Overall, it looks like Colorado carriers are asking for a weighted average rate increase of 2.2% on the individual market and 5.7% on the small group market. There's some important tables breaking out exactly which carriers are offering their policies in which counties, and they've even broken out the average rate hikes by rating area, which is unusual to see but takes on special significance in Colorado due to thier unusual Section 1332 reinsurance waiver program, which is more robust in some parts of the state than others (I believe most reinsurance programs are pretty much an across-the-board sort of thing, though I could be wrong about that).
Back in March, I launched my own COVID-19 case/fatality tracking spreadsheet project which mostly duplicates any number of existing sites, but with a couple of additional twists:
I've included the estimated total population of every U.S state/territory via Wikipedia (as of July 2019) which allows me to add new columns listing both the confirmed COVID-19 cases and deaths per capita. This gives a much clearer picture of how relatively ugly things have gotten in each state/territory to date.
I've added columns to rank the daily percent increase in both confirmed cases and deaths for each state/territory (on the right side), which is important for tracking the rate of the virus' spread.
I've added the Presidential partisan lean of each state as well as which party holds the governor's seat. This may seem incredibly inappropriate (and it is), but it's sadly necessary because Donald Trump has apparently decided to only grant his favor and any substantial assistance to states which a) voted for him and b) whose governors kiss his ass enough.
I've taken some amount of criticism from people who got the vapors and claimed that I was "politicizing" the pandemic, which is laughable in the Trump era, where everything has been politicized by the Trump Administration.
2021 Requested Commercial Health Insurance Rates Have Been Submitted to OHIC for Review
CRANSTON, R.I. (July 21st, 2020) – The Office of Health Insurance Commissioner (OHIC) today released the individual, small, and large group market premium rates requested by Rhode Island’s insurers. The requests were filed as part of OHIC’s 2020 rate review and approval process (for rates effective in 2021). Tables 1 – 3, below, summarize the insurers’ requests for 2021, and provide the requested and approved rate changes for the previous two years. Two insurers, Blue Cross Blue Shield of Rhode Island (BCBSRI) and Neighborhood Health Plan of Rhode Island (NHPRI) filed plans to be sold on the individual market for persons who do not receive insurance through their employer. In addition to BCBSRI and NHPRI, UnitedHealthcare and Tufts Health Plan filed small group market plans. Five insurers (BCBSRI, UnitedHealthcare, Tufts Health Plan, Aetna, and Cigna) filed large group rates.
ST. PAUL, Minn.—Searching for MNsure on the internet can yield misleading results. If you search for MNsure, you may see ads and websites that appear to be the official MNsure website but are not. Some of these sites collect your contact information and either bombard you with phone calls or try to sell you sub-standard health insurance. Here’s how to be sure you’re working with MNsure and purchasing comprehensive health care coverage:
Those eligible for the urgent need program must:
Check the website URL: make sure you’re clicking on MNsure.org when using a search engine or simply type MNsure.org into your address bar.
July 23, 2020 - Early 2020 Effectuated Enrollment Snapshot
This report provides effectuated enrollment, premium, and advance payments of the premium tax credit (APTC) data for the Federally-facilitated and State-based Exchanges (“the Exchanges”) for February 2020 and for the 2019 plan year.
February 2020 Effectuated Enrollment Snapshot Key Findings
The data below comes from the GitHub data repositories of Johns Hopkins University, execpt for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.
Here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, July 25th (click image for high-res version):
The Connecticut Insurance Department has posted the initial proposed health insurance rate filings for the 2021 individual and small group markets. There are 14 filings made by 10 health insurers for plans that currently cover about 214,600 people.
Important: As noted below, the 214,600 figure is Connecticut's individual & small group market combined.
Two carriers – Anthem and ConnectiCare Benefits Inc. (CBI) – have filed rates for both individual and small group plans that will be marketed through Access Health CT, the state-sponsored health insurance exchange.
The 2021 rate proposals for the individual and small group market are on average slightly lower than last year:
Unfortunately, it looks like only some of the 2021 ACA individual market premium rate filings have been uploaded to the SERFF database as of today, so I'm unable to calculate anything even close to an accurate weighted average. There are, however, several noteworthy items on the TX market:
It's been a solid year since Joe Biden rolled out his own official healthcare policy proposal. I did a fairly in-depth writeup on it last summer, but it's the understatement of the year to say that "a lot has changed since then".
The two most obvious developments on this front are 1. Biden has gone from one candidate of two dozen to being the presumptive Democratic Nominee; and 2. The COVID-19 pandemic has completely upended not only the Presidential race but the economy and the entire U.S. healthcare system. A third important (if less consequential) development is that the House has actually passed their own "ACA 2.0" bill in the form of H.R. 1425, the Affordable Care Enhancement Act, which partially overlaps Biden's healthcare plan.
Tennessee has also posted their preliminary 2021 rate filings for both the individual and small group markets. Aside from being one of the few states where a significant number of carriers are including any COVID-19 pandemic factor at all (in both markets), Tennessee has several new entrants and one significant withdrawl (I think).
On the individual market, UnitedHealthcare is newly entering, while Cigna is expanding their coverage areas as noted here. Cigna is also newly entering Tennessee's small group market, as is Bright Health Insurance.
Overall, Tennessee carriers are asking for a 10.3% increase on the indy market (the second highest so far after New York's 11.7% average), mostly driven by Blue Cross Blue Shield, which holds a whopping 83% of the market. On the small group market, the average increase is 5.5%.
COVID-19 accounts for 1.7 points of the increase on average in the indy market and 2.6 points in the small group market. This, again, is the highest statewide average COVID impact I've seen after New York state so far.
Last year, thanks to the Section 1332 Reinsurance waiver allowed for by the ACA, Montana health insurance carriers reduced their premiums for 2020 by 13.1% on average on the individual market, while raising them by 7% on the small group market (which the reinsurance program doesn't impact).
Between the COVID-19 pandemic and just getting generally swamped, I haven't gotten around to writing about Pennsylvania's state-based ACA exchange, due to launch this fall, since way back in December:
PA’s A Step Closer To Starting A State-Based Health Insurance Exchange
Pennsylvania’s new, state-run health insurance exchange is getting rolling ahead of its launch in 2021.
The commonwealth has chosen a California-based company, GetInsured to run it.
...Zachary Sherman, who heads the newly-created Pennsylvania Health Insurance Exchange Authority, said the contract with GetInsured will cost around $25 million annually, plus startup expenses that’ll be spread over several years.
“That’s compared to what we currently pay for Healthcare.gov, which is in the $90 to $95 million range,” he said.
Sherman said the administration chose GetInsured because it has already contracted with other states, like Nevada and Minnesota.
He said the new exchange is expected to save people between five and ten percent every year on premiums.
When I first read the quote, I assumed it was either a paraphrase, out of context or sarcasm. Sadly, it was none of those:
A series of controversial remarks by Missouri Gov. Mike Parson on a St. Louis radio show are getting widespread attention — and some pushback.
In an interview on Friday with talk-radio host Marc Cox on KFTK (97.1 FM), Parson indicated both certainty and acceptance that the coronavirus will spread among children when they return to school this fall. The virus has killed 1,130 people in the state despite a weekslong stay-at-home order in the spring that helped slow the virus’ spread — and the state set a record on Saturday with 958 new cases.
...Parson’s comment on the coronavirus signaled that the decision to send all children back to school would be justified even in a scenario in which all of them became infected with the coronavirus.
Yesterday Donald Trump was interviewed by Chris Wallace on FOX News Sunday. It was full of the usual batcrap insane lies and babbling on Trump's part, but one exchange in particular caught my attention:
Wallace: "I want to talk to you about Obamacare. Since the pandemic hit, millions of people have lost their jobs, and thereby lost their health insurance. Almost a half million have signed up for Obamacare. Your administration just announced that you're signing onto a lawsuit to overturn Obamacare..."
Trump: "And replace it."
Wallace: "Why does it make sense to overturn Obamacare, which people are now relying on...Democrats are gonna say, the man who's wanted to kill Obamacare is gonna take it away...the protections for pre-existing conditions..."
Trump: "First of all, we got rid of the individual mandate, pre-existing conditions will always be taken care of by me and Republicans, 100%.."
Wallace: "But you've been in office 3 1/2 years, you don't have a plan..."
The data below comes from the GitHub data repositories of Johns Hopkins University, execpt for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.
Here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, July 18th (click image for high-res version):
NEARLY 58,000 MARYLANDERS GAIN HEALTH COVERAGE DURING TWO SPECIAL ENROLLMENT PERIODS
BALTIMORE, MD – A total of nearly 58,000 Marylanders enrolled in health coverage during Maryland Health Connection’s two special enrollment periods that began in February and March and ended Wednesday, July 15.
The Maryland Health Insurance Easy Enrollment program launched Feb. 26 as the first of its kind in the nation. The Comptroller of Maryland asked state tax filers to check a box on their state tax return if they lacked health insurance and desired that information to be shared with the Maryland Health Benefit Exchange. Several states are in the process of looking at creating similar programs.
Since February:
More than 41,000 filers checked the box
More than 3,700 enrolled as of July 13
Final numbers are pending, because tax filers had until the July 15 tax filing deadline to check the box on their state tax form, and will have several weeks to enroll.
Amid a pandemic-stricken nation struggling to find ways to reopen, massive unemployment and employees lucky enough to have jobs hanging onto them as tightly as possible, New York health care strategists are floating a plan to offer health insurance tax credits assistance to loan-saddled college graduates who have no overage or fear of losing what they do have.
As envisioned in a new report released last week by the United Hospital Fund, recent college graduates could be allowed to deduct the monthly costs of their student loan payments from their total adjusted income as calculated under the Affordable Care Act.
Covered California approved a $440 million budget for fiscal year 2020-21 that includes a $30 million increase in marketing investments and $13 million for additional customer service upgrades to meet the needs of consumers.
The increased spending, which represents a 16 percent increase over last year’s budget, comes amid continued uncertainty in the lives and livelihoods of Californians as public health officials fight against the spread of COVID-19.
The budget also calls for greater investments in information technology to improve efficiency, as well as increased efforts to help inform state and national policy on health care-related issues.
More than 209,000 people have signed up for coverage through Covered California since the exchange announced a special-enrollment period, which runs through the end of July, in response to the COVID-19 pandemic.
Gov. Brian Kemp on Wednesday extended Georgia’s coronavirus restrictions while explicitly banning cities and counties from adopting rules requiring masks or other face coverings, a measure that could bolster the state’s case in a possible legal battle.
Kemp’s executive order — which was set to expire Wednesday evening — still encourages, rather than requires, Georgians to wear masks in public. The governor has called such a requirement “a bridge too far,” and his office has said local mandates are unenforceable.
The governor’s coronavirus orders have for months banned local governments from taking more restrictive or lenient steps than the state. But the new set of rules he signed on Wednesday specified for the first time that cities and counties can’t require the use of masks or other face coverings.
For the record, here's how Georgia is doing when it comes to handling COVID-19 at the moment:
But actually, he thought as he re-adjusted the Ministry of Plenty’s figures, it was not even forgery. It was merely the substitution of one piece of nonsense for another. Most of the material that you were dealing with had no connexion with anything in the real world, not even the kind of connexion that is contained in a direct lie. Statistics were just as much a fantasy in their original version as in their rectified version. A great deal of the time you were expected to make them up out of your head.
Special Enrollment for Uninsured New Yorkers Will Extend for Additional 30 days and Remain Open Through August 15, 2020
Governor Andrew M. Cuomo today announced that the Special Enrollment Period for uninsured New Yorkers will be extended for another 30 days, through August 15, 2020, as the State continues to provide supportive services during the COVID-19 public health crisis. New Yorkers can apply for coverage through NY State of Health, New York State's health insurance marketplace, or directly through insurers.
I've referenced Families USA several times before (and I've attended their annual conference for the past three years), but for those not familiar with them:
Families USA, a leading national, non-partisan voice for health care consumers, is dedicated to achieving high-quality, affordable health care and improved health for all. Our work is driven by and centered around four pillars: value, equity, coverage, and consumer experience. We view these focus areas — and the various issues unique to each area — as the cornerstones of America’s health care system.
Public policy analysis that is rooted in Hill and administration experience, movement-building advocacy, and collaboration with partners are deep-rooted hallmarks of our work. In turn, our work promotes a health system that protects consumers’ financial security as much as it does their health care security.
As we advance our mission by combining policy expertise and partnerships with community, state, and national leaders, we forge transformational solutions that improve the health and health care of our nation’s families and speak to the values we all have in common.
Back in March I noted that while the U.S. Supreme Court has indeed agreed to hear the Texas Fold'Em lawsuit to strike down the Affordable Care Act (aka "Texas vs. Azar", aka "Texas vs. U.S.", aka "CA vs. TX") sometime this fall, the odds of actually getting a final decision in the case from SCOTUS before the November election (or even before either Trump or Biden are sworn into office in January) is extremely unlikely:
#SCOTUS grants petition filed by California & other states, as well as petition filed by Texas on whether individual mandate can be separated from rest of ACA. Argument is likely in the fall, w/decision to follow by June 2021.
Nevada Health Link Announces Licensed Broker/Agent,
Navigator and In-Person Assister Recipients of Grant Program for Plan Year 2021
Carson City, Nev. –The Silver State Health Insurance Exchange (Exchange), the state agency that connects Nevadans to qualified health plans (QHPs) through the online State Based Exchange (SBE) known as Nevada Health Link, announces the licensed Brokers/Agents, Navigators and In-Person Assisters selected as part of its plan year 2021 grant program. The program is designed to help close the uninsured gap in Nevada by helping those on the frontline to more effectively market to uninsured and underinsured populations.
TWO SPECIAL ENROLLMENT PERIODS FOR HEALTH INSURANCE END JULY 15
Nearly 53,000 residents have enrolled since mid-March
BALTIMORE, MD – The Maryland Health Benefit Exchange announced it is entering the final week for Marylanders to enroll in health insurance coverage through the Coronavirus Emergency Special Enrollment Period and the Easy Enrollment Health Insurance Program. Maryland made the decision to re-open the Coronavirus Emergency Special Enrollment Period and extend the deadline in an effort to give more residents the opportunity to enroll. Both are set to end on July 15.
The deadline extension for the Coronavirus Special Enrollment Period comes as more than 49,000 residents have received coverage during this special enrollment period that began in March with Gov. Larry Hogan’s announcement of a State of Emergency in Maryland. Even before this extension, Maryland already offered one of the longest special enrollment periods in the country since the emergency began.
via MNsure...this is from a couple of weeks ago but it's still important for all Minnesota residents to know!
ST. PAUL, Minn.—The Minnesota Insulin Safety Net Program launched today, July 1, 2020, allowing Minnesotans in urgent need of insulin (less than a 7-day supply on hand) to access the lifesaving drug through their pharmacy. The program – implemented by MNsure, the state's health insurance marketplace, and the Minnesota Board of Pharmacy – was created to help Minnesotans facing difficulty affording their insulin.
The Insulin Safety Net Program is made up of two parts: 1) The urgent need program for eligible Minnesotans to receive a once-per-year 30-day supply of insulin immediately at their pharmacy for no more than a $35 copay; and 2) The continuing need program for eligible Minnesotans to receive up to a year supply of insulin for no more than $50 per 90-day refill.
Interested individuals should visit MNinsulin.org to see if they qualify and learn how to apply.
IMPORTANT:As noted here, I made some sort of serious data transfer error in at least two states (Michigan and Texas), making last week's "top 100" ranking questionable. For this week (and going forward) I'm triple-checking to make sure the county names, populations, case totals and fatality totals are sorted properly for all 50 states.
Now that I've brought all 50 states (+DC & the U.S. territories) up to date, I'm going to be posting a weekly ranking of the 100 U.S. counties (or county equivalents) with the highest per capita official COVID-19 cases and fatalities.
Again, I've separates the states into two separate spreadsheets:
In U.S. politics, the Hyde Amendment is a legislative provision barring the use of federal funds to pay for abortion except to save the life of the woman, or if the pregnancy arises from incest or rape. Legislation, including the Hyde Amendment, generally restricts the use of funds allocated for the Department of Health and Human Services and consequently has significant effects involving Medicaid recipients. Medicaid currently serves approximately 6.5 million women in the United States, including 1 in 5 women of reproductive age (women aged 15–44).
Federal dollars can't be used to pay for abortion outside of the above restrictions, but Medicaid is funded via hybrid federal/state funding, so there are 15 states where Medicaid does pay for abortion using the state's portion of the funding.
Back in 2018, I was all over the trend of deep red states putting ACA Medicaid expansion on the ballot after getting fed up with years of their elected leaders refusing to do so. Idaho, Utah and Nebraska voters all did exactly that, passing it by solid margins. Unfortunately, state Republicans got in the way (or at least tried to) in all three states, adding hurdles, barriers and caveats which have either delayed or partly weakened them.
The big story with COVID-19 the past few weeks has been, of course, the out-of-control increase in new cases (if not actual deaths...yet) from the virus in red states like Texas, Florida and especially Arizona which were relatively unscathed throughout the spring while the pandemic was raging across Northeastern blue states like New York, New Jersey and Rhode Island, as well as Michigan and California.
While most of the states being hit with the summer wave are historically Republican strongholds (the states being hit hardest in June/July also include Georgia, Arkansas, South Carolina, etc.), there's one important exception to this: California, which was hit early but which clamped down fairly quickly, has re-emerged as a major hot spot. So what gives?
Over a year ago, the Washington State legislature passed (and Gov. Inslee signed) a bill to create, for the first time, a state-based Public Option healthcare plan for the individual market. As I noted at the time, there's a few important caveats which illustrate again just how difficult it is to make major overhauls to the healthcare system, even at the state level:
The good news out of Minnesota is that the Commerce Dept. has published the preliminary 2021 average rate changes for both the individual and small group markets in a simple table.
The bad news is that they haven't published any of the actual actuarial memos or templates which include the two other critical pieces of data I need to run my analysis: The current effectuated enrollee totals for each carrier, and what (if any) impact the COVID-19 pandemic had on the proposed rate changes.
via MNsure (this was actually posted a couple of weeks ago but I missed it):
ST. PAUL, Minn.—99,688 Minnesotans have come to MNsure.org and enrolled in private health insurance through a special enrollment period (SEP) or received eligibility for a public assistance program (Medical Assistance or MinnesotaCare) since March 1. As expected, sign-ups across all programs have been driven by concerns amid the pandemic.
"It’s never been more important to know you’re covered. That’s why we are so glad to have been able to help almost 100,000 Minnesotans gain access to comprehensive health care coverage," said CEO Nate Clark. "But we know there are others out there who are currently uninsured and may qualify to sign up. If you’ve recently lost your employer-sponsored health insurance, had an income change, or have another qualifying life event, come to MNsure.org to see if you’re eligible."
Hawaii only has two carriers participating in the Individual health insurance market. For 2020, they're reducing unsubsidized premiums by 1.7%.
COVID-19 isn't listed as a factor at all by either of the carriers, nor by any of the small group carriers in Hawaii either...which makes total sense since Hawaii has the lowest rate of COVID-19 infection in the country.
The small group carriers are requesting a weighted average reduction of 2% as well, although one of the four doesn't have their actual rate change or current enrollment available yet, so this could change.
However, it's a bit overly cumbersome: It stretches out over 5 full pages, and includes columns for Standalone Dental Plans as well as a bunch of info regarding the Small Group Market.
To that end, I've cleaned up/simplified the 2021 Submission Deadline table considerably to only include the individual and small group market dates. I'll be perfectly honest: I'm not quite sure what the distinction is between the "Form/Rate Filings" and the "Binder Deadlines", but the dates tend to match up pretty closely, so I've included all of them below.
The graph below is a linear depiction of how COVID-19 has spread across the state of Florida every day since March 20th.
As you can see, the thick orange line shows the ramping up of testing, the thick blue line is the increase in cases and the thick red line is the (official) rate of fatalities. In order to fit all three measurements on the same graph in a presentable way, the scale is different for each: Tests are per 100 residents; cases are per thousand, and deaths are per ten thousand.
The thinner lines are for Orange County, Florida specifically...and there's a reason for that which I'll explain below.
After all, they were eventually able to eliminate the single least popular provision of the law: The federal individual mandate penalty. Most of the rest of the elements are actually quite popular...and in fact poll after poll finds that the bulk of the public wants those other provisions strengthened, not weakened or eliminated.
IMPORTANT UPDATE: I've been alerted to the fact that I had data entry errors in at least two of the states last weekend (Michigan and Texas). It looks like the sort order got messed up during the data transfer in those states. As a result, at least 2 of the "Top 40" / "Top 100" counties I had listed were wrong. I've deleted the spreadsheets for this week and will triple-check everything for this weekend's weekly update. My apologies for the error.
Now that I've brought all 50 states (+DC & the U.S. territories) up to date, I'm going to be posting a weekly ranking of the 40 U.S. counties (or county equivalents) with the highest per capita official COVID-19 cases and fatalities.
Again, I've separates the states into two separate spreadsheets:
Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.
Carriers jump in and out of the market, their tendency repeatedly revise their requests, and the confusing blizzard of actual filing forms which sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:
New Mexico is the latest state to post their preliminary 2021 rate change filings for both the individual and small group markets. There's several key things to note here:
Michigan is the 8th state (by my count) where the insurance carriers have posted their preliminary 2021 premium rate change filings. Every year brings some new twist (in 2018 it was CSR reimbursement payments being cut off; in 2019 it was the zeroing out of the ACA's federal individual mandate penalty; in 2020 it was sort of the repeal of the ACA's health insurer tax (HIT), although that didn't actually happen until after 2020 premiums had already been locked in; and for 2021...it's the COVID-19 pandemic, of course.
I've therefore added a new column for my weighted average rate change spreadsheets. So far only a handful of carriers have tacked on any substantial rate changes due to expected cost increases from testing & treatment of COVID-19 next year...the general rule of thumb seems to be that the added costs are pretty much gonna be cancelled out by reduced claims from non-COVID healthcare services (delayed/cancelled treatments/procedures, etc).
In Red State Oklahoma, Medicaid Expansion Nears 2020 Ballot
A campaign in Oklahoma to expand Medicaid via the ballot box far eclipsed the necessary number of signatures needed to put the measure before voters next November 2020, supporters said Thursday.
The submission of 313,000 signatures to put a constitutional amendment on next year’s general election ballot shattered the required 178,000 needed by the Oklahoma Secretary of State’s office, organizers said. Media reports in Oklahoma said supporters of Medicaid expansion broke a state record when it comes to signatures needed for a statewide ballot initiative.
