MIT health economist Jonathan Gruber was the Republican Party's favorite stock villian during the absurd King v. Burwell (formerly Halbig v. Burwell) Supreme Court saga which raged throughout the first half of 2015, in large part because of his tendency to have a bad case of diarrhea of the mouth when speculating about the reason why certain sections of the ACA were written the way they were.
From a pure, cold economic perspective, the debate going on between the dueling studies above is about how much the first is being cancelled out by the second.
The debate which should be going on from a human perspective is about whether more or fewer people are better or worse off health-wise and economically thanks to/due to the ACA than they would otherwise be without it.
Unfortunately, when it comes to healthcare, this is a nearly impossible task to measure properly.
For instance, let's take someone with cancer. Under the ACA, they're allowed to enroll in a policy which will cover their treatments. If they have a low income, they'll receive heavy APTC assistance and possibly CSR assistance.
Without the ACA, they'd be utterly screwed and would very likely go bankrupt trying to pay the full price for treatment, or die without it, or the first followed by the second.
In an effort to prevent more insurers from abandoning the Obamacare exchange in Tennessee, the state's insurance regulator is allowing health insurers refile 2017 rate requests by Aug. 12 after Cigna and Humana said their previously requested premium hikes were too low.
As of last week, five companies in Arizona had announced plans to pull out or pull back: Health Choice, United Healthcare, Humana, Blue Cross Blue Shield of Arizona and Health Net.
Well, there you have it: Across all 50 states (+DC), taking a bunch of caveats into account (see below), as far as I can estimate, the average premium rate increases being requested by health insurance carriers sits at right around 23% overall.
Off-exchange policies are included whenever possible, but only if they're ACA-compliant (grandfathered/transitional plans are in a different risk pool anyway). The ACA-compliant individual market totals roughly 18-19 million people nationally (11 million on-exchange, another 7-8 million off-exchange). Grandfathered/Transitional plans likely total around 2-3 million more.
Only individual market policies are included (there's a few states where the small group market has been merged with the individual market risk-pool wise, but I only include indy enrollees for purposes of weighting). The small group market was around 13.5 million people, according to Mark Farrah Associates.
Some carriers are pulling out of either specific counties or entire states next year, or are dropping certain plans while keeping others. There's no way of estimating the "average rate increase" for anyone who's losing their existing plan altogether.
Well, I've managed to put together estimates (some very rough, some pretty specific) of the weighted average requested ACA-compliant individual market rate hikes for 49 out of 50 states, along with the District of Columbia. This leaves just one state left: Minnesota. For whatever reason, I've been informed that Minnesota's requested rate filings won't be available to the public until September 1st, which is too late for my purposes...because by that point, many of the other states will have started releasing their approved rates for next year (in fact 3 of them--Oregon, New York and Mississippi--have already done so). Minnesota's approved rates will be posted on October 1st. It's always been my intent to lock down the requested rates for every state before the approved numbers are posted in order to run a comparison between what was asked for and what the final approved rate changes are.
Mississippi remains one of only two states which still don't have their 2017 Rate Filings posted over at HC.gov's Rate Review database. In addition, while Mississippi does use the SERFF system for other types of insurance, major medical doesn't appear to be among them. Finally, while the MS Dept. of Insurance does include a special website specifically designed for searching/comparing rate changes for health insurance policies...it doesn't appear to have been updated in awhile (the only recently listings are for obscure carriers which seem to be mostly offering short-term plans and other "mini-med" types of policies, not full ACA-compliant plans.
Health Insurer Aetna Inc on Wednesday said it plans to continue its Obamacare health insurance business next year in the 15 states where it now participates, and may expand to a few additional states.
"We have submitted rates in all 15 states where we are participating and have no plans at this point to withdraw from any of them," said company spokesman Walt Cherniak. But he noted that a final determination would hinge on binding agreements being signed with the states in September.
Aetna sells the individual coverage on exchanges created by the Affordable Care Act, also called Obamacare. By also filing proposed rates in several other states, Aetna said it had preserved its options to participate in them as well next year. It declined to identify the potential new markets.
Massachusetts' total individual market was only around 72,000 people in 2014, but their ACA exchange had disastrous technical problems during the first ACA open enrollment period, causing tens of thousands of Baystaters to enter a sort of "limbo" status healthcare coverage-wise (the first version of the exchange couldn't properly confirm which enrollees qualified for APTC assistance, so only those paying full price were actually enrolled in exchange QHPs; those claiming APTC status were temporarily transferred over to state-based coverage until it could be sorted out, which took nearly a year in most cases). Fortunately, in 2015, the state got their act together and enrolled nearly 214,000 people in exchange-based policies this year.
New Hampshire has only 5 carriers offering individual market policies, all 5 of which will still be participating in the NH market next year as well. Two of the five (Community Health Options and Minuteman Health) are among the 7 surviving ACA-created Co-Ops.
Even so, NH is proving to be a very tricky state to estimate, because only one of the 5 carrier rate filings includes their actual current rate-impacted enrollment data. As a result, I've had to take my best shot at estimating the market share of the other four. The only way I could think of to do this was to look up the latest NH DOI 2016 QHP Monthly Membership Report. New Hampshire, to their credit, is one of the only states without their own state-based ACA exchange which still actually posts regular reports about how many residents are enrolled in ACA exchange policies. Furthermore, they even break these numbers out by metal level and carrier, making the relative market share easy to calculate.
