last year, according to the Oregon Insurance Division.

The article goes on to tally every single one of Oregon's individual policy QHP enrollees. The bad news is that they don't break them out by exchange vs. off-exchange. The good news is that they specifically clarify that these are all ACA compliant policies (ie, no "grandfathered" or "transitional" numbers included):

Since the 2015 Open Enrollment Period began, in addition to the weekly HC.gov "snapshot" reports which gave state-by-state breakouts of exchange-based private policy enrollments, the Oregon Insurance Division has also been tracking and reporting the number at their site...along with off-exchange (direct) QHP policies. As the only state reporting the off-exchange data on a regular basis, OR has become the only hard source I have for this number (other states like Washington, Florida and Louisiana report off-exchange data as well, but only on a quarterly or annual basis).

Their exchange-based data has always lagged slightly behind the HC.gov number, partly because the thru-dates don't match up and partly because at least one of the insurance companies in Oregon only reports paid enrollments instead of plans selected. Still, with the final week or two of HC.gov data missing at the moment, this is a handy estimate of how things played out in the final "overtime" enrollment week:

Members enrolled,
Nov. 15-Feb. 22
On Healthcare.gov 113,219
Outside of Healthcare.gov 102,232

Total 215,451​

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.

As noted earlier, there's a lag between the exchange-based QHP data from HC.gov vs. the Oregon Insurance Division, so you can ignore that number. However, the off-exchange number should be accurate (and this is the official source for it anyway):

Members enrolled,
Nov. 15-Feb. 1
On Healthcare.gov 86,606
Outside of Healthcare.gov 95,859
Total 182,465

Last week the off-exchange total was 92,872, so that's about a 3,000 enrollee increase, for whatever that's worth.

According to the HC.gov weekly snapshot report, as of 2 days earlier (1/30), Oregon's exchange-based total was 94,126...slightly less than the off-exchange number. It'll be interesting to see if that ratio holds steady next week after the final deadline surge goes through.

As I noted a week or so ago, there's a slight discrepancy between Healthcare.Gov's ON-exchange QHP tally for Oregon (currently 92,059 as of 1/23) and the state insurance division's record (85,912 through 1/25). This turns out to be due to a combination of lag time between HC.gov recording new enrollments & the state insurance dept. receiving them, plus the fact that one of the companies is only reporting paid enrollees, not total, which skews the numbers. As such, I'm using HC.gov's data for the on-exchange QHPs.

However, for off-exchange QHPs, the only source is the Oregon Dept. of Insurance, and this has gone up a couple thousand people over the past week or so:

The Insurance Division will collect enrollment information from carriers each week throughout 2015 open enrollment. Updated numbers will be posted each week on this web page.

Members enrolled,
Nov. 15-Jan. 25
On Healthcare.gov 85,912
Outside of Healthcare.gov 92,872
Total 178,784

A few days ago, I posted an article over at healthinsurance.org which delved into the mysterious world of OFF-exchange QHPs...ie, people who just enroll in a private, individual/family healthcare policy the old-fashioned way, by contacting Blue Cross, Aetna, UnitedHealthCare or whoever directly instead of going through one of the ACA exchange websites.

I also posted an accompanying piece here which noted how hard it is to lock down these enrollment numbers, since the carriers aren't generally required to provide that information publicly except in a general sort of way (and even then, usually only once a year or so). Only Oregon and Washington State really post off-exchange data with any sort of frequency, and only Oregon is doing so weekly.

Updating Oregon's QHP total does nothing to change the overall tally this year because they're operating on HC.gov now. It is useful to keep a running total on the state, however. In addition, Oregon is the only state (so far) providing hard numbers for off-exchange QHP enrollments.

Members enrolled, Nov. 15-Jan. 4

  • On Healthcare.gov 81,037
  • Outside of Healthcare.gov 62,678
  • Total 143,715

About the data: Enrolled means a person has selected a plan. Consumers must pay the first month's premium for their coverage to become effective. These numbers do not identify whether the first month's premium has been paid. These numbers do not include Oregonians enrolled in the Oregon Health Plan (Medicaid).

Pages