Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has 10 different carriers participating in the individual market.
One thing which sets Massachusetts (along with Vermont) apart from every other state is that their Individual and Small Group risk pools are merged for premium setting purposes.
Normally you would think this would make my job easier, since I only have to run one set of analysis instead of two...but until recently, it was surprisingly difficult to get ahold of exact enrollment data for each carrier on the merged Massachusetts market (and even more difficult to break out how many are enrolled in each market since they're merged...not that that's relevant to the actual rate changes).
Kentucky is yet another state where the actuarial memos are heavily redacted, making it difficult to acquire information such as the number of enrollees...which in turn makes it impossible to run a weighted average requested rate change for the individual or small group markets.
There are four carriers offering policies on the KY individual market (Anthem, CareSource, Molina and WellCare), with an unweighted average rate change request of 4.1%. Molina has provided an unredacted actuarial memo which includes their enrollment...but it's only 505 people, while KY's total indy market is likely closer to 75,000 or so including the off-exchange market.
While numerous other states have already done the same thing (and several more are in the process of doing so as well), Georgia's move to their own enrollment platform was especially noteworthy for two reasons:
First, because it represents as complete 180-degree policy turn from their prior attempts (over the course of several years) to eliminate any formal ACA exchange (federal or state-based) in favor of outsourcing it to private insurance carriers & 3rd-party web brokers.
Back in late 2021, Colorado launched their own new, state-based ACA financial subsidies on top of federal subsidies which have already been enhanced (at least through the end of 2025) via the American Rescue Plan and Inflation Reduction Act:
The financial help you can get to lower your out-of-pocket costs are healthcare discounts called Cost-Sharing Reductions. Connect for Health Colorado is the only place you can apply for financial help to lower the cost of private health insurance. Due to the American Rescue Plan, Coloradans are now eligible for more savings than ever before.
Consider a Silver plan if your Health First Colorado (Medicaid) coverage recently ended or your income is over the limit to qualify
Connect for Health Colorado launched a new state-funded program recently to provide even more healthcare savings to people shopping on the Marketplace for 2022 whose income is just over the limit to receive Health First Colorado (Medicaid) and who enroll in a Silver-level plan.
The IDOI will finalize its review of the 2024 ACA compliant filings both on and off the federal Marketplace by August 17, 2023. The Centers for Medicare and Medicaid Services (CMS) will issue the ultimate approval for the Marketplace plans sold in Indiana. CMS will issue its approval on or before September 20, 2023.
It's been over six weeks since the last time I checked in on how many Americans had lost Medicaid or CHIP coverage due to the ongoing Medicaid Unwinding process playing out nationally. At the time, "only" 612,000 people had been confirmed to have lost coverage purely due to procedural/red tape reasons (as opposed to others who lost coverage after being determined ineligible any longer).
The Kaiser Family Foundation (KFF) has taken up the mantle on this front, and the data so far, while still limited, is pretty much as bad as many healthcare advocates feared. Since then, a lot more data has been collected and the numbers have grown dramatically:
In April 2023, 94,151,768 individuals were enrolled in Medicaid and CHIP.
87,062,629 individuals were enrolled in Medicaid in April 2023, an increase of 348,055 individuals from March 2023.
7,089,139 individuals were enrolled in CHIP in April 2023, a decrease of 73,121 individuals from March 2023.
Since February 2020, enrollment in Medicaid and CHIP has increased by 23,276,699 individuals (32.8%).
Medicaid enrollment has increased by 22,982,836 individuals (35.9%).
CHIP enrollment has increased by 293,863 individuals (4.3%).
Medicaid enrollment likely increased due to the COVID-19 PHE and Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA), which started in March 2020 and ended on March 31, 2023.
Not a whole lot stands out to me other than Cigna apparently dropping out of the states indy market and Humana pulling out of the small group market. Otherwise, neither market has rate changes which seem terribly surprising--they come to a weighted average increase of 4.3% for individual market plans and 6.6% for the small group market.
As always, these are subject to state regulatory review and approval.
The most noteworthy developments below are that in addition to Friday, Oscar and Bright Health Plans all leaving the Colorado market (as documented/reported on several times earlier this year), it looks like Anthem is reducing its offerings on the individual market, while Aetna and Humana both appear to be dropping out of the states small group market.
Update: Correction, apparently I misread that about Anthem; they have the same total number of plans available after all...not sure how I messed that up; apologies. Their Rocky Mountain division is offering off-exchange policies only, abut aren't listed on CO DARA's summary for whatever reason.
In any event, the weighted average increase being requested is 9.8% on the individual market and 10.6% for the small group market.
While numerous other states have already done the same thing (and several more are in the process of doing so as well), Georgia's move to their own enrollment platform was especially noteworthy for two reasons:
First, because it represents as complete 180-degree policy turn from their prior attempts (over the course of several years) to eliminate any formal ACA exchange (federal or state-based) in favor of outsourcing it to private insurance carriers & 3rd-party web brokers.
