Virginia

As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.

My standard methodology applies:

As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.

My standard methodology applies:

(sigh) OK, with three states still missing, you just knew I wouldn't rest until I was able to fill in the missing pieces of the puzzle. Sometime today, the HHS Dept. finally entered the approved rate hikes for individual makret carriers in two of those states: New Hampshire and Virginia. Louisiana is still AWOL for whatever reason.

It's important to note that sometimes the "Final Rate Increase" percentages listed at RateReview.HealthCare.Gov dont' actually end up matching the approved rate hikes found in the official SERFF databases or even at the state's Dept. of Insurance website. Normally I cross-check all three to make sure nothing weird is going on, but given that it's well past time to move on, I'm relying purely on the RateReview numbers for these states.

With that in mind, here's what it looks like in each:

Virginia was the very first state which I ran an estimated 2017 average requested rate hike for, way back in mid-April.

Since then, aside from Humana pulling out (leaving just 1,800 current enrollees to find a new policy), Virginia's ACA exchange market has actually been remarkably calm; the state somehow managed to escape the wrath of both UnitedHealthcare and Aetna relatively intact, with both carriers still participating in the state's exchange next year as of this writing.

There have, however, been a few other changes to some of the rate filings here and there, found via this updated PDF on the VA DOI website as of July 19th. The overall average requested hikes don't really change much, but do nudge a bit higher than I had previously estimated, from 17.5% to 18.4%:

This is really just a summary of my last 4 posts. I've combed through the SERFF databases for every state which uses the system for rate filings, and while very few have the actual 2017 rate filing requests listed yet, at least 4 of them have official individual market exit letters submitted for 2017 from Jane Rouse, the Product Compliance Process Owner for Humana Insurance Co:

This list may grow as additional state filing data and/or press releases come out from Humana, but assuming these are the only 4 states Humana is bailing on, the news isn't quite as bad as it appears at first.

To keep things in perspective, add the 4 numbers above up and it's 25,512 people across 4 states with a combined population of 21.8 million. Put another way, these 25.5K people represent only 2.9% of the 875,700 people Humana currently has enrolled in individual policies (both on & off exchange) nationally.

To be clear, I'm not saying this is a good development; when you combine it with the recent UnitedHealthcare Dropout Odometer it's more of a drip-drip-drip sort of thing. But it isn't disasterous for the exchanges either (at least not yet).

UPDATE: I've been informed by a reliable source that Humana is also dropping out of the individual market in Nevada next year, although I don't have any actual enrollment data there. Humana is not currently participating on the Nevada exchange, however, so any dropped enrollments would be OFF-exchange only. In fact, I'm pretty sure that the only individual market enrollees Humana has in Nevada are grandfathered policies anyway, so the numbers should be pretty nominal there.

I already noted last month that Humana is dropping out of Virginia's individual market next year, but since I'm in a "Humana pulling out!" mode this morning, I might as well post their official exit notice for completeness. Thankfully, the impact is nominal in Virginia, as only 1,800 people are being impacted total.

It's also worth noting that "grandfathered" enrollees only make up around 11% of Humana's total Virginia individual market as of this spring, which is somewhat higher than my overall ballpark estimate of around 1 million nationally.

 

So, yesterday I posted my first 2017 Weighted Average Rate Hike entry, using Virginia, since they appear to be the first state to post their requested rate changes for 2017.

As you can see, while the requested rate increases stayed consistent throughout the various updates, the number of enrollees changed dramatically depending on which filing source I used. Case in point: Anthem/HealthKeepers Inc.

The first filing I found for Anthem HealthKeepers made it pretty clear that they're asking for a 15.8% average rate hike next year which is expected to potentially impact up to 122,581 policy holders:

Pretty cut & dry, right? Note that according to the filing that number covers current Anthem HealthKeepers enrollees both on and off the exchange, so it should cover all ACA-compliant policies.

In light of today's confirmation that the average 2016 premium rate increase ended up only being appx. 8% nationally on the individual market (as opposed to the headlines screaming about 40%, 50%, 60%+ rate hikes being "typical"), I've decided to get a jump on the 2017 rate changes. Someone gave me a heads up that Virginia appears to be first out of the gate this year, with requested 2017 rate filings having already been submitted by at least 8 carriers.

Now, for 2016 there are actually 13 carriers offering individual policies in Virginia (although some of these are available off-exchange only). I'm don't know if the 5 missing carriers have decided to drop out of the VA market or if they simply haven't submitted their 2017 filings yet (it looks like in Virginia the carriers technically have until July 15th to get their requests to the HHS Dept. in states which have their own rate review process, but the state itself presumably has an earlier deadline). It's also possible that some additional carriers might join the exchange and/or start offering policies in the state which don't this year.

In any event, here's what I've found so far for Virginia:

Some relatively welcome news going into the home stretch: After a series of ugly (over 20%) rate hike averages from Alabama, Delaware, South Dakota and especially Minnesota, I've just completed the Virginia analysis:

Unlike many other states, there's no guesswork or educated guesses here; the Virginia Dept. of Insurance SERFF filings are quite complete and straightforward, so I have every company providing individual and/or sm. group coverage listed, both on and off the exchange, with the exact average rate changes and affected enrollee numbers for pratically every one of them.

The only exceptions are Piedmont Community Healthcare HMO, whose SERFF filings, oddly, included the enrollee count but not the rate change (usually it's the other way around). In addition, there's a couple of new additions to each (UHC of Mid-Atlantic on the indy market, Federated Mutual on the sm. group market). However, none of these have large enough enrollment numbers to amount to more than a rounding error in either category.

Throughout the long, tortured life of the Affordable Care Act over the past 5+ years, one of the easiest attack points has been to go after the sheer bulk and complexity of the law itself. Whether you're referring to the actual wording of the law (supposedly a whopping 2,700 pages long) or, even worse, the 8-foot tall stack of 10,000 - 20,000 pages of regulations related to "Obamacare", Republican politicians, pundits and talk show hosts have used the immense size of the ACA itself to go after it.

I'm bringing this up now because my big project the past week or two has been to track down the various 2016 policy premium rate change requests for the companies operating both on and off the ACA exchanges in all 50 states (+DC, of course).

So far I've done a pretty good job with OR, WA, CT, MI, DC and VT...and I have partial data for MD & IA.

COLORADO: Exchange COO joins exodus, new system late

Colorado’s 2.0 “Kentucky-style” system that is supposed to simplify the way people get health insurance won’t be ready until days before the Nov. 15 open enrollment starts.

And as Colorado’s health exchange enters its busy season, a third “chief” has announced she’s leaving Connect for Health Colorado. Chief Executive Patty Fontneau departed in August. Chief Financial Officer Cammie Blais left two weeks ago. And Chief Operating Officer Lindy Hinman announced her resignation and plans to leave next month after open enrollment begins.

VIRGINIA: Funds to help Va. health care coverage signups

Virginia is getting $9.3 million in federal funding to help residents sign up for health insurance.

Gov. Terry McAuliffe said the money will help hire more than 100 people to help with enrollment that runs from Nov. 15 through Feb. 15.

Oy gevalt. I made a big stink about this bizarro story when it broke back in June, so it behooves me to post a follow-up now when it appears that at least one Democrat in Virginia (well, besides the "Democrat" who was the subject of the original bribe offer) was basically guilty of the same thing that the state Republicans were:

RICHMOND — Virginia Gov. Terry McAuliffe’s top lieutenant apologized Friday after admitting that he had tried to keep a Democrat from quitting the evenly divided state Senate with the prospect of a lucrative state job for the senator’s daughter.

But it was not entirely clear to Richmond’s increasingly bewildered and antsy political class just what Chief of Staff Paul Reagan had done.

Last week I noted that the "OMG!! GAZILLIONS OF POLICIES CANCELLED!!!" freakout over non-ACA compliant healthcare policies being sunsetted to be replaced by policies which are compliant with the law is about to raise its ugly head again this fall. Sure enough, we're off and running in Virginia:

After a year’s reprieve, up to 250,000 Virginians will receive notice by the end of November that their health insurance plans will be canceled because the plans do not comply with the Affordable Care Act and accompanying state law.

The affected policyholders were allowed to renew their old plans late last year, even though the plans did not provide all of the benefits required under the health care law, but they won’t have that option when the policies expire this year.

I went with 240K instead of 250K because later in the article it says:

Between my son being sick for the past 4 days (he's better now, thanks!), losing my internet connection for 2 days (it's back up now, thanks!) and just generally being swamped with work, I don't have time to give these stories the attention they deserve, but they're all worth checking out:

McAuliffe unveils 10-step plan to expand health coverage for Virginians

Beyond that [the 25,000 people being added to Medicaid], the strategy seeks to chip away at the ranks of the uninsured, by enrolling them in programs they already qualify but haven't signed up for. The state will launch a website to help Virginians enroll in health care coverage through existing programs such as Medicaid and will step up efforts to sign up more Virginians for the federal health insurance exchange, HealthCare.gov.

Bill Straub: Kentucky GOP’s rendition of ‘I’m Against It’ may hit sour note on health care

The Republicans controlling the Virginia state legislature have been fighting tooth & nail to prevent 400,000 of their fellow Virginians from receiving healthcare, but Democratic Governor Terry McAuliffe has finally found a way to squeeze 25,000 people onto Medicaid anyway by reshuffling the deck of existing executive regulatory rules:

RICHMOND — Gov. Terry McAuliffe (D) on Monday unveiled a plan to insure an additional 25,000 Virginians, a measure that falls far short of his vow to defy the Republican-controlled legislature and find a way to expand coverage to 400,000.

After losing a months-long Medicaid fight in June, McAuliffe declared that he would close the “coverage gap” on his own.

On Monday, he announced a much more modest series of proposals, primarily designed to improve care for people already in Medicaid and boost outreach efforts to people who already qualify for it, but are not enrolled.

The plan would change enrollment criteria for about 25,000 people, including 20,000 who are severely mentally ill and 5,000 children of state employees.

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