Charles Gaba's blog

via the Washington Insurance Dept.:

OLYMPIA, Wash. — Thirteen health insurers filed an average requested rate increase of 11.3% for Washington's individual health insurance market. The proposed plans and their rates are currently under review and final decisions will be made this fall. 

"I recognize that any proposed increase in price is deeply upsetting to those struggling to pay for coverage today,” said Insurance Commissioner Mike Kreidler. “People should know that these rates are not final and my office will be carefully reviewing each request to validate the assumptions being made by our state’s insurers. We will do everything under our authority ensure that any rate changes are justified." 

I've been following this bill for awhile now but never got around to writing about it until after it passed through both chambers of the Illinois legislature. That's a shame, because it's a pretty Big F*cking Deal for Illinois residents.

Via WAND Illinois:

 The Illinois House passed the Healthcare Protection Act Saturday to help curb predatory insurance practices and protect consumers.

Gov. JB Pritzker's monumental plan could make Illinois the first state to ban prior authorization for in-patient adult and children's mental healthcare. The legislation also bans step therapy, or the fail first method, where insurers force people to receive less effective treatment before moving to options initially recommended by doctors.

...The measure requires prior approval from the Department of Insurance before large group insurance plans can increase rates and states premiums must align with the actual cost of providing care as well.

Via Pennie:

Pennie Has Issued a New Request for Proposal (RFP) for an Enrollment Assister Contract to Expand Support Across Pennsylvania Communities  

Pennie is seeking an organization to build grassroots awareness and provide direct enrollment assistance to Pennsylvanians seeking health coverage. Proposals due at 1 pm on June 27th.   

Harrisburg, PA – May 2024 – Pennie, PA’s official health insurance marketplace, has issued a Request for Proposal for Assister Services.  The awardee will collaboratively drive statewide activities to increase awareness of the financial help and health coverage available through Pennie, and work directly with community organizations to provide local, in-person enrollment assistance.  

The primary goals of this project are to:  

via the Centers for Medicare & Medicaid Services (CMS):

CMS Approves State Plan Amendments Extending Postpartum Coverage in Nevada

May 3: CMS marked another important maternal health milestone by approving Medicaid and Children’s Health Insurance Program (CHIP) postpartum coverage extensions in Nevada, an opportunity made possible through the American Rescue Plan (ARP). Nationally, people across 46 states, the District of Columbia, and U.S.V.I. now have access to Medicaid and CHIP coverage for a full 12 months following pregnancy — up from just 60 days before the ARP.

Via the U.S. Health & Human Services Dept (HHS):

Today, U.S. Health and Human Services Secretary Xavier Becerra released the following statement after the Centers for Disease Control and Prevention (CDC) released new data - PDF showing the uninsurance rate holding steady at 7.7 percent:

“Under President Biden’s leadership more people have health coverage than under any previous president. Even more encouraging, the data released today does not reflect the record-breaking open enrollment period that saw over 21 million people sign up for insurance. The Biden-Harris Administration will redouble our efforts to make sure tax breaks for working families stay in place so that every single person in America can go to the doctor and afford the care that will keep them and their families healthy.”

Vermont

And here...we...go...

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 tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms 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:

Wyoming

Someone just sent me this article from WyoFile which had a rather tiring & familiar headline:

Wyomingites may be skeptical of Obamacare, but many use it for health insurance

(sigh)

Wyoming leaders have repeatedly rejected Medicaid expansion, but a new study shows many residents here rely on another component of the Affordable Care Act: the health insurance marketplace.

Among 10 states with the highest share of farmers, Wyoming uses the federal health insurance marketplace the most, according to a new analysis by the Robert Wood Johnson Foundation. That marketplace is a virtual space for comparing plans and finding insurance that’s often more affordable than elsewhere thanks to federal subsidies. 

Disclosure: The RWJF has banner ads on this site.

Last month I noted that North Carolina's ACA Medicaid expansion initiative, which started in December 2023, had officially enrolled more than 400,000 of the estimated 600,000 NC residents eligible for the program.

I just checked on the official NC Dept. of Health & Human Services Medicaid expansion dashboard, and it says that as of May 3rd, expansion enrollment there was up to 447,498 people.

It will be interesting to see how close to that 600K estimate enrollment ends up being over the next year or so.

Back in February I posted a colorful graph which showed the progress of ACA Medicaid Expansion from January 2014 through June 2023.

The data comes from the Centers for Medicare & Medicaid Services quarterly Medicaid Budget & Expenditure System reports. Unfortunately, the MBES reports only ran through June of last year, so it was missing the last half of the year...which is pretty important since that's when the drop in Medicaid coverage due to the ongoing Unwinding process really started to kick in.

Fortunately, CMS recently updated the MBES data to include the third quarter of 2023, bringing Medicaid enrollment *up through September. It's still 8 months out of date but it's better than nothing.

Note: Medicaid expansion enrollment actually peaked in May 2023 at just shy of 24.8 million, but the graph below only includes 6-month increments (January/June).

As of September 2023, MBES put Medicaid expansion enrollment at 23,225,220 nationally.

No further analysis or comment here; I just think this is a pretty cool graphic...and keep in mind that most of the people represented here would have been utterly screwed from early 2020 - early 2023 without the Affordable Care Act being in place when the pandemic hit.

Click the image for a higher-resolution version; the states are listed on the right-hand side, though they might be difficult to make out (also note that Guam, Puerto Rico and the U.S. Virgin Islands also have a number of ACA expansion enrollees shown):

New York State of Health

As I've written about several times before, starting April 1st, New York State expanded their wildly popular Essential Plan program (NY's name for the ACA's Basic Health Plan program) up the household income scale from 200% of the federal poverty level (FPL) to 250% FPL:

On March 1, 2024, the U.S. Department of Health and Human Services (HHS) and U.S. Department of Treasury approved New York's Section 1332 State Innovation Waiver application to expand the Essential Plan.  Section 1332 State Innovation Waivers allow states to pursue innovative strategies for providing residents with access to high quality, affordable health insurance.  The waiver was approved for five years, from 2024 through 2028.

...Key Components of the Waiver

This approved State Innovation waiver expands health insurance and covers health-related social needs, improving health care and advancing health equity.  The waiver includes the following key components: 

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