Charles Gaba's blog

In July, Covered California announced the preliminary weighted average 2024 premium rate changes for the ACA individual market. They still haven't released the final/approved rates, or the small group market average rate changes, but today they released the final rate changes for standalone dental plans:

SACRAMENTO, Calif. — Covered California announced that the statewide weighted average rate change for dental coverage in 2024 will be 4.31 percent. The rate increase is the first since 2020 and continues a trend of holding costs steady for consumers.

New York State of Health

via NY State of Health:

Marketplace Hosts Informational Campus Events, Enrollment Assistors Help Eligible New Yorkers Maintain Health Coverage as Renewal Deadlines Approach

ALBANY, N.Y. (August 28, 2023) – NY State of Health, the state’s official health plan Marketplace, today announced a state-wide college campaign, with informational events taking place on campuses as students return. Certified enrollment assistors will be available in popular spots on campus to educate students on affordable, quality health insurance through the Marketplace, and help current enrollees renew their coverage.

via Connect for Health Colorado:

There Are Just a Few Days Left for Friday Health Plans Customers to Avoid a Gap in Coverage 

08/29/2023

  • Customers must enroll in a plan by this Thursday to have coverage that starts Sept. 1

DENVER— Friday Health Plans customers have less than three days to choose a new health insurance plan before their current health insurance coverage ends. Last month, the Colorado Division of Insurance announced that it had asked the courts to move Friday Health Plans into liquidation, ending coverage for all Friday Health Plans customers on August 31, 2023. Connect for Health Colorado, the state’s official health insurance marketplace, continues to urge Friday Health Plans customers to sign up for a new plan on or before this Thursday, August 31, to avoid a gap in coverage.

via the Centers for Medicare & Medicaid Services:

Since 2013, Navigators have helped Americans understand their health insurance options and facilitated their enrollment in health insurance coverage through the Federally-facilitated Marketplace (FFM). As trusted community partners, their mission focuses on assisting the uninsured and other underserved communities. Navigators serve an important role in connecting communities to health coverage, including communities that historically have experienced lower access to health coverage and greater disparities in health outcomes. Entities and individuals cannot serve as Navigators without receiving federal cooperative agreement funding, authorized in the Affordable Care Act, to perform Navigator duties.

New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.

The Delaware Dept. of Insurance has posted the preliminary 2024 individual & small group market rate filings from insurance carriers participating in those markets.

Not much noteworthy here other than that Celtic is joining the Delaware individual market for the first time next year. Aetna Health seems to have added a second division in the small group market as well, but perhaps not since both the requested rate change and the current enrollment are identical to the existing Aetna Health listing, so I'm not sure what to make of that. It's a nominal number of enrollees, however, so it doesn't really move the needle anyway.

In any event, Delaware carriers are asking for an average 4.7% rate increase on the individual market and an 8.7% hike for small group plans...subject to state regulatory approval, of course.

Michigan

Back in February, I posted an updated & overhauled version of my Michigan healthcare legislative wish list for the newly-elected Democratic majorities in my home states House and Senate.

The list includes 9 major items (some of which actually include a lot more than one provision within them). It really should include ten, since I forgot about implementing a Basic Health Plan program like New York and Minnesota have (and as Oregon is ramping up to do soon as well), but it's still a pretty full plate.

The second and third items on the list included:

via the U.S. Dept. of Health & Human Services (HHS):

For the first time, Medicare will be able to negotiate prices directly with drug companies, lowering prices on some of the costliest prescription drugs.

For the first time, thanks to President Biden’s Inflation Reduction Act – the historic law lowering health care costs – Medicare is able to negotiate the prices of prescription drugs. Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced the first 10 drugs covered under Medicare Part D selected for negotiation. The negotiations with participating drug companies will occur in 2023 and 2024, and any negotiated prices will become effective beginning in 2026. Medicare enrollees taking the 10 drugs covered under Part D selected for negotiation paid a total of $3.4 billion in out-of-pocket costs in 2022 for these drugs.

Vermont

Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:

Georgia's health department doesn't publish their annual rate filings publicly, but they don't hide them either; I was able to acquire pretty much everything via a simple FOIA request. Huge kudos to the GA OCI folks!

Back in July, I compiled the weighted average requested rate changes for 2024 for both the Georgia individual and small group markets. At the time, individual market carriers were asking for rate hikes ranging from a relatively modest 6% (UnitedHealthcare) to a stunning 27.7% increase (Cigna). The weighted average came in at right around 15% even.

On the small group market, meanwhile, only around half the carrier filings were available at all, so I couldn't really run a proper average, although of those which had filed theirs, the average came in at 12.6%.

Earlier today I acquired the most recent rate filings for every carrier in both markets. I don't know for certain whether these are the final, approved rates for 2024, but it seems likely:

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