As I just noted with my Arizona post, the federal Rate Review database website heavily redacts the rate filing forms submitted by insurance carriers, making it impossible to run a weighted average even when all of the individual and small group market carrier rate change requests are readily available.
The good news is that the federal Rate Review database has now posted the preliminary avg. 2021 rate filings for the individual and small group markets for every state. This makes it very easy to plug in the average requested rate changes in 2021 for every carrier participating in both markets.
The bad news is that most of the underlying filing forms are heavily redacted, meaning I can't use the RR database to acquire the other critical data I need in order to run a proper weighted average: The number of people actually enrolled in the policies for each carrier.
This means that in cases where this data isn't available elsewhere (either the state's insurance department website, the SERFF database or otherwise), I'm limited to running an unweighted average. This can make a huge difference...if one carrier is requesting a 10% increase and the other is keeping prices flat, that's a 5.0% unweighted average rate hike...but if the first carrier has 99,000 enrollees and the second only has 1,000, that means the weighted average is actually 9.9%.
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, August 29th (click image for high-res version):
Large Decreases in 2021 Premium Rates Expected in Individual Market
CONCORD, NH – The federal government has published information on proposed rates for New Hampshire’s health insurance exchange (https://ratereview.healthcare.gov/) in 2021.
The New Hampshire Insurance Department is reviewing 2021 forms and rates for individual health plans. For 2020, the second lowest cost silver plan was $404.60. The 2021 second lowest cost silver plan proposed premium rate is $318.95. This represents a 21.2% decrease.
It's important to note that the 21.2% decrease only refers to the difference between the 2020 benchmark and the 2021 benchmark plans. They aren't necessarily from the same carrier, and even if they are, that's not the same as the weighted average rate changes for all policies at all metal levels from all carriers.
It was recently brought to my attention that revised rate filings have been submitted by Maine carriers for 2021...and while these still aren't the final/approved rates, they're significantly lower than the original filings.
Two of the three indy market carriers (Anthem and Harvard Pilgrim) have reduced their rates dramatically. The third (CHO) only reduced theirs by a couple of points, but the net result is that they're now averaging a 13% reduction...9 points lower than the 4 points they were already being knocked down.
The small group market carriers didnt' change their requests by as much, but they're still lower: A 4.4% average increase instead of 6.2%.
Virginia is usually the first state to publicly post their preliminary annual individual/small group market health insurance premium rate filings; historically they've published them as early as mid-April. This year, however, due primarily to the COVID-19 pandemic, I presume, they didn't actually post them until mid-August.
The average premium changes for 2021 on the individual market range from a 13% drop to a 7.7% increase, with the statewide weighted average coming in at around a 7.2% reduction. For the small group market, premiums are increasing by around 3.6% on average, ranging from a 2.4% drop to a 10.9% increase.
Two other noteworthy items: First, Optimum Choice is expanding into VA's individual market (this isn't the same as Optima Health); secondly, VA's indy market has dropped from over 300,000 last year to around 256,000 this year, presumably due to the lingering effects of Medicaid expansion enrollees shifting over from subsidized private plans.
Nolan Finley is the conservative editorial page editor of The Detroit News.
On July 29th, he tweeted this out in response to criticism of the COVID-19 policy recommendations by himself and Michigan Republican legislative leadership:
Florida 20 million population, 6100 deaths. Michigan 10 million population, 6400 deaths. https://t.co/O1tNoyWwB0
Let's take a look at the data, shall we? Here's a graph of official COVID-19 positive test cases and fatalities per capita for both Michigan and Florida. Cases are per 1,000 residents; deaths are per 10,000 in order to make the trendlines more visible:
Covered California Opens New Paths to Coverage for Wildfire Victims and Those Who Lose Their Job or Income During the Pandemic and Recession
Covered California establishes a new special-enrollment period to benefit victims of the 500+ wildfires raging across the state.
In addition, Covered California announced new paths to coverage that will run through the end of 2020, for Californians who have lost employment or income due to the pandemic and resulting recession.
The moves come during ongoing uncertainty in the lives of Californians caused by the wildfires and the continuing fight against COVID-19.
More than 271,000 people have signed up for coverage through Covered California since the exchange’s initial announcement of a special-enrollment period in response to the pandemic.
La versión en español de este Comunicado puede ser descargada en este enlace.
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, August 22nd (click image for high-res version):
The Indy market is about as simple as it gets since there's only a single carrier offering ACA policies either on- or off-exchange (Highmark BCBS). They're actually cutting premiums on average slightly next year, by half a percent. They state in their summary that "Covid19 is expected to increase claim costs in 2021"...but that's all they have to say about it. The full actuarial memo includes an extensive section about the COVID-19 impact factor...but the numbers/percentages are all redacted:
The Department of Insurance receives preliminary health plan information for the following year from insurance carriers by June 1 and reviews the proposed plan documents and rates for compliance with Idaho and federal regulations. The Department of Insurance does not have the authority to set or establish insurance rates, but it does have the authority to deem rate increases submitted by insurance companies as reasonable or unreasonable. After the review and negotiation process, the carriers submit their final rate increase information. The public is invited to provide comments on the rate changes. Please send any comments to Idaho Department of Insurance.
Back in April, in the midst of the earlier stages of the COVID-19 pandemic sweeping through much of the nation, there was a loud outcry for the various ACA health insurance exchanges, including the federal exchange at HealthCare.Gov which hosts enrollment for over 3 dozen states, to re-open enrollment to anyone who missed the official Open Enrollment Period which had ended several months earlier.
Eventually, twelve of the thirteen state-based exchanges did just that, launching COVID-19-specific Special Enrollment Periods of varying time periods for any resident who would normally be eligible to enroll during Open Enrollment to do so. Many of those SBEs would go on to extend the deadlines of their SEPs by a month...or two months...or even more. As of this writing, in fact, California, Maryland, New York and the District of Columbia are are still offering "open" COVID-19 SEPs.
Way back in May (a lifetime ago), Vermont was among the first states to publicly post their preliminary 2021 rate filings for their combined individual & small group market. At the time, the carriers were requesting an average 6.8% rate increase, and noted that they had no clue how much to tack on to cover themselves for the COVID-19 factor...or to even reduce rates because of it.
This week, the Vermont insurance regulatory board issued their final decisions about both BCBS of Vermont and MVP Health Plan, and cut down on each of their requested increases by several points (h/t Louise Norris for the links):
Hmmm...back in June, the New York Dept. of Financial Services published the preliminary 2021 rate filing requests for the individual & small group markets. As I noted at the time:
Hmmmm....some of these seem suspiciously high, at least as compared to the handful of other states which have released their preliminary requests so far, but we'll have to see...
Republican Senator Cory Gardner is up for re-election this fall, and he's in major trouble. Various polling over the summer has him trailing his Democratic opponent, former CO Governor John Hickenlooper, by around 6 points on average.
Governor Andrew M. Cuomo today announced that the Special Enrollment Period for uninsured New Yorkers will be extended for another 30 days, through September 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.
"While we've crushed the curve of the virus, we are still in challenging times for hard-working families throughout the state who need access to quality, affordable health care," Governor Cuomo said. "The state has maintained low infection rates and is moving in the right direction, but we know we're not out of the woods yet. By offering this special enrollment period, we're making sure New Yorkers who need affordable and at times live-saving health care coverage can get it."
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.
It was just a few weeks ago that the Montana Insurance Department posted the preliminary 2021 rate filings for the individual & small group markets. At the time, the individual market carriers were requesting a 3.2% average rate increase, while the small group carriers wanted a 2.4% bump.
Unfortunately, the actual actuarial filing memos ("Part II Justification") weren't available as of this writing, so I couldn't tell whether there's any COVID-19 impact specifically mentioned or not. Montana is one of the states with the fewest casese of COVID per capita, so I wasn't expecting much, but it would be nice to know.
Today I checked again and it looks like they've not only posted the Actuarial Memos (which don't mention COVID-19 at all, as I expected), but it also looks like Montana is the first state to publish their final/approved 2021 rate changes as well. They also modified the estimated enrollment numbers somewhat. Here's what it looks like now:
The good news is that both of last years' individual market carriers (Blue Cross Blue Shield and Bright Healthcare) do have listings for 2021 in the SERFF database.
The bad news is that those listings don't include actual rate filings, just some other forms.
The good news is that rate filings for every state appear to be available at RateReview.HealthCare.Gov this week.
The bad news is that the filings at RR.HC.gov appear to be incomplete so far; BCBS is listed but Bright isn't (and since I do have other forms for Bright being listed in 2021, I'm pretty sure it's not because they're pulling out of the Alabama market).
Welcome to the latest chapter in the long, epic CSR Lawsuit Saga which has been slogging along for six years now.
Here's a quick recap (again):
The ACA includes two types of financial subsidies for individual market enrollees through the ACA exchanges (HealthCare.Gov, CoveredCA.com, etc). One program is called Advance Premium Tax Credits (APTC), which reduces monthly premiums for low- and moderate-income. The other is called Cost Sharing Reductions (CSR), which reduces deductibles, co-pays and other out-of-pocket expenses for low-income enrollees.
In 2014, then-Speaker of the House John Boehner filed a lawsuit on behalf of Congressional Republicans against the Obama Administration. They had several beefs with the ACA (shocker!), including a claim that the CSR payments were unconstitutional because they weren't explicitly appropriated by Congress in the text of the Affordable Care Act (even though the program itself was described in detail, including the payment mechanism/etc.)
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, August 15th (click image for high-res version):
The good news is they include the number of people enrolled by each carrier in both markets, making it easy to calculate a weighted average, and th ey even include the SERFF tracking number for each.
The bad news is they don't include links to the actuarial memos, and even plugging the tracking numbers into the SERFF database only brings up the memos for three of the six carriers on the individual market...and of those, two of the three have been redacted (Oscar and Cigna), while the third (UnitedHealthcare) is brand-new to the North Carolina market anyway and therefore has no COVID-19 impact on their rate changes to speak of.
Are you turning 26 soon and still on your parent’s health insurance policy? Did you know that you will need to take action or you may no longer have health insurance? Don’t worry, you have options!
If you have a job that offers insurance, you can enroll in that coverage as turning 26—known as aging out—is considered a qualifying life event and will enable you to enroll in job-based coverage outside of your job’s open enrollment period.
Get covered through your school
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Nolan Finley is the conservative editorial page editor of The Detroit News.
Two weeks ago, he tweeted this out in response to criticism of the COVID-19 policy recommendations by himself and Michigan Republican legislative leadership:
Florida 20 million population, 6100 deaths. Michigan 10 million population, 6400 deaths. https://t.co/O1tNoyWwB0
Let's take a look at the data, shall we? Here's a graph of official COVID-19 positive test cases and fatalities per capita for both Michigan and Florida. Cases are per 1,000 residents; deaths are per 10,000 in order to make the trendlines more visible:
As I noted last year, the Nevada Insurance Dept. website is both helpful and frustrating when it comes to tracking down the type of data that I need. On the one hand they make it very easy to view the individual & small group market rate filing summaries: Carrier names, markets, sumission dates, status, effective dates and most importantly, the proposed and approved average rate changes are all easily found.
On the other hand, they don't actually link to the filing memos or URRT forms, which means I can't find the actual effectuated enrollment numbers for each carrier, the impact of COVID-19 on each carrier's request or other noteworthy info about the filings. Oddly, they do include the SERFF tracking numbers...except that plugging those into the SERFF database still doesn't bring anything up, which kind of defeats the point.
Fortunately, the NV DOI does provide the weighted average of the entire market and COVID-19 impact elsewhere. I've also been able to piece together the total market enrollment (both on & off-exchange) using some other public data.
With recent reports illustrating the growing number of uninsured Americans across the country, MNsure is reminding Minnesotans that there are options. For those who have lost their health insurance, seen a change in income, or experienced a qualifying life event, enrollment opportunities may be available.
"The last couple of months has brought tremendous uncertainty to many families across the state," said MNsure CEO Nate Clark. "It's important that Minnesotans know there are enrollment opportunities available if they lose their health insurance. MNsure is here to help."
Since the start of the COVID-19 pandemic, more than 100,000 Minnesotans have come through MNsure to find health insurance coverage.
For new customers, you may be eligible to enroll if:
I've acquired the preliminary 2021 rate filings for Georgia's individual and small group market carriers. There were two filings submitted for many of the carriers because of a (since delayed) ACA Section 1332 waivier submission; the carriers submitted one in case the waiver was approved and a second if it wasn't. Since the process has been delayed, however, the no-waiver filing is the one which is relevant.
As you can see in the tables at the bottom of this entry, the overall weighted rate change requested by individual market carriers in Georgia is a 1.3% reduction, which would have been more like a 2.3% drop if not for the COVID-19 factor, according to the carriers. The small group market carriers are requesting an 11.1% average increase, which is unusually high these days. I haven't reviewed all the memos for the sm. group market to see what they're pinning on COVID-19, however.
Here's what the indy market carriers have to say about the COVID-19 factor in their 2021 filings:
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, August 8th (click image for high-res version):
I don't often swear on this site (and almost never in the lede of the blog post, but this is the most sickening bit of gaslighting I've seen in awhile, which is saying something for the Trump Administration.
About an hour or so ago, Trump held a "press conference" in which he announced that he's supposedly signing an executive order to do exactly what the Patient Protection & Affordable Care Act, which he's currently suing to have struck down, ALREADY DOES.
So how is this being reported by certain "news media" outlets? Let's take a look:
Back on March 10th, the Washington HealthPlanFinder became the first state-based ACA exchange/marketplace to formally create an official COVID-19 Special Enrollment Period, which was originally scheduled to have a deadline of April 8th.
Since that time, nearly every other state-based ACA exchange (all of them except for Idaho) has done likewise. Some of them required some sort of verbal or written attestation of thier eligibility status, while others didn't, but all of them were wide open to any uninsured resident who would normally be eligible to enroll during the official Open Enrollment Period.
The deadlines for the "open" COVID-19 SEP varied by state...but most of them ended up extending them out as that deadline approached. In some cases, they bumped it out again...and again...and yet again, as it became increasingly clear that the deadly pandemic isn't going away anytime soon.
Yesterday the Pennsylvania Insurance Dept. posted the preliminary 2021 rate filings for the individual and small group markets. On the surface, it appears that Pennsylvania has an absurdly competitive market, with 17 carriers listed on the indy market and 21 small group carriers...but when you look closer, many of these are simply branches of the same main company.
For instance, fully five of the individual market carriers are variants of "Highmark"...which is actually Pennsylvania's rebranding of Blue Cross Blue Shield. Two are branches of Geisinger and another two are both UPMC. The same is true in the small group market.
And don't even get me started about "Capital Advantage Assurance Company" and "Capital Advantage Insurance Company". Sheesh.
In any event, the overall rate filings average out to rougly a 2.6% premium decrease on the individual market and a 2.3% increase for small group plans, when weighted by carrier market share.
The Kentucky Insurance Dept. has posted KY's preliminary 2021 rate filings for the individual and small group markets, and the requested average rate increases for both are unusually high compared to the other states which have submitted their filings so far. In another unusual development, most of the carriers on each market are being pretty specific about the impact (or lack thereof) on their 2021 rate filings from the COVID-19 pandemic (I only have UnitedHealthcare posted once but they account for three of the seven small group carriers listed.
...Most troubling of all, perhaps, was a sentiment the expert said a member of Kushner’s team expressed: that because the virus had hit blue states hardest, a national plan was unnecessary and would not make sense politically. “The political folks believed that because it was going to be relegated to Democratic states, that they could blame those governors, and that would be an effective political strategy,” said the expert.
On Tuesday, August 4, all Missourians will have the chance to vote Yes On 2 to bring more than a billion of our tax dollars home from Washington every year – money that’s now going to places like California and New York instead.
By bringing our tax dollars home, we can protect thousands of frontline healthcare jobs, help keep rural hospitals open, and deliver healthcare to Missourians who earn less than $18,000 a year. That includes thousands of veterans and their families, those nearing retirement, working women who don’t have access to preventive care, and other hardworking Missourians whose jobs don’t provide health insurance.
California’s Efforts to Build on the Affordable Care Act Lead to a Record-Low Rate Change for the Second Consecutive Year
The preliminary rate change for California’s individual market will be 0.6 percent in 2021, which marks a record low for the second consecutive year and follows California’s reforms to build on and strengthen the Affordable Care Act.
Covered California’s increased enrollment, driven by state policies and significant investments in marketing and outreach, has resulted in California having one of the healthiest individual market consumer pools and lower costs for consumers.
The impact of COVID-19 on health plans’ costs has been less than anticipated as many people deferred or avoided health care services in 2020, and while those costs are rebounding, it now appears the pandemic will have little effect on the total costs of care in California’s individual market for 2020 and 2021.
All 11 health insurance companies will return to the market for 2021, and two carriers will expand their coverage areas, giving virtually all Californians a choice of two carriers and 88 percent the ability to choose from three carriers or more.
Paulding County, Georgia has a population of around 169,000 people. According to Johns Hopkins University, as of yesterday, they had 1,452 known COVID-19 cases and 19 COVID-19 deaths.
That's around 8.6 cases per thousand residents, which is lower than 37 states (but still higher than Colorado, Ohio or Washington), but 1.13 deaths per 10,000 residents, which is higher than...well, in the upper half of counties in America (Paulding ranks #1,478 out of over 3,100 counties/county equivalents nationally).
via Twitter:
This is the first day of school in Paulding County, Georgia.
Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Arkansas Insurance Department for review and approval before plans can be sold to consumers.
The Department reviews rates to ensure that the plans are priced appropriately. Under Arkansas Law (Ark. Code Ann. § 23-79-110), the Commissioner shall disapprove a rate filing if he/she finds that the rate is not actuarially sound, is excessive, is inadequate, or is unfairly discriminatory.
The Department relies on outside actuarial analysis by a member of the American Academy of Actuaries to help determine whether a rate filing is sound.
Below, you can review information on the proposed rate filings for Plan Year 2020 individual and small group products that comply with the reforms of the Affordable Care Act.
Users will only be able to view the public details of the filing, as certain portions are deemed confidential by law (Ark. Code Ann. § 23-61-103).
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, August 1st (click image for high-res version):
Wallace: "But you've been in office 3 1/2 years, you don't have a plan..."
Trump: "But we haven't had...uh...excuse me...you heard me yesterday. We're signing a healthcare plan...within two weeks. A full and complete healthcare plan that the Supreme Court decision on DACA gave me the right to do. So we're gonna solve...we're gonna sign an immigration plan, a healthcare plan, and various other plans....and nobody will have done what I'm doing in the next four weeks.
