Charles Gaba's blog

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!

Unfortunately, it looks like less than half of Georgia's small group market carriers have submitted their filings (alternately, it's conceivable that the other have have pulled out of the G small group market, though I highly doubt that). Only four of the eleven carriers offering policies in 2023 have filings included in the package sent to me by GA OCI. Not sure what that's about.

In any event, Georgia's individual market has grown dramatically over the past year (813,000 people vs. 660,000 a year ago), but the requested 2024 rate filings are pretty ugly, ranging from a somewhat reasonable 6.4% to as high as 27.7% for Cigna (ouch). The weighted average overall is just over 15% even.

Arkansas is a problematic state for many reasons, but I have to give their insurance dept. website high praise for posting their annual rate filings in a clear, simple & comprehensive fashion (which is to say, not only do they post the avg. premium changes for each carrier, they also post the number of covered lives for each, which is often difficult for me to dig up). Better yet, they also include direct links to the filing summaries and include the SERFF tracking number for each in case I need to look up more detailed info.

Anyway, there's nothing terribly noteworthy in the 2024 filings, in which AR carriers are seeking an average 5.0% rate hike on the individual market and 5.5% for small group plans. USAble HMO is launching a new line of HMO insurance products in the state next year (called "Octave" I believe) but otherwise it looks pretty calm.

via the Centers for Medicare & Medicaid Services (CMS):

New Report Projects Nearly 19 Million Seniors Will Save $400 Per Year on Out-of-Pocket Prescription Drug Costs

Today, the U.S. Department of Health and Human Services (HHS), announced actions to protect consumers from junk health plans, surprise medical bills, and excess costs that lead to medical debt. These actions build on the Biden-Harris Administration’s effort to eliminate hidden fees in every sector of the economy and lower health care costs for American seniors and families.

Coinciding with the actions taken today, HHS also released a new report projecting that nearly 19 million seniors will save approximately $400 per year on prescription drug costs when the $2,000 out-of-pocket prescription drug spending cap from the Inflation Reduction Act – President Biden’s historic lower cost prescription drug law – goes into effect in 2025.

Surprise!

 

In late 2020 after years of bipartisan attempts to tackle one of the uglier problems with the U.S. healthcare system, Congress somehow ended up quietly slipping in a bill which resolved a large chunk of the issue with minimal fanfare:

Sarah Kliff and Margot Sanger-Katz have written an excellent summary of the problem and the proposed solution:

Surprise bills happen when an out-of-network provider is unexpectedly involved in a patient’s care. Patients go to a hospital that accepts their insurance, for example, but get treated there by an emergency room physician who doesn’t. Such doctors often bill those patients for large fees, far higher than what health plans typically pay.

See my prior post about short-term, limited duration plans & their regulation history under the Obama, Trump & Biden Administrations.

via the Centers for Medicare & Medicaid Services:

Short-Term, Limited-Duration Insurance; Independent, Noncoordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; and Tax Treatment of Certain Accident and Health Insurance (CMS-9904-P)

Jul 07, 2023

Original story: 6/29/23:

I haven't written about #ShortAssPlans ("Short-Term, Limited Duration") healthcare policies since back in January, when it was announced that the Biden Administration would be announcing new regulations on them sometime in April 2023. Obviously that time has come and gone, but it looks like the Office of Management & Budget (OMB) is finally ready for the Centers for Medicare & Medicaid Services (CMS) to roll the new rule out:

via the Maryland Health Benefit Exchange:

MARYLAND WINS FEDERAL APPROVAL FOR “REINSURANCE” FOR ANOTHER FIVE YEARS

  • Program has helped drive down rates for Marylanders who buy their own health coverage to among the most affordable in the nation

BALTIMORE (July 5, 2023) – The Reinsurance Program that helped drive down costs for consumers who purchase their own health insurance in Maryland to among the lowest rates in the nation has been renewed for the next five years.

The U.S. Department of Health and Human Services and the Department of the Treasury informed Maryland health and insurance officials that they have approved the state’s application for the period from Dec. 31, 2023, when the current authorization expires, until Dec. 31, 2028.

Mark Farrah Associates is an electronic publisher of business information and analytics for the U.S. healthcare industry; they aggregate industry data and market metrics for their own database products that they sell on a subscription basis.

They typically release state-level breakout estimates of the total U.S. individual market once or twice a year. They haven't done so in 2023 as of yet, but today they did release this overview analysis:

A few days ago, a federal Trump-appointed district court judge in Louisiana ruled that the federal government is no longer allowed to fight disinformation online in a devastating ruling:

District Court Judge Terry Doughty, who was appointed by President Donald Trump, issued a preliminary injunction on Tuesday that bars several federal departments and agencies from various interactions with social media companies.

On Wednesday, the Justice Department filed a notice that it will appeal the injunction with the Fifth Circuit Court of Appeals in New Orleans. The government also expects to ask the court to stay the district judge's decision, meaning it would not go into effect while the appeal is heard.

Last month I posted an explainer about a situation in California which boiled down to a huge pot of extra revenue (~$330 million per year, give or take) being fought over between Governor Gavin Newsom and the Democratically-controlled State Legislature.

The bottom line is that this funding was intended to go towards reducing health insurance premiums for ACA exchange enrollees via Covered California as supplemental subsidies to be added on top of federal ACA tax credits...but the passage of the American Rescue Plan and the subsequent Inflation Reduction Act kind of made that moot, since the federal subsidies were made more generous than what the state subsidies would have been anyway.

As a result, Gov. Newsom decided that the extra revenue should go into the general state fund, while Democrats on the state legislature wanted to redirect it to eliminate deductibles and other types of cost sharing for ACA enrollees instead. This led to an impasse for the past several months:

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