Charles Gaba's blog

Back in February, I wrote about how the state of Georgia, in an eyebrow-raising move, announced that they were moving from the federal ACA exchange (HealthCare.Gov) onto their own state-based ACA exchange.

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.

Secondly, because of the timeframe involved:

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.

Originally published on 7/11/23

via the Indiana Dept. of Insurance:

INDIANA 2024 ACA FILINGS

The companies listed below have submitted ACA-compliant rate filings for Plan Year 2024. Information about the filings may be found at the IDOI SERFF Filing Access or Healthcare.gov Rate Review.

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.

General Note:

Medicaid Unwinding

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:

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

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.

The Missouri Insurance Dept. has posted their preliminary 2024 single risk pool filings for the individual and small group markets.

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.

Via the Colorado Department of Regulatory Agencies (I accidentally deleted the original blog post so I'm recreating it using the graphics below).

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.

Back in February, I wrote about how the state of Georgia, in an eyebrow-raising move, announced that they were moving from the federal ACA exchange (HealthCare.Gov) onto their own state-based ACA exchange.

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.

Secondly, because of the timeframe involved:

via the Idaho Dept. of Insurance:

Each year, the Idaho Department of Insurance posts rate changes of individual and small group health insurance products so consumers can review and provide comments on the proposed increases.  Insurance companies submit proposed rates for the upcoming calendar year to the Department, along with descriptions and justifications for why the rates are reasonable and not excessive.  

The Department of Insurance is seeking public input for rate changes of individual and small group health insurance products to improve insurer accountability and transparency.  By following the links below, the public can access a summary of the increase amounts and the carrier justifications for the rates.  Please submit any comments to the Department for consideration.

Preliminary Rates - 2024

Please choose one of the categories to proceed:

Back in March, after years of failed and stalled attempts to get it passed, the North Carolina legislature finally pushed ACA Medicaid expansion over the line to be signed into law by Democratic Governor Roy Cooper.

As for when the program would actually go into effect, however...that's been something of a mystery for awhile now. Apparently the wording of the legislation ties it in with it being included in the general state budget, which hasn't happened yet. As a result, no one seems to be sure whether NC Medicaid expansion will kick off in October, November, December or January of next year.

However, the state's Health & Human Services Dept. has decided to take a proactive, optimistic stance:

State Takes Action To Start Medicaid Expansion Oct. 1; Launch depends on General Assembly acting by Sept. 1

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