Charles Gaba's blog

Ouch. Via the New York Dept. of Financial Services, the preliminary, weighted average rate increases being requested for individual market health insurance policies for 2024 are looking pretty ugly indeed: 20.9% overall according to DIFS. I get a slightly lower weighted average of 20.7%, but it still ain't pretty.

Two of the highest increases are for carriers which are only offering policies off-exchange next year and which have fewer than 100 enrollees each anyway; I assume they're both winding down their operations in the state. 


From the individual carrier narrative summaries:

Wow. It took less than 12 hours from this announcement by the COLORADO Dept. of Regulatory Agencies to be released...

Friday Health Plans, Inc. Winding Down Business

What Happened?

Friday Health Plans, Inc., the parent company of Friday Health Plan of Colorado, ,Inc. (HMO), has announced that it will begin to wind down its business activities throughout the country, working in close conjunction with state regulators, including the Colorado Division of Insurance.

In recent months, it became apparent that the parent company would need to raise substantial capital to continue. Friday was ultimately unable to raise that capital and on June 1, Friday Health Plans, Inc. (Parent) stated publicly that they would begin to wind down. this press release from the NEVADA Division of Insurance:

This post has a long intro, but please bear with me...

Back in 2018, after the then-Republican controlled Congress zeroed out the ACA's federal "individual mandate penalty" (officially the "shared responsibility penalty"), I posted both a video and slideshow explainer about what this penalty was and why it was included in the ACA in the first place.

The very short and simplified version is this:


October 2022:

Texas: Friday Health Plans Bails; Another ~230K Enrollees Will Have To Pick A Different Day Of The Week

It was just four days ago that Bright Healthcare, which had been aggressively expanding their individual market coverage area footprint as recently as a year ago, suddenly announced that they were doing a complete 180 and instead pulling out of virtually the entire individual & small group markets nationally starting in January 2023.

...Well, just one day after the Bright Healthcare bombshell news broke, Texas-based health insurance broker Jenny Chumbley Hogue sounded the alarm on another large carrier bailing on Texas next year:

And its confirmed. Email received from Friday. Buckle up folks! Individual OEP in Texas is going to be a bumpy ride!


via Covered California:

Covered California Launches Statewide Push to Help Californians Stay Covered if They Lose Their Medi-Cal Eligibility

Covered California lanza una campaña estatal para ayudar a los californianos a permanecer cubiertos si pierden su elegibilidad para Medi-Cal

SACRAMENTO, Calif. — Covered California launched a virtual media tour on Wednesday to spread the word about the upcoming Medi-Cal to Covered California Enrollment Program and how it will help keep Californians covered. 

October 2022:

...Well, just one day after the Bright Healthcare bombshell news broke, Texas-based health insurance broker Jenny Chumbley Hogue sounded the alarm on another large carrier bailing on Texas next year:

TX Marketplace Rumor Mill: Friday Health Plans is OUT for 2023. @LouiseNorris @charles_gaba @bjdickmayhew

— Jenny Chumbley Hogue (@kgmom219) October 12, 2022

And its confirmed. Email received from Friday. Buckle up folks! Individual OEP in Texas is going to be a bumpy ride!

— Jenny Chumbley Hogue (@kgmom219) October 12, 2022

via the Washington Insurance Dept.:

OLYMPIA, Wash. — Fourteen health insurers filed an average requested rate increase of 9.11% 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.

"Nearly 250,000 people in Washington state get their health coverage through our individual market,” said Insurance Commissioner Mike Kreidler. “I'm pleased that so many insurers are filing plans again and to see such healthy competition. Now, we'll spend the next few months closely reviewing the companies' requests and the assumptions they’re making to be sure any rate change is justified.”

Back in February, I wrote about a bill introduced into the Illinois State Senate by Sen. Laura Fine (SD-09) which made my heart sing:

  • Amends the Department of Insurance Law.
  • Provides that the Department of Insurance shall establish the Office of the Healthcare Advocate.
  • Provides that the Office shall be administered by the Chief Health Care Advocate, who shall report to the Director of Insurance.
  • Amends the Illinois Insurance Code and the Health Maintenance Organization Act.
  • Provides that all individual and small group accident and health policies written subject to certain federal standards must file rates with the Department for approval.
  • Provides that unreasonable rate increases or inadequate rates shall be modified or disapproved.
  • Provides that when an insurer files a schedule or table of premium rates for individual or small group health benefit plans, the insurer shall post notice of the premium rate filings and a filing summary in plain language on the insurer's website.
  • Provides that the Department shall post all insurers' rate filings and summaries on the Department's website.
  • Provides that the Department shall open a 30-day public comment period on the date that a rate filing is posted on the website.

I wrote about Illinois House Bill 579 back in March:

...With the recent trend of more & more states (most recently including Georgia) splitting off from the Federally Facilitated Marketplace (FFM) hosted via HealthCare.Gov, it's hardly surprising...but it's still a pretty big deal, especially given that Illinois is the 6th largest U.S. state by population. Via Amy Lotven of Inside Health Policy:

Illinois’ Department of Insurance would be authorized to operate a state-based exchange, starting in plan year 2026, under legislation introduced late Thursday by the Illinois Democratic House Majority Leader Robyn Gabel. Sources earlier this week told IHP they had heard state officials were working with lawmakers on exchange legislation and the bill could be unveiled by this week.

via Access Health CT:

These free, in-person events will take place in Meriden, Norwich and Waterbury

HARTFORD, Conn. (May 24, 2023) — Access Health CT (AHCT) today announced it will host three free, in-person enrollment fairs in June to help HUSKY Health enrollees who have been affected by recent legislation. HUSKY Health is Connecticut’s Medicaid program. The events will take place in Meriden, Norwich and Waterbury.

Medicaid Unwinding is a term the federal government is using to describe the process of resuming the regular annual review of households for Medicaid eligibility after a three-year hiatus during COVID. The eligibility redetermination process resumed April 1. The Medicaid Unwinding process will be taking place over a 12-month period.

Connecticut residents who remain eligible for HUSKY Health will likely be automatically reenrolled; those who need to take action will receive mail with instructions about when they need to take action.