Charles Gaba's blog

COVID-19 Vaccine

Exactly a month ago I posted an in-depth analysis in which I broke out all 3,114 counties, parishes, boroughs & census areas throughout the 50 United States (+DC) into a 3x3 grid as follows:

  • Blue Counties: Low-Vaxx
  • Blue Counties: Moderate-Vaxx
  • Blue Counties: High-Vaxx
  • Swing Counties: Low-Vaxx
  • Swing Counties: Moderate-Vaxx
  • Swing Counties: High-Vaxx
  • Red Counties: Low-Vaxx
  • Red Counties: Moderate-Vaxx
  • Red Counties: High-Vaxx.

...or, put more visually:

At the time I was mostly interested in looking at the outlier counties--the poorly-vaccinated solidly blue counties and the highly-vaccinated solid red counties.

I also noted that, to no great surprise, the makeup of those 146 "Blue Low-Vaxx" counties is pretty telling:

CMS Logo

via Amy Lotven of Inside Health Policy:

CMS tells Inside Health Policy that it will be releasing a final report on its COVID-19 Special Enrollment Period in September and points out that consumers who submitted their applications by the Aug. 15 SEP deadline still have 30 days to select a plan. Additionally, staffers are contacting the “very small group” of consumers who reached out to the Marketplace Call Center just before the deadline but were unable to get through to a representative so that those individuals have a chance to enroll, the agency confirms.

The final report was obvious, since the 2021 "No Excuses Needed" SEP still ran through August 15th in most states (and is still ongoing in a few), but I figured they'd come out with it in late August, not September.

I admit that I didn't know (or had forgotten?) about those who submitted their apps prior to 8/15 still having a full month to select a plan. Granted, if they wait until mid-September their coverage won't start until October, giving them just 3 months to use up a full 12-month deductible, but still.

New Jersey

via the New Jersey Dept. of Banking & Insurance:

NJ DOBI Announces Grant Opportunity for Navigators to Assist New Jerseyans With Health Insurance Enrollment

  • Open Enrollment Period at Get Covered New Jersey Begins November 1, 2021

TRENTON – The New Jersey Department of Banking and Insurance today announced it is now accepting applications for community organizations to serve as Navigators to assist residents with health insurance enrollment for the upcoming Open Enrollment Period and during 2022. The department is making available a total of $4 million in grant funding for Navigators, in an effort to ensure enrollment assistance is available in the community for residents seeking coverage through Get Covered New Jersey, the state’s official health insurance marketplace, during the Open Enrollment Period that starts November 1, 2021 and through the year.

Arkansas

via the Arkansas Insurance Dept:

Health Insurance Rate Changes for 2022

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 2022 individual and small group products that comply with the reforms of the Affordable Care Act.

Michigan

I'm gonna be posting mea culpas for a few days for missing important ACA-related announcements over the past few weeks.

Michigan's preliminary 2022 rate filings actually came out a solid month ago, but as noted above I'm way behind on my rate filing project this year:

Highlighting Michigan’s increasingly competitive health insurance market, the Michigan Department of Insurance and Financial Services (DIFS) has reported that consumers will have more health plan options from an increased number of insurers on the Health Insurance Marketplace for the upcoming open enrollment period.

“As we look toward the end of the pandemic and beyond, it is critical that Michiganders are able to get the affordable, high quality health coverage they need for themselves and their families,” said DIFS Director Anita Fox. “Consumers will have more options to choose from when shopping for health insurance coverage on the Marketplace during open enrollment later this year.”

Covered California Logo

via Covered California:

  • Covered California’s enrollment continues to surge — with 364,000 signing up since February, more than double normal enrollment rates — as more people sign up for coverage to benefit from the new savings and lower premiums available through the American Rescue Plan.
  • Lower-income households are getting a quality plan for an average of $35 per month, with more than 738,000 people getting brand-name plans for just $1 per month.
  • Middle-income consumers, who were previously ineligible for federal financial help, are saving an average of nearly $800 per month and seeing their monthly premiums reduced by more than 70 percent.
  • Covered California’s increased enrollment includes a higher proportion of African American and Latino Californians, two of the communities hit hardest by the COVID-19 pandemic and ensuing recession.
  • Those who enroll by Aug. 31 would be insured starting Sept. 1.
Michigan Flag

 

via the Michigan Dept. of Insurance & Financial Services:

DIFS Files Cease and Desist Order Against Health Care Sharing Ministry, Connected Businesses Operating in Michigan

(LANSING, MICH) The Michigan Department of Insurance and Financial Services (DIFS) has issued a cease-and-desist order against a healthcare sharing ministry and two connected companies for allegedly acting in violation of the Michigan Insurance Code.

“Health care sharing ministries can have a role in fostering the health, fellowship, and sense of community for individuals of faith, but they must follow the requirements of the law,” said DIFS Director Anita Fox. “The DIFS investigation showed that the companies under this cease-and-desist order are essentially operating as unlicensed health insurance companies, in violation of the Insurance Code.”

Arizona

The good news is that the federal Rate Review database has now posted the preliminary avg. 2022 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%.

Alabama

Via the Alabama Insurance Dept:

The Affordable Care Act (ACA) requires that insurers planning to increase plan premiums submit their rates to the Alabama Department of Insurance for review.

The rate review process is designed to improve insurer accountability and transparency. It ensures that experts evaluate whether the proposed rate increases are based on reasonable cost assumptions and solid evidence. The ACA also requires that a summary of rate review justifications and results be accessible to the public in an easily understandable format. The Federal HealthCare.gov Rate Review website is designed to meet that mandate. For more information, see here.

The information is provided in the tables below. Also attached are links to the redacted actuarial memorandum, which support these changes. The rate changes are being proposed and reviewed by the Alabama Department of insurance (ALDOI). As soon as they are final, they may be purchased on the Federal Exchange or through private agents and brokers. The programs will be effective beginning on January 1, 2022.

Peterson / KFF

A few weeks ago, I wrote a piece reminding people that the Affordable Care Act explicitly prohibits insurance carriers from charging higher premiums for enrollees who voluntarily refuse to get vaccinated against COVID-19 (presumably not including those who can't do so due to being allergic, being immunocompromised, being under 12 years old, etc), and noting several reasons why this is the case.

I concluded, however, by noting that:

Having said that, those who don't get vaccinated will start facing more financial penalties soon anyway...a point which is included in the NY Times article above itself:

In 2020, before there were Covid-19 vaccines, most major private insurers waived patient payments — from coinsurance to deductibles — for Covid treatment. But many if not most have allowed that policy to lapse. Aetna, for example, ended that policy on Feb. 28; UnitedHealthcare began rolling back its waivers late last year and discontinued them by the end of March.

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