Charles Gaba's blog

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Via the Centers for Medicare & Medicaid Services:

Today, the U.S. Department of Health and Human Services (HHS) announced new guidance and communication to ensure all patients — including pregnant women and others experiencing pregnancy loss — have access to the full rights and protections for emergency medical care afforded under the law. This announcement follows President Biden’s executive order on reproductive health issued Friday.

This was actually issued a few days ago but I'm running behind this week...

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

Section 1.  Policy.  Nearly 50 years ago, Roe v. Wade, 410 U.S. 113 (1973), articulated the United States Constitution’s protection of women’s fundamental right to make reproductive healthcare decisions.  These deeply private decisions should not be subject to government interference.  Yet today, fundamental rights — to privacy, autonomy, freedom, and equality — have been denied to millions of women across the country.

Connecticut

Ouch. Via the Connecticut Insurance Dept:

The Connecticut Insurance Department has posted the initial proposed health insurance rate filings for the 2023 individual and small group markets. There are 13 filings made by 9 health insurers for plans that currently cover approximately 206,000 people.

Anthem, ConnectiCare Benefits Inc. (CBI) have filed rates for both individual and small group plans that will be marketed through Access Health CT, the state-sponsored health insurance exchange. ConnectiCare Insurance Company, Inc. has filed rates for the individual market on the exchange.

Harvard Pilgrim Health Care and HPHC have decided to leave the CT market and will no longer offer new business small group health plans. They will only renew existing plans through the end of their appropriate plan years.

The 2023 rate proposals for the individual and small group market are on average higher than last year:

As I noted a couple of weeks ago, Sword of Damocles dangling over the. head of extending the enhanced premium subsidies temporarily included as part of the American Rescue Plan has been circling the runway in an on-again, off-again pattern for the past month or two.

I know I mangled several metaphors there, but the bottom line is that it's starting to look like Senate Democrats may end up bringing it in for a landing after all. Yesterday, via Benjy Sarlin & Sahil Kapur of NBC News:

Manchin weighs options for extending ACA funding to avert premium hikes

Rate Changes

I'm about 1/3 (update: make that 2/3) of the way through my Annual Individual & Small Group Market Rate Filing project, having analyzed & crunched the numbers for 18 36 states + DC. This seems like a good time to step back and see where things stand.

So far, I've compiled the preliminary unsubsidized average premium rate filings for both the ACA-compliant individual and small group markes in Akransas, Colorado, Connecticut, Delaware, DC, Georgia, Hawaii, Indiana, Kentucky, Maine, Maryland, Michigan, Minnesota, New York, Oregon, Rhode Island, Tennessee, Vermont and Washington State. It's important to remember that these are preliminary filings only--many of the carriers will have their final 2023 rate changes reduced, although in most cases they tend to be approved as is, and in some cases they're even increased beyond what the carrier originally requested.

It's also important to note that these 18 states + DC only represent around 30% of the total U.S. population...aside from New York, the other big states (California, Florida, Texas, Pennsylvania, etc.) haven't posted their 2023 filings yet.

Georgia

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 which was responded to within an hour of my asking.

There's one significant development apiece in Georgia's individual & small group markets:

INDIVIDUAL: A few years ago, Georgia's GOP Governor, Brian Kemp, put in a request to the Centers for Medicare & Medicaid Services (CMS) for what's known as a Section 1332 State Innovation Waiver. If approved, these waivers allow individual states to modify how the ACA operates in their state as long as they can prove that the changes would a) cover at least as many residents b) at least as comprehensively without c) increasing federal spending in the process.

Michigan

A few weeks ago I compiled the weighted average 2023 premium rate filings for Michigan's individual and small group markets. At the time, I came up with average rate hikes of 6.8% for the ACA individual market and 6.8% for the small group market.

Today, the Michigan Dept. of Financial Services posted the official preliminary 2023 filings, and while I was dead on for most of the carriers, I was off slightly for a few of them:

Michiganders to Have More Opportunities to Shop Around During Upcoming Health Insurance Open Enrollment Period

Arkansas

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 2023 filings, in which AR carriers are seeking an average 5.9% rate hike on the individual market and 5.1% for small group plans. The only item which sticks out is Oscar Insurance Co., which is leaving the Arkansas market...after just a single year:

Hawaii

Hawaii only has two health insurance carriers serving the individual market, Hawaii Medical Service Assocation and Kaiser Foundation Health Plan. Both of them have submitted their proposed premium rate filings for 2023, and unlike most states so far this year, their initial requests are quite reasonable: Just a 2% average hike apiece.

Unfortunately, things are much spottier for Hawaii's small group market: I can only find the rate change & current enrollment filings for one of the 5 carriers offering small business plans, at 5.7%. This doesn't mean much without the data from the other carriers, however:

UPDATE 10/19/22: Both of Hawaii's individual market carrier filings have been approved as is, so that's a 2% average rate increase. On the small group market there's still some missing data but I was able to fill in some fields for both the preliminary and final rate filings:

Indiana

The Indiana Insurance Dept. has quietly posted their preliminary 2023 health insurance premium rate change requests for both the individual and small group markets:

INDIANA 2023 ACA FILINGS

The overall average rate increase for 2023 Indiana individual marketplace plans is 5.7%.

The IDOI will finalize the review of the 2023 ACA compliant filings both on and off the federal Marketplace by August 18, 2022.

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