HealthSource RI enrollments up by nearly 2,000 customers as RI’s uninsured rate reaches all-time low
Feb 25, 2019
According to the latest Rhode Island’s Health Information Survey, only 3.7% of Rhode Islanders were uninsured in 2018, down from 4.2% in 2016.
HealthSource RI’s individual and family enrollments increased by 1,849. This Open Enrollment, 32,486 customers enrolled and paid compared to 30,637 last year.
The "...and paid" caveat is important. Last month HealthSource RI reported 34,533 QHP selections after the 2019 OEP wrapped up, so that's an impressive 94% paid/effectuated rate. For comparison, last year 30,637 paid out of 33,021, or 92.8%, so they've improved on that front as well.
By the close of this year’s Open Enrollment, Coloradans had selected 169,672 medical insurance plans, which compares to 165,777 medical plan selections for the 2018 Open Enrollment period.
Hmmm...I'll have to look into these numbers a bit further. Colorado's 2018 Open Enrollment total was indeed 165,777 according to C4HCO...but according to CMS's official report it was only 161,764 QHP selections. This is the same thing which happened last year, when C4HCO reported 172,361 QHPs vs. CMS's 161,568. It's therefore possible that the final/official 2019 CMS report will put Colorado's total around 4,000 enrollees lower than my own numbers.
However, either way, Colorado joins Massachusetts in increasing their ACA open enrollment numbers every year for five years straight, bucking the national trend!
A couple of weeks ago, Louise Norris gave me a heads up that not only has the New Mexico Insurance Dept. restricted the sale of non-ACA compliant "short-term, limited duration" plans to be...you know...both short term and of limited duration via regulation...
In September 2018, the New Mexico Office of the Superintendent of Insurance (OSI) and Health Action NM (an advocacy group for universal access to health care) presented details about potential state actions to stabilize the individual market. OSI has the authority to regulate some aspects of the plans, including maximum duration, but they noted that legislation would be needed for other changes, including minimum loss ratios and benefit mandates.
New Mexico’s insurance regulations were amended, effective February 1, 2019, to define short-term plans as nonrenewable, and with terms of no more than three months. The regulations also prohibit insurers from selling a short-term plan to anyone who has had short-term coverage within the previous 12 months.
Last week, the state of Arkansas released its latest round of data on implementation of its Medicaid work reporting requirement – the first in the country to be implemented. As readers of SayAhhh! know, over 18,000 lost coverage in 2018 as a result of not complying with the new reporting rules. And the policy is clearly failing to achieve its purported goal – incentivizing work – with less than 1% of those subject to the new policy newly reporting work or community engagement activities.
Minnesota's new Democratic (pardon me..."Democratic-Farmer-Labor", or DFL) Governor, Tim Walz, has just posted his proposed state budget for the next fiscal year, and it includes some fantastic expansions & improvements to the healthcare system of Minnesota, including both state-level ACA enhancements and a push for a robust Public Option, along with other ideas.
Bill expanding ‘Insure Oklahoma’ program passes Senate committee
A Senate bill seeking to expand the Insure Oklahoma program has advanced out of committee Monday morning.
Senate Bill 605, authored by Sen. Greg McCortney, R-Ada, directs the Oklahoma Healthcare Authority to implement "the Oklahoma Plan" within Insure Oklahoma. An agency spokesperson said the program provides premium assistance to low-income working adults employed by small businesses.
The latest numbers from Insure Oklahoma show less than 19,000 are enrolled.
According to McCortney, the intent of his bill is to provide insurance for Oklahomans who would qualify for Medicaid in states which opted to expand but are currently not insured.
Note: Huge props to Amy Lotven for breaking this story!
WARNING: Before you read any of the following, first read this entire post, which explains the latest insane twist in the never-ending Cost Sharing Reduction legal saga. Yeah, I know, I know...just do it. I'll wait.
....
OK, now that you're all caught up, there's yet another aspect to this craziness which has arisen.
Towards the end of the first post, I noted that:
I'm not sure of the details on how those MLR rebates are allocated, but I know in 2018, nearly 6 million people received an average rebate of $119 apiece. Most of that came from the large and small group markets, but around 1 million people on the ACA individual market received $137 apiece (around $133 million total). That's right: It's theoretically possible that the carriers could have to dole out up to 75 times as much in MLR rebates for 2018 as they did last year.
First of all, it turns out that the amount of money potentially at stake is even higher than that:
Note: Huge props to Amy Lotven for breaking this story.
I've written about the CSR Saga so many times that I'm getting tired of explaining the backstory. However, once again, here's the short version:
Once again, the very short version is this:
The contract insurance carriers sign when they offer policies on the ACA exchanges is to cover a chunk of low-income enrollee deductibles, co-pays and other out-of-pocket costs which would normally be the enrollees' responsibility. These are called Cost Sharing Reductions (CSR).
The carriers then submit their CSR invoices to the federal government, which is supposed to reimburse the insurance carriers every month.
Donald Trump cut off contrctually-required CSR reimbursement payments to insurance carriers in October 2017...and hasn't made any payments since.
(I'm not going to rehash how Trump was able to cut off those payments with a Thanos-like snap of his fingers; suffice to say it's connected to a lawsuit filed so long ago that John friggin' Boehner was still Speaker of the House at the time).
Back in early December, I noted that while I applauded both New Jersey and the District of Columbia for creating their own individual healthcare coverage responsibility requirements (aka, The Individual Mandate) in response to Congressional Republicans repealing the ACA's federal penalty, doing so also required making sure that residents of NJ/DC *knew* they had done so:
There's only one problem with this: The impact of the mandate penalty is completely psychological in nature. It only works (to the extent that it does at all) if people know that they'll be penalized financially for not complying with the mandate.
I still expect the final national QHP selection tally to increase by around 35,000 more when the dust settles, including perhaps 1,000 more from DC, 5K - 10K more from New York and around 28,000 from Vermont (which hasn't reported anything so far this Open Enrollment Period). If so, the official total should end up around 11.47 million nationally, with the 12 State-Based exchanges coming in around 1.6% higher than last year (an all-time high for them collectively) vs. the 39 states on the federal exchange, which dropped another 3.8% this year. Nationally, the official total should end up around 280,000 enrollees short of last year.
Since then I've plugged in the final numbers from New York (which indeed added around 6,700 more enrollees), the District of Columbia (which added over 3,000 more) and, just this morning, Vermont (which only added 25,000 more, with a caveat). Net increase? 34,889 QHP selections.
That indeed brings the grand total to 11,465,327 QHP selections nationally...or 11.47 million...with the state-based exchanges increasing 1.6% year over year, and the national total dropping 285,000 enrollees.
UPDATE: The final, official CMS enrollment report came out in late April, and there's some minor discrepancies in a few states (especially Minnesota). Nationally, the official total is around 22,000 fewer than I thought. The table below has been updated to reflect this. The state-based exchanges still increased enrollment over last year, but only by 0.9%; nationally, enrollment dropped by 306,000 people.