Charles Gaba's blog

South Dakota

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.

The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

In South Dakota, there are only 2 carriers offering individual market coverage next year. I have hard enrollment numbers for one of them; for the other, I'm assuming equal enrollment for each based on a rough assumption of ~42,000 total indy market enrollees statewide.

Assuming this is fairly close, that would put the weighted average rate increases at roughly 10.5%. If not...well, the unweighted average would be 11.3%.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.3%.

Montana

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.

The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

In Montana, there are only 3 carriers offering individual market coverage next year. I have hard enrollment numbers for one of them; for the other two, I'm assuming equal enrollment for each based on a rough assumption of ~52,000 total indy market enrollees statewide.

Assuming this is fairly close, that would put the weighted average rate increases at roughly 8.8%. If not...well, the unweighted average would be 9.3%.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.9%.

Oklahoma

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available. The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

In Oklahoma, there are 7 carriers offering individual market coverage next year (it looks like Bright Health Insurance is dropping out). I have hard enrollment numbers for 4 of them; for the other three, I'm assuming equal enrollment for each based on a rough assumption of ~190,000 total indy market enrollees statewide.

Assuming this is fairly close, that would put the weighted average rate increases at roughly 8.8%. If not...well, the unweighted average would be 9.0% anyway, so this is at least somewhat more accurate.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 8.1%.

Iowa

Here's the preliminary 2023 rate filings for Iowa's individual & small-group markets. Unfortunately, I only have the enrollment data for the two smaller carriers on the individual market (and none for the small group market), but based on my estimate of Iowa's total ACA-compliant individual market, I can make an educated guess as to the weighted average, which should be roughly 2.0%.

Unfortunately I can't do the same for the small group market; for that, the unweighted average rate increase is around 5.1%.

I should also note that Iowa also has 35,400 residents still enrolled in pre-ACA ("transitional" or "grandmothered") medical policies, with nearly all of them being via Wellmark: 

Illinois

Unfortuantely, Illinois is another state which doesn't make it easy to analyze annual health insurance premium rate filings.

There's no details on their insurance department website, their SERFF listings don't seem to include the actuarial memos or URRT forms, and even the federal Rate Review listings only include the average requested rate changes; the actuarial memos there are mostly heavily redacted.

Illinois' total individual market enrollment should be roughly 330,000 people. Fortunately, three of the carriers do reveal their 2022 enrollment, including the biggest one in the state (Blue Cross). This allows me to make an educated guess as the the enrollment of the other 7, which in turn means I can make an estimate of the weighted rate increase of roughly 6.9%. The unweighted average is 8.9%.

For the small group market I have to go with the fully unweighted average of 6.8%.

So Close

SEE UPDATES BELOW!

With all 50 Republican Senators refusing to lift a finger to fight climate change, tackle prescription drug pricing or extend the enhanced ACA subsidies for over 13 million people, Democrats have watched helplessly as two of their own Senators (Joe Manchin and Kyrsten Sinema) have repeatedly blocked or otherwise stymied efforts to get these vital measures through the Senate.

The drama appears to finally be coming to an end this weekend, however.

Last week Sen. Manchin announced that he & Senate Majority Leader Chuck Schumer had come to an agreement on a heavily modified & pared-down version of what was once called the "Build Back Better Act"...newly christened as the "Inflation Reduction Act of 2022". He then spent the past week pushing the bill heavily on TV appearances/etc, and the rest of the Democratic leadership joined in a coordinated effort to promote the bill.

via Dan Diamond at the Washington Post:

Health and Human Services Secretary Xavier Becerra declared the monkeypox outbreak a public health emergency on Thursday in an effort to galvanize awareness and unlock additional flexibility and funding to fight the virus’s spread.

“We’re prepared to take our response to the next level in addressing this virus, and we urge every American to take monkeypox seriously and to take responsibility to help us tackle this virus,” Becerra said at a Thursday press briefing.

The health secretary is also considering a second declaration empowering federal officials to expedite medical countermeasures, such as potential treatments and vaccines, without going through full-fledged federal reviews. That would also allow for greater flexibility in how the current supply of vaccines is administered, Becerra said.

...Federal officials Thursday afternoon said they were still finalizing the formal declaration of a public health emergency, which would be posted on an HHS webpage.

via the White House website:

President Biden will issue an Executive Order on Securing Access to Reproductive and Other Healthcare Services, building on actions that the Biden-Harris Administration has taken to protect access to reproductive healthcare services and defend women’s fundamental rights.  The President kick off the Vice President’s first meeting of the Task Force on Reproductive Healthcare Access. At the meeting, the Cabinet will discuss their progress and the path forward to address the women’s health crisis in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization.

EXECUTIVE ORDER ON SECURING ACCESS TO REPRODUCTIVE AND OTHER HEALTHCARE SERVICES

Through today’s Executive Order, the President will announce actions to:

Wyoming

Wyoming is the smallest state and only has two carriers offering individual market policies (and just three offering small group plans). This makes it pretty simple for me.

Unfortunately, neither their insurance department website nor their SERFF filings give any indication of the enrollment numbers for any of the carriers. Fortunately, the federal rate review website does list enrollment for Blue Cross Blue Shield of Wyoming...which also has something like 95% of the individual market share in the state. By estimating the enrollment for the 2nd carrier (Montana Health Co-Op), I should be pretty close to the weighted average...a pretty ugly 18.5% average rate hike. Ouch.

It's no better on the small group side, although I don't have the actual enrollment for the other two carriers; the unweighted average is "only" an 11.9% increase, but it's over 20% for BCBSWY enrollees.

South Carolina

The South Carolina Insurance Dept. website isn't particularly helpful when it comes to getting the annual rate filing data for these analyses--they post a link to the federal Rate Review website and the SERFF database, but that's it...and most of the filings don't show up in SERFF, while many Rate Review database actuarial memos are all heavily redacted.

Fortunately, this year the Rate Review database has Consumer Justification Narratives for 4 of the 5 carriers participating in SC's individual market (Bright Health Co. appears to be dropping out of the state's indy market). While the fifth one is missing (Molina), I can make an educated guess as to their enrollment based on South Carolina's total individual market size, which should be roughly 300,000 people, give or take.

Based on that, it looks like SC carriers are asking for around a 10.4% average rate hike in 2023.

For the small group market, all of the actuarial memos are redacted, so all I have is the unweighted 2022 average rate changes, which comes in at +5.4%.

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