Charles Gaba's blog

So just last Friday I posted the weighted average requested rate hikes for the Arkansas individual market; it came in at 14.9% overall, which is actually one of the lower statewide averages this year. As a reminder, here's what how the breakout looks:

OK, so 3 major carriers asking to jack up rates 15-24%, plus one at 8.5% and two others with just 7 enrollees between them (one of which is, once again, Freedom Life Insurance). So what?

As regular readers know, I'm currently in the thick of my state-by-state analysis of the requested, weighted average rate changes for 2017 by insurance carriers for the entire ACA-compliant individual market. As of this writing, the overall average looks like it's just a hair over 20% across 28 states + DC.

Does the first sentence above include a lot of clarifiers? Yes, yes it does...and with good reason. I try to be very specific when I discuss this stuff, because it's very easy to get confused about what a given number is actually referring to.

For instance, a few days ago, Avalere Health released their own analysis which concludes that the average requested/proposed premium rates are around 12%. If I left it at that, you might think that either my average is 8 percentage points too high...or that Avalere's is 8 points too low.

Thanks to commenter "Junaed S" who directed me towards this simple, cut 'n dry PDF from the Connecticut Dept. of Insurance detailing the requested rate hikes for the CT individual and small group markets for 2017:

Over 150,000 Colorado residents selected QHPs via Connect for Health Colorado during open enrollment this year, and the total CO individual market was well over 270,000 in 2014; as of today, it's supposedly up to a whopping 450,000 people, which sounds awfully high to me (nationally the indy market has grown by around 25% over the past 2 years, so 66% is an outlier):

In addition, Anthem has decided not to offer its PPO (Preferred Provider Organization) individual plans in 2017. In all, the Colorado Division of Insurance said Monday around 92,000 people with individual plans from Anthem, UnitedHealth, Humana, and Rocky Mountain Health Plans will have to find other coverage during open enrollment in the fall.

Last month I noted that the Washington Healthplanfinder was reporting currently effectuated QHP enrollment at 170,527 as of the end of March, a 15.0% drop from the official number of QHP selections during the 2016 Open Enrollment Period. I also noted that due to some confusion about how the numbers are reported by the exchange, it could also be argued that WA has seen just a 6.6% net drop, depending on how you look at it.

However, since 200,691 is the official number included in the ASPE report, I'm finally letting that one go...and actually, that's OK, because a 15% drop by 3/31 is fairly close to what I would expect anyway (a bit higher than the 13% national drop from last year, but not out of line).

Anyway, the WA exchange just released their May report (with data through the end of April), and it's actually pretty good--there's only been a very slight net drop since March, for an overall drop of just 15.2% from the 200K figure:

Presented without comment:

Nicholas Bagley in The Incidental Economist, December 1st, 2015:

Did Marco Rubio Kill Obamacare?

A simmering dispute over the risk corridor program has broken into the presidential campaign, with Senator Rubio crowing that an arcane budget move has “kill[ed] Obamacare” and “saved the American taxpayer $2.5 billion.” On account of that move, health plans are set to receive only pennies on the dollar from the risk corridor program, which was supposed to cushion them from big losses.

...The administration has vaguely said that it will “use other sources of funding for the risk corridors payments, subject to the availability of appropriations.” But the budget bill limits the administration’s power to dip into other funds, and a Republican-controlled Congress isn’t likely to appropriate money for a program that’s been decried as an insurer bailout.

Can I first say that I absolutely love the way Nevada's rate filing database is set up, especially their (apparently proprietary and mandatory) filing format system?

Unlike the standard SERFF database, which is comprehensive but also can be confusing as hell, Nevada's system is simple, clean, easy to navigate and, most of all, every single carrier filing listed displays the number of current enrollees clearly. This is a huge pet peeve of mine, which is understandable given what I'm trying to do here!

OK, that said, here's what things look like in the Silver State:

Delaware is a small state, and only has a total of 4 carriers offering individual polcies (2 on exchange, 2 off). One of those, however, is once again "Freedom Life" which, once again, is asking for precisely a 17.37% rate hike on their almost-certain-to-be-nonexistent enrollees. So...never mind them. That leaves Aetna (split into HMOs and PPOs) and Highmark BCBS offering policies on the exchange, and Golden Rule off the exchange.

Unfortunately, I can't find Golden Rule's actual current enrollment number, but as you can see below, it really doesn't matter:

As you can see, no matter how many enrollees Golden Rule has, their 30.3% average hike request is very close to the 30.6% average of the other carriers. The very most it could do is nudge the weighted average down by a tenth of a point or two, so let's call it 30.5%. 

On Wednesday I noted that a whopping 175,000 Louisianans had somehow managed to enroll in the state's just-launched Medicaid expansion program within less than 12 hours of the floodgates being opened up. This was even more amazing when you consider that number represents 47% of the total people estimated to be eligible for the program state-wide (375K).

Now, obviously there's no way that 16,000 people per hour were individually visiting HealthCare.Gov or their local state health agency; on it's busiest day (December 15, 2015), HealthCare.Gov was averaging 25K/hour...but that was across 38 states, many of which are much larger than Louisiana. Instead, I assumed that LA had done something similar to Oregon/West Virginia's "fast-track" programs, where they use existing food stamp/welfare databases to automatically enroll people, not "officially" pulling the trigger until after the stroke of midnight.

The good news about Kansas is that 5 of the 6 carriers which have submitted 2017 individual market rate filings included their current enrollment totals in a clear, easy to see format...and the 6th one is (once again) "Freedom Life" which, judging by the dozen other states they've popped up in, almost certainly has only 1 or 2 enrollees (or none at all) anyway.

The bad news is...well, the requested rate hikes are pretty ugly: About 35.3% on weighted average.

Also, is it really necessary for Blue Cross Blue Shield to operate under three nearly-identical names? Really?

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