Way back in May, the requested rate hikes on the individual market for our nation's capital appeared to average roughly 5.3%. Earlier today, the District of Columbia Dept. of Insurance, Securities & Banking (DISB) announced the approved rate changes for DC:
DISB announced Sept. 15 the approved health insurance plan rates for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2016.
Eight carriers through four major insurance companies – Aetna, CareFirst BlueCross BlueShield, Kaiser Permanente and UnitedHealthcare – will have plan offerings for individuals, families and small businesses on DC Health Link when enrollment opens Nov. 1, 2015.
As we head into the final batch of states, it looks like the national weighted average rate increases, which had been hovering in the 11-12% range up until a week or so ago, are unfortunately starting to inch upwards, slammed by 20%+ averages out of South Dakota, Montana, West Virginia, Oklahoma and Utah. Lower average rate hikes out of Connecticut and Wyoming have also been announced, but the other 5 states more than cancelled those two out.
And now you can add Tennessee to the mix. Starting with Louise Norris' exchange-only data (which comes in at a 33% average hike), I've also plugged in additional off-exchange individual market numbers to come up with what looks like an overall average rate hike of around 28.3%:
Wyoming's total individual health insurance market in 2014 was just 27,000 people. While the total market likely increased somewhat this year, those gains are likely offset by perhaps 15% being either "grandfathered" or "transitional" policies.
Just over 18,000 were enrolled in effectuated exchange-based policies as of June 30 of this year, leaving perhaps 9,000 more enrolled in off-exchange plans.
According to Louise Norris of HealthInsurance.org, there's only two companies operating on the exchange in Wyoming this year: WINhealth Partners and BCBS of WY. WINhealth is asking for a 13.37% average rate hike; Blue Cross is asking for an uknown increase...except that it's under 10%.
Over at HealthInsurance.org, Louise Norris has done her usual excellent job of summarizing the enrollment/rate/exchange participation situation for another state, Utah. As she notes, in addition to the companies which operated on the Utah ACA exchange this year, one more "mystery" company is expected to join in 2016. Of course, Louise only focuses on the companies actually operating on the exchange, while I'm looking at the entire ACA-compliant individual market state-wide (because the risk pool includes off-exchange policies as well).
Fortunately, Utah has a fairly comprehensive rate review database with an easy-to-use lookup feature. Unfortunately, a few of the entries don't quite jibe with HHS's RateReview website. Most notably, the HHS site claims that Arches Mutual Insurance has 2 filings from the same date: One requesting a jaw-dropping 58% hike, the other for a slightly less-insane 46.65% increase, neither of which includes the actual number of covered lives:
While their reports have always been comprehensive, they were also a bit confusing. Thankfully, starting with their June report, they've made the appropriate data points a bit more obvious. While the QHP selection total is still confusing, the effectuated number (which is really more relevant at this point) is the combination of APTC/CSR + non-APTC/CSR enrollees, or 74,583 + 59,617 = 134,200 people as of the end of June.
"Benchmark" in this case refers to the plans which are used as the basis for the ACA's Advance Premium Tax Credit (APTC) formula. How much/little these particular rates change is even more important than the change in other policy rates, because these are the ones which the federal tax credit amounts are based on.
This is really important, because if the benchmark policy rate in your area changes, it can seriously impact how you receive in tax credits...even if nothing has changed at your end.
Back in July, after several revised rate hike requests, the overall weighted average rate hikes requested for the individual market in Connecticut had dropped twice: From 7.7% overall to 7.2%, and then again to just 5.2%, as individual insurance carriers reevaluated their numbers and estimates.
Today, Arielle Levin Becker reports that the final approved rate changes have been released, and the overall, weighted average hike has dropped even further:
Premiums for the 55,000 people who buy Anthem Blue Cross and Blue Shield health plans through the state's individual market will rise by an average of 2.4 percent next year, while ConnectiCare Insurance Company's 34,400 customers will see an average rate hike of 8.5 percent.
Oklahoma is an example of how frustrating this rate review stuff can be, even when there's only a handful of companies involved and much of the data is easily accessible.
According to RateReview.Healthcare.Gov, Oklahoma only has a single company asking for rate hikes greater than 10%: Blue Cross Blue Shield of OK.
The main listing gives the requested rate increase as a jaw-dropping 43.95%...but the description below it says that "the range of rate increases by product is 22% to 34%".
Now, there are two additional BCBSOK listings on the Rate Review site which do appear to be included in the first one (all 3 list the total "members affected" as exactly 137,506)...but the other two have 22.64% and 33.83% listed as the "official" requested rate increase, both of which are still well below 44%.
How on earth you can have the individual product rate hikes range from 22-34% but average 43.95%, I have no idea. Obviously I'm missing something here.
West Virginia is pretty easy to calculate. Their total 2014 individual market was only 42,225 people (including "grandfathered" plans...WV did not allow "transitional" policies to be extended beyond 2013), and they had 33,421 people select exchange-based QHPs during the 2015 open enrollment period, of whom 31,106 were still effectuated as of 6/30/15.
Assuming about 5% are "grandfathered" (and not part of this risk pool), and assuming their total individual market grew by about 20% this year (this has been typical of many other states), that means they should have around 48,000 ACA-compliant enrollees at the moment (31K exchange-based plus another 17K or so off-exchange).
The Massachusetts Health Connector just held their monthly board meeting this morning, and have released the August dashboard report with a whole mess of demographic data for Baystate-obsessed nerds to revel in.
Effectuated QHPs have reached 175,605 enrollees...a whopping 35,065 higher (25%) than at the end of Open Enrollment.
While the national effectuation number is 2.3% lower or so today than it was in March (9.95 million vs. 10.19 million), in Massachusetts it's 42% higher. There's two main reasons for this, both connected to "ConnectorCare", which is unique to Massachusetts. ConnectorCare consists of the same low-end Qualified Health Plans that anyone can purchase (ie, they're still counted as QHPs in the national tally), except that in addition to the federal Advanced Premium Tax Credits (APTC), enrollees in ConnectorCare also receive additional state-based financial assistance, making them even more attractive to enrollees. In addition, however, unlike "normal" APTC or Full Price QHPs, which are limited to the official open enrollment period for most people, ConnectorCare enrollment, like Medicaid/CHIP, is open year round. That makes a dramatic difference, as you can see below; the vast bulk of the net QHP enrollment increase since March is thanks to ConnectorCare additions.
In addition, MA is the only state I know of which actively reports their attrition numbers--that is, so far this year they've had just 16,874 people drop their QHP policies, meaning a total of 192,479 people have selected a plan and paid at least their first monthly premium.
Assuming a 90% payment rate (confirmed for Massachusetts back in April), this also suggests that the cumulative QHP selection total should be roughly 213,000 people to date, which is only significant to me and The Graph.
But wait, there's more! Look below and you'll see a whole mess of pie charts, bar charts and line charts, breaking out everything from Metal Level selections and Market Share by Provider to SHOP enrollments (5,486 lives covered as of September 1st) and even Dental Plans!
