Rhode Island

Oof. Regular readers know that I've compiled plenty of evidence showing that while the 39 states run through the federal exchange (HC.gov) showed a ~5% enrollment drop this year, the state exchanges have been showing an overall net increase of roughly 2% over 2016. Rhode Island, however, is the odd man out on this front, as shown in this email I just received (not up on their website yet):

Despite facing a unique set of challenges this open enrollment, 29,420 individuals selected 2017 coverage through HealthSource RI during open enrollment period (November 1, 2016 – January 31, 2017). As of January 31, 27,395 of those individuals paid, and are therefore confirmed, in 2017 coverage. We do anticipate these number will change as payments are made through the February 23 payment deadline and also as HealthSource RI remedies account issues incurred during the open enrollment period. It is difficult to point to one clear cause for this year-over-year drop in enrollment, but we believe several factors might have played a role:

1. System and service issues

As i noted last week, with all renewing enrollees accounted for, Rhode Island's ACA exchange is likely to come up short not only of my pre-election projection (40,000 enrollees), but will likely see a drop from last year's 34,670 QHP selections. They had only hit 29,312 QHPs as of Christmas Eve, and have only tacked on another 580 people since then:

INDIVIDUAL AND FAMILY ENROLLMENT • As of December 31, 2016

Rhode Island is one of three states (along with Washington and Massachusetts) which allowed people to enroll for January coverage as late as December 23rd. RI's numbers have also included auto-renewals for some time now, so today's report includes everyone whose 2017 policies will kick off effective this Sunday, January 1st:

INDIVIDUAL AND FAMILY ENROLLMENT  •  As of December 24, 2016

Last week, the Rhode Island exchange reported 27,555 QHP enrollees as of 12/10, a tiny increase over the prior week mainly due to auto-renewed enrollees dropping out, cancelling out most of the increase.

Rhode Island is one of 3 states which are still taking enrollments for January, but they've released another report (thorugh 12/17) which brings the tally up to 

INDIVIDUAL AND FAMILY ENROLLMENT As of December 17, 2016

Huh. Rhode Island didn't post any updates at all for the first 5 weeks of OE4, but has now posted weekly updates back to back:

INDIVIDUAL AND FAMILY ENROLLMENT As of December 10, 2016

I've been posting so many stories about the ugly implications of the ACA being repealed that it's kind of nice to get back to actually reporting on the number of people enrolling for ACA coverage again (hey, it's right there in the title of this site and everything...)

Rhode Island, which issued regular weekly enrollment reports last year, has been unusually silent so far this year...until today:

HealthSource RI (HSRI) has released certain enrollment, demographic and volume data through Saturday, December 3, 2016 for Open Enrollment.

INDIVIDUAL/FAMILY ENROLLMENT
As of December 3, 2016

Rhode Island, in addition to being one of the smallest states, is also one of the first states I crunched the rate hike numbers for back in late May. It was actually pretty easy to run a weighted average hike request since there are only 2 carriers even operating on the individual market next year: Blue Cross Blue Shield of RI and Neighborhood Health Plan (UnitedHealthcare is dropping out of the RI indy market entirely, but only has about 1,400 people enrolled to begin with).

Anyway, BCBS was asking for a 9% increase, while Neighborhood is among the very few carriers to actually request a rate decrease...of around 5%. As a result, Rhode Island has the honor of having the lowest average rate hike request of all 50 states (+DC) next year...a mere 3.6% overall, which is awesome.

Well, nearly 3 months later, the RI Insurance Commissioner has weighed in with even more good news: Rates will be going up even less than that in 2017:

This year only 3 insurance carriers are offering policies on the individual market in Rhode Island: Blue Cross Blue Shield, Neighborhood Health Plan and UnitedHealthcare. The bad news is that United is pulling out of RI, although they only hold about 4% of the on-exchange market anyway. The rest of the on-exchange market is split almost evenly between BCBS and Neighborhood.

Both Neighborhood Health Plan and BCBS have submitted their filings, and there's some great (and surprising, for this year) news:

Carriers file two average rate increase amounts with OHIC: the EHB base rate increase and the weighted average rate increase. These two percentages reflect different calculations.

Again, Rhode Island is the only state to continue with regular, weekly exchange enrollment reports during the off season. I would love it if every exchange did this:

INDIVIDUAL AND FAMILY ENROLLMENT • As of February 20, 2016:

  • 36,004 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.
  • The majority of these individuals are 2015 HSRI enrollees that were auto-renewed into a 2016 plan.
  • 8,657 of the 36,004 individuals have selected a plan for 2016 coverage, and are new to HSRI this year or returning after being enrolled with HSRI at some point during a prior year.
  • 33,920* of the 36,004 individuals are enrolled in 2016 coverage through HSRI, and have paid their first month’s premium.

*The number of paid enrollments is expected to increase as payments for March coverage are made by today’s deadline and processed over the next several days.

Last week I noted that the Rhode Island ACA exchange has become my newest BFF: They've decided to continue posting weekly enrollment reports even during the off-season!

Better yet, they're also making sure to include both the gross enrollment and net effectuated enrollment numbers. If every state exchange (and especially HealthCare.Gov, of course) were to do this, I'd be a very happy man indeed. In the meantime, I'll have to settle for RI's regular updates, although extrapolating anything nationally from a single state with just over 1 million people is a bit tricky.

Anyway, last week they reported (thru 2/06):

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