Charles Gaba's blog

h/t to Esther F. for the heads up:

Amy Goldstein at the Washington Post writes:

Evergreen Health, Maryland’s version of the innovative nonprofit insurers created under the Affordable Care Act, decided Monday to become a for-profit company to avoid the possibility of a shutdown, according to its chief executive.   

If the switch is approved as expected by federal and state officials, Evergreen’s unprecedented move will leave standing only five of the 23 co-ops, or Consumer Operated and Oriented Plans, which started nearly three years ago.

...Evergreen, which covers nearly 38,000 Marylanders, has been trying for the past year to forge an arrangement with federal health officials to stabilize its finances. It enlisted help from the state’s congressional delegation and in June filed suit against the federal government.

As noted below, only around 8,000 are on enrolled in individual ACA exchange policies; the rest are either off-exchange or small/large group coverage.

More last-minute shuffling... (h/t commenter "M E"):

Baptist Health Plan to stop selling insurance in Ky.

FRANKFORT (AP) — Baptist Health Plan says it will not sell policies in Kentucky next year, meaning about 7,000 people will have to find a new insurance provider.

Kentucky’s fourth-largest insurer notified state officials in a letter. In a news release, state officials say company President James S. Fritz said Baptist Health Plan had enrolled more people than it planned and said federal risk assessments imposed by the federal Affordable Care Act are “unsustainable.”

The company’s insurance plans sold on the state’s health exchange will be good through Dec. 31. Plans sold off the exchange will expire March 31, 2017.

The news means next year people in 59 counties will have one insurance provider selling plans on the state health exchange. Off the exchange, most counties will have two options, state officials said.

OK, this is earlier than I expected...Your Health Idaho has decided to be first out of the gate with official 2017 ACA Exchange Window Shopping: 

October 1, 2016

Preview Health and Dental Plans on Your Health Idaho

BOISE, Idaho – Starting today, Idahoans can get a preview on YourHealthIdaho.org of the 225 different health and dental insurance plans being offered on the exchange in 2017.

“Before open enrollment begins on November 1, Idahoans can preview and compare different health and dental insurance plans to figure out which one best meets their needs,” said Pat Kelly, executive director of Your Health Idaho. “There are not only more plans being offered this year than ever before, but customers can see the size of the plan’s network to get a full perspective on the choices available to them.”

Prior to the 2017 open enrollment period, health insurance carriers will reach out to their customers to inform them of any changes to their current plan, including differences in rates and deductibles.

Back in June, BCBS of Minnesota announced that they were pulling all of their PPO plans out of the state. Aside from that, and some hefty proposed rate hikes for everyone else, there hasn't been a whole lot of news out of the Land of 10K Lakes.

Today, however, they announced their approved rate increases, and the unsubsidized prices don't look pretty:

Health insurers are boosting individual market premiums by an average of 50 percent or more next year, increases that regulators say are necessary to save a market that otherwise was on the verge of collapse.

The increases were announced Friday by the state Commerce Department, and show premiums will jump even higher than proposed rates that were made public on Sept. 1.

At that point, carriers sought increases ranging from 36 percent to 67 percent. But the final average increases will range form 50 percent to 67 percent, depending on the insurer.

Here's how it actually plays out by the hard numbers:

In yesterday's New Hampshire Business Review, a reporter named Bob Sanders has written an excellent piece about the 2017 Open Enrollment Period situation in the Granite State:

As the dust settles on the Affordable Care Act, New Hampshire is feeling tremors from shifts occurring nationally, although the state’s health care landscape is more stable than the rest of the country. 

About a quarter of the nation, geographically, and around 17 percent, demographically, only have one insurer on the exchange, meaning less competition on rates, and therefore higher costs. Over the past year, UnitedHealthcare, Aetna and Humana have pulled out of the markets in most states, not getting the healthy populations they expected.

It's a good article, full of stats, figures, context and quotes. THere's even a nifty pie chart showing the relative market share of the carriers and so on.

Only one problem; can you spot it?

More last-minute carrier scrambling ahead of the OE4 kickoff...

Arise Health Plan, a subsidiary of WPS Health Solutions, said Thursday that it will not sell health plans on the marketplaces set up through the Affordable Care Act next year, becoming the latest company to abandon the market.

Arise and WPS Health Insurance also will sell only high-deductible health plans for individuals and their families off the marketplace, and those plans will be available only in a limited number of counties.

...For now, the marketplace for Milwaukee County next year will have four companies offering health plans: Molina Healthcare; Network Health Plan, owned by Ascension Wisconsin and Froedtert Health; Common Ground Healthcare Cooperative; and Children’s Community Health Plan.

Waukesha County tentatively will have those companies as well as Anthem Blue Cross and Blue Shield in Wisconsin and Dean Health Plan.

...Arise Health Plan has a relatively small share of the market in southeastern Wisconsin.

The Kaiser Family Foundation runs a monthly tracking survey, which I've referenced here many times before. Here's some key points from their September survey:

  • 77% of Americans say prescription drug costs are unreasonable in light of the Epi-Pen scandal, up from 72% a year ago
  • Approval/Disapproval of the ACA is split almost evenly, as usual (44% favorable, 47% unfavorable...which is actually better than I expected given all the bad news about rate hikes and carrier drop-outs in recent weeks)
  • The biggest healthcare-related concerns are (in order of decreasing importance): The future of the ACA in general; insurance premiums; insurance deductibles; drug prices; the uninsured; the opioid epidemic; and the Zika virus

There's a whole bunch of other interesting stuff, mostly about prescription drug issues, but there's one which made me feel like sticking my head in the oven (which wouldn't be very effective anyway, since ours is electric; I'd just end up burning my face):

THE NUMBER OF AMERICANS WITHOUT HEALTH INSURANCE

There's been story after story over the past few months about insurance carriers large and small either dropping out of the ACA exchanges or (in the case of 4 co-ops) going belly-up altogether. Along the way, there have also been a few stories about other carriers expanding into new states or additional counties in states they're already participating in.

Case in point:

Residents in more West Virginia counties will have additional health plan options when the open enrollment period on the Mountain State’s insurance exchange, created in the Affordable Care Act, opens on Nov. 1.

In its 2nd year in West Virginia, CareSource, a nonprofit managed care provider based in Dayton, Ohio, is expanding its coverage area to include 32 counties.

...In 2016, CareSource is providing health insurance coverage to more than 1,300 West Virginia residents in ten counties: Brooke, Cabell, Hancock, Kanawha, Lincoln, Marshall, Mason, Ohio, Putnam, Wayne.

Two bits of news out of the DC exchange today: First, they announced that the uninsured rate has been slashed in half over the past 3 years thanks in no small part to the Affordable Care Act. Not a huge shocker given the recent surveys/studies released by the CDC, Gallup, Kaiser and so on of late, but still good to see:

District's Uninsured Rate Drops by Half

Washington, DC­­ – A new survey by the Center for the Study of Services conducted for the DC Health Benefit Exchange Authority (DCHBX) concludes that the District of Columbia made huge gains during the most recent open enrollment period to provide access to health insurance coverage to people who were previously uninsured. Results from this survey show that more than 25,500 people, who were not previously covered in 2015, gained access to health insurance coverage in 2016 through DC Health Link, the District’s online health insurance marketplace.

...Additional findings show:

Zach Tracer reports over at Bloomberg News...

UnitedHealth Group Inc., the biggest U.S. health insurer, is scaling back its experiment in Obamacare markets as its Harken Health Insurance Co. startup withdraws from the two exchanges where it was selling plans.

Harken will not offer individual plans through Obamacare exchanges in Georgia and Chicago in 2017, the company said Thursday in an e-mailed statement. It will continue to offer individual plans off the exchange, Harken said.

As commenter ME notes, there are currently around 22,800 Harken enrollees in Illinois and another 10,500 in Georgia. I have no idea what the on/off exchange ratio is, however, so the number of people who will actually have to shop around will be up to 33,300; assuming, say, 2/3 are on the exchange, that would be roughly 22,000 people.

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