I probably won't have any other blog posts today as I'm off to Lansing, Michigan this morning to attend this:
The fight to stop health care repeal isn’t over yet — far from it. At stake right now: Higher costs. Medicaid. Medicare. Coverage for pre-existing conditions. Prohibitions on discrimination against women and people over age 50.
If you’re sick and tired of the Republican war on health care, join people across the country who are joining Protect Our Care’s nationwide bus tour. Make your voice heard at the Protect Our Care bus stop in Lansing.
Join us at the Michigan State Capitol in Lansing on Wednesday, October 3 to voice your opposition to Republicans’ repeal-and-sabotage agenda, which has cut health care coverage and driven up health care costs for millions.
Minnesota, currently entering their second year of their official reinsurance waiver program to help keep unsubsidized premiums down, announced their preliminary 2019 rate hikes way back in June. At the time, the carriers were looking at roughly an 8% average reduction in rates next year...although they would be dropping prices by more like 15% if not for the ACA's individual mandate being repealed and the expansion of #ShortAssPlans.
Today the Minnesota Dept. of Commerce posted the approved 2019 premium changes, and there's been some dramatic reductionsfor three of the five carriers offering policies in the state. Group Health and Medica were approved as is, but Blue Plus was told to drop their rates a whopping 27.7% instead of the 11.8% they were planning on. Ucare was shaved down from a 7 point reduction to 10 points, and PreferredOne (which only sells individual market policies off-exchange and only has 300 enrollees anyway) was knocked down from a 3-point reduction to 11 points.
The official annual ACA Open Enrollment Period (OEP) starting and ending dates have jumped around a lot since the exchanges kicked off back on October 1, 2013.
For the first OEP, people were given 6 months since the technology and the process were brand new to everyone...and thank God they were given the technical mess that the federal exchange (HealthCare.Gov) as well as many of the state-based exchanges experienced at launch. Things were eventually worked out, but not only was that extra time in spring 2014 vitally important, many people still needed some extra time beyond that as well. The official deadline to enroll for 2014 coverage was March 31, but the HHS Dept. gave people who had started their application by then an extra 15-day "overtime" period to complete the process.
For the 2015 OEP, the official dates were from November 15 - February 15th, cutting the time period down to three months. This time there was a one-week "overtime" period tacked onto the end.
For 2016 and 2017, HHS settled on November 1st - January 31st, which seemed to make sense since it was easier to remember: November, December, January.
I ran the numbers for Nevada's preliminary 2019 ACA individual market rate changes back in July. At the time, the average requested rate increase was around 2.3% statewide.
With the 2019 Open Enrollment Period coming up fast, I checked on the approved rate changes and found that state regulators had cut down on the rates quite a bit...although mostly for carriers which only offer off-exchange plans and only have small numbers of enrollees anyway.
For instance, HMO Colorado (dba HMO Nevada) originally requested a 20.9% increase; this was reduced to 9.5%...but they only have 200 people enrolled anyway, so it's not even a rounding error. Rocky Mountain was cut from 34.4% to 18.5%...but only has 300 enrollees, and so on.
The three carriers which hold the vast bulk of the market had far less dramatic changes, although Silver Summit was cut from a 5.2% increase to a 1.1% decrease for 2019.
eHealth Insurance is a leading private online health insurance exchange, and is licensed to sell health insurance in all 50 states and the District of Columbia. They also publicly post survey results of both their membership and insurance carriers from time to time. While eHealth isn't necessarily fully representative of the entire individual health insurance market, the fact that they cover every state +DC means their surveys should provide at least some big picture insight into the landscape.
(For those wondering: No, this is not an endorsement, they aren't paying me to promote them, and I haven't a clue whether or not they're a good or bad company to do business with.)
New Mexico has a unique exchange; the state runs the small business portion, and while the individual exchange is also technically state-run, Healthcare.gov is used to enroll people in individual insurance (ie, a federally-supported state-based marketplace). But the exchange is planning to establish its own enrollment platform that will be in use by the fall of 2020.
Normally I'd just use a snippet of the entry, but Norris manages to cover all the relevant angles in just a few paragraphs; I think she'll be OK with me cribbing more of it:
Initially, the state had planned to establish a state-run website for individual enrollments fairly soon after the exchanges went live in the fall of 2013, and that was still in the works until early spring 2015. But in April 2015, the exchange board voted to continue to use Healthcare.gov, as that was viewed as the less-costly alternative.
Tomorrow, HHS Secretary Azar will join Governor Haslam in Nashville, Tennessee to deliver remarks at an event hosted by the Nashville Health Care Council.
Secretary Azar will share news regarding the Affordable Care Act marketplace and reflect on lessons for healthcare reform.
In advance of tomorrow, here are a few excerpts of Secretary Azar’s remarks (as prepared for delivery):
“The previous administration’s major healthcare achievement, the Affordable Care Act, was an attempt to use more government regulation and intervention to improve American healthcare.
“As we all know, the results were disastrous, with skyrocketing costs and disappearing choices.
“But today, I am here to share with you some good news.
Later Wednesday, [Democratic Governor Gina] Raimondo held her own news conference to sign an executive order that, among other steps, directs the state to seek to codify in state law protections for people with preexisting conditions, dependents up to age 26, prescription drug benefits and maternity coverage in case federal action is taken to weaken the Affordable Care Act.
Rhode Island has one of the highest insured rates in the country, and Raimondo said she was defending "Rhode Islanders' access to high-quality, affordable health coverage."
I'm not quite sure what an executive order has to do with codifying ACA protections into law, since that's really up to the state legislature to do, but I guess it at least kicks their butts into gear?
This is also refreshing to hear from a Republican challenger:
A few minutes ago I posted about North Dakota'sapproved 2019 rate hikes, which are coming in at a mere 3.2% on average (but which would likely be dropping nearly 20 points without both last and this year's #ACASabotage factors).
As I noted last month when I first analyzed the requested 2019 rates for North Dakota insurers, ND was somewhat unique last year in that it was one of only two states (the other was Vermont) which didn't tack on any extra premium increases for 2018 to account for the lost Cost Sharing Reduction reimbursement revenue after Donald Trump cut off those payments last October.
This led to one of North Dakota's three carriers, Medica, dropping off the ACA exchange altogether, though they still ended up enrolling a few hundred people directly via the off-exchange market.
