Washington State

Yesterday New York was the first state exchange to report their final OE4 enrollment tally; it was a bit mixed, with QHP selections 29,000 (10.7%) lower than last year...but BHPs increasing by a whopping 286,000 (75.3%) year over year, for a net combined gain of over 256,000 people.

Today, the Washington State exchange chimes in, and their numbers are impressive: Over 225,000 QHP selections.

More than 225,000 people used Washington Healthplanfinder to select Qualified Health Plans – a 13% increase over last year’s total.

The ASPE report for OE3 showed WA's official 2016 tally at 200,691, so 225K would actually only be 12.1% higher, but the press release says it's 13%, so either they're basing it on a slightly lower unofficial 2016 tally, or "over 225K" actually means closer to 226,000.

From a last-minute press release:

The Washington Health Benefit Exchange is alerting customers that tomorrow, Jan. 31 is the deadline to sign up for 2017 health and dental coverage through Washington Healthplanfinder.

Individuals and families have until 11:59 p.m. tomorrow to select a plan that is good for the remainder of the year. Residents who fail to secure coverage by the deadline could be required to wait until the following year to sign up for health and dental coverage.

This isn't a particularly dramatic update given that CMS released their "mid-season" report yesterday, which already updated Washington's tally from 180K thru 12/20 to 194K as of 12/24...but an update's an update:

The Washington Health Benefit Exchange today announced that more than 200,000 customers have selected 2017 health and dental coverage through Washington Healthplanfinder since the open enrollment period began on Nov. 1 – an increase of almost 14 percent over the same point last year.

Hmmmm...the numbers look good, but that "...and dental" caveat is a bit troubling. I've asked for clarification; it's possible that the "dental" reference simply refers to the fact that some Qualified Health Plans also include dental coverage, as opposed to referring to standalone dental plans, which shouldn't be counted as QHPs.

A few days ago, the Washington State exchange posted their first official enrollment report: 161,381 QHP selections as of 12/13.

Today, as part of a deadline reminder press release (WA is among 3 states which are still letting people sign up for January coverage as late as midnight Friday), they gave a rough update:

The Washington Health Benefit Exchange today is warning customers without 2017 coverage that this Friday, Dec. 23 at 11:59 p.m. is the deadline to sign up for health and dental plans through Washington Healthplanfinder that begin on Jan. 1.

In yesterday's state-by-state roundup, I noted that there are 4 states where I didn't have any enrollment data whatsoever yet (ID, NY, VT & WA), plus only very limited numbers out of DC. Today, the Washington HealthPlanFinder scratched one of those off the list by providing the following update:

Since the start of open enrollment on Nov. 1, more than 160,000 individuals and families have already signed up for Qualified Health Plans (QHP) through Washington Healthplanfinder. The updated total reflects an increase of more than 20,000 QHP selections over the same point in the open enrollment period last year. In addition to 2017 QHP selections, more than 22,000 Washingtonians have signed up for Qualified Dental Plans (QDP) that are now offered through Washington Healthplanfinder.

The Washington HealthplanFinder just released a comprehensive report detailing their 2016 exchange enrollment status. It's important to keep in mind this has little to do with the ongoing 2017 open enrollment period we're in the middle of:

Total effectuated QHP enrollment as of September 2016: 166,098 people...or about 5% higher than they had in March, according to the official CMS report. This is unusual; almost every other state has seen a substantial drop-off in effectuated enrollment. The only other state which constantly increases effectuations during the off-season is Massachusetts, and that's mainly because they have special "ConnectorCare" policies which are available year-round to anyone. On the other hand, according to the WA exchange report, there has been a slight net drop since March...of around 4.5% (see 2nd slide below). Not sure what to make of that. Either way, however, the point is that attrition is unusually low compared to other states.

As noted before, I'm really trying to move onto the actual enrollment part of the 2017 open enrollment period, but I can't resist doing some more final cleanup of my Rate Hike project:

  • SOUTH CAROLINA: This is one of the 5 states which I still didn't have approved rate changes for. Today the RateReview.HC.gov site finally added in the final numbers for SC, so here's what it looks like:

Aetna was a bit tricky--the total enrollee number is actually 41,988. They dropped out of the ACA exchange but are sticking around the off-exchange market, so I had to figure out how many of those 42K are on vs. off-exchange. The answer is in this article which notes:

More than 220,000 South Carolinians rely on the federal health care law for insurance. This year, only 8,000 of them are covered by Aetna plans.

A week or so ago, the Washington Insurance Commissioner announced that the weighted average rate hike for 46 plans certified by the state insurance dept. regulators is 13.1%. However, there was a major caveat: There were another 52 plans which still had to be certified by the board. Without knowing the average rate hike for the other half of the plans, there's no way of knowing what the final approved average increase will be.

In addition, I also don't know what the relative market share of any of the plans (certified vs. uncertified) is, so there's no way of weighting the average across the full market. For all I know, 90% of enrollees might be among the first 46 (in which case any variances mong the other 52 plans would barely move the needle). Alternately, 90% could be among the missing 52 plans, or anywhere in between.

WIth that in mind, here's a press release from the WA exchange yesterday:

The Washington Insurance Commissioner just issued the following press release. On the surface, it looks straightforward: 13.5% avg. requested, 13.1% approved. However, it's more complicated than that, because that 13.1% figure only applies to fewer than half of the plans (46 out of 98). The other 52 are still being reviewed:

OLYMPIA, Wash. – The Office of the Insurance Commissioner (OIC) has approved 46 individual health plans from seven insurers who will offer them in the Exchange, Wahealthplanfinder (www.wahealthplanfinder.org), for sale in 2017. The Washington Health Benefit Exchange Board is scheduled to certify the approved insurers and their plans at its board meeting later today.  

Regence Blueshield also filed 21 plans for sale in the Exchange and Bridgespan filed 31 plans. Both companies’ filings and rates are still under review. They must be approved by the OIC before they can be considered for certification by the Exchange.

Now that the official ASPE Q1 2016 Effectuated Enrollment report is out, I can compare various state exchange reports against that to see how they're doing. In Washington State, 158,245 people were reported as being enrolled in active, effectuated exchange policies as of 3/31/16.

The WA HealthplanFinder has issued their July dashboard report, and their off-season retention numbers look pretty good: 168,958 people had paid their monthly premiums as of June...a 6.8% increase over the March figure. Even if this is off slightly due to methodology differences, it's still a good thing to see exchange enrollment up from earlier in the year, since overall enrollment is down at least 12.6% since the end of open enrollment due to non-payments, legal issues and so on.

Just yesterday I posted the Washington Healthplanfinder's latest monthly report, which showed either 177,613, 170,267 or 167,827 people currently enrolled in exchange QHPs statewide, depending on whether you go by the number who have "selected plans", the number that the carriers have reported as being paid up or the number who the exchange has recorded as having paid.

The first number has been pretty confusing to me over the past few months, because the actual number of people who selected QHPs during the 2016 open enrollment period was reported as just over 200,000 by both the exchange itself as well as in the official national ASPE report, so I wasn't quite sure whether to report the net effectuated enrollment drop since then as being almost none at all or around 15%. I finally went with the 15% figure because dividing into the 177K number just didn't make sense by any other measure.

Last month I noted that the Washington Healthplanfinder was reporting currently effectuated QHP enrollment at 170,527 as of the end of March, a 15.0% drop from the official number of QHP selections during the 2016 Open Enrollment Period. I also noted that due to some confusion about how the numbers are reported by the exchange, it could also be argued that WA has seen just a 6.6% net drop, depending on how you look at it.

However, since 200,691 is the official number included in the ASPE report, I'm finally letting that one go...and actually, that's OK, because a 15% drop by 3/31 is fairly close to what I would expect anyway (a bit higher than the 13% national drop from last year, but not out of line).

Anyway, the WA exchange just released their May report (with data through the end of April), and it's actually pretty good--there's only been a very slight net drop since March, for an overall drop of just 15.2% from the 200K figure:

A few days ago, I noted that Premera Blue Cross was asking for a 19.6% average rate hike for ACA-compliant individual policies in Washington State, while also pulling out of several WA counties entirely.

Today, the Washington Insurance Commissioner issued a press release with the full, weighted average rate hike requests for the individual market (including both on and off-exchange carriers):

13 health insurers file 154 plans for 2017 - 13.5 average requested rate change • May 16, 2016

OLYMPIA, Wash.– Thirteen health insurers have filed 154 individual health plans for 2017 both inside and outside of the Exchange, Washington Healthplanfinder. The average requested rate change based on enrollment is 13.5 percent.

This year, Washington State has a total of 16 carriers offering policies on the individual market: 13 via the ACA exchange, plus another 3 selling off-exchange only (one of them, Regence Blue Shield, seems to be selling both on and off exchange, but I might be misunderstanding something there):

2016 insurers with plans approved to be certified by the Exchange, Wahealthplanfinder:

  • Bridgespan Health Company
  • Columbia United Providers
  • Coordinated Care Corporation
  • Community Health Plan of Washington
  • Group Health Cooperative
  • Health Alliance Northwest Health Plan, Inc.
  • Kaiser Foundation Health Plan of the Northwest
  • LifeWise Health Plan of Washington
  • Moda Health Plan, Inc.
  • Molina Healthcare of Washington, Inc.
  • Premera Blue Cross
  • Regence BlueShield
  • United Healthcare of Washington, Inc.

Off-exchange only (?):

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