Commenter "M E" has been doing a great job of revisiting the rate hike situation in states which I originally ran the numbers on back in May and June. Earlier today he brought the revised Arizona numbers to my attention, and now he's also noted that Tennessee (which was already facing the ugliest hike requests in the nation before I revised Arizona's average) will likely see their average hike requests jump up further in the days ahead:

In an effort to prevent more insurers from abandoning the Obamacare exchange in Tennessee, the state's insurance regulator is allowing health insurers refile 2017 rate requests by Aug. 12 after Cigna and Humana said their previously requested premium hikes were too low.

In yesterday's "all 50 state" wrap-up of my 2017 Requested Rate Hike analysis, among the numerous caveats/disclaimers was this one:

In some cases, estimates that I ran as recently as a few weeks ago may prove obsolete.

I was planning on revisiting some of the states I crunched numbers for back in May and June, but commenter "M E" beat me to the punch in Arizona, finding this Arizona Republic article from yesterday and, more importantly, the official AZ Dept. of Insurance Revised Rate Filing memo from August 3rd.

The article isn't pretty...

As of last week, five companies in Arizona had announced plans to pull out or pull back: Health Choice, United Healthcare, Humana, Blue Cross Blue Shield of Arizona and Health Net.

8/14/16: SEE IMPORTANT UPDATE

Well, there you have it: Across all 50 states (+DC), taking a bunch of caveats into account (see below), as far as I can estimate, the average premium rate increases being requested by health insurance carriers sits at right around 23% overall.

As I keep reiterating, there are many caveats to these "statewide weighted averages":

  • Off-exchange policies are included whenever possible, but only if they're ACA-compliant (grandfathered/transitional plans are in a different risk pool anyway). The ACA-compliant individual market totals roughly 18-19 million people nationally (11 million on-exchange, another 7-8 million off-exchange). Grandfathered/Transitional plans likely total around 2-3 million more.
  • Only individual market policies are included (there's a few states where the small group market has been merged with the individual market risk-pool wise, but I only include indy enrollees for purposes of weighting). The small group market was around 13.5 million people, according to Mark Farrah Associates.
  • Some carriers are pulling out of either specific counties or entire states next year, or are dropping certain plans while keeping others. There's no way of estimating the "average rate increase" for anyone who's losing their existing plan altogether.

Well, I've managed to put together estimates (some very rough, some pretty specific) of the weighted average requested ACA-compliant individual market rate hikes for 49 out of 50 states, along with the District of Columbia. This leaves just one state left: Minnesota. For whatever reason, I've been informed that Minnesota's requested rate filings won't be available to the public until September 1st, which is too late for my purposes...because by that point, many of the other states will have started releasing their approved rates for next year (in fact 3 of them--Oregon, New York and Mississippi--have already done so). Minnesota's approved rates will be posted on October 1st. It's always been my intent to lock down the requested rates for every state before the approved numbers are posted in order to run a comparison between what was asked for and what the final approved rate changes are.

The only real estimate I have until Sept. 1st, then, is this quote from Christopher Snowbeck's StarTribune article on June 23:

Mississippi remains one of only two states which still don't have their 2017 Rate Filings posted over at HC.gov's Rate Review database. In addition, while Mississippi does use the SERFF system for other types of insurance, major medical doesn't appear to be among them. Finally, while the MS Dept. of Insurance does include a special website specifically designed for searching/comparing rate changes for health insurance policies...it doesn't appear to have been updated in awhile (the only recently listings are for obscure carriers which seem to be mostly offering short-term plans and other "mini-med" types of policies, not full ACA-compliant plans.

The point is that I don't have the actual rate filings to go on for now...but thanks to commenter farmbellpsu for bringing my attention to this (corrected) news article which escaped my radar last week:

Less than 3 months ago, in mid-May, Aetna Inc. made splashy headlines by announcing that not only did they plan on sticking with the ACA individual market exchanges in the 15 states they were already participating in, they were even considering expanding participating to several additional states:

Health Insurer Aetna Inc on Wednesday said it plans to continue its Obamacare health insurance business next year in the 15 states where it now participates, and may expand to a few additional states.

"We have submitted rates in all 15 states where we are participating and have no plans at this point to withdraw from any of them," said company spokesman Walt Cherniak. But he noted that a final determination would hinge on binding agreements being signed with the states in September.

Aetna sells the individual coverage on exchanges created by the Affordable Care Act, also called Obamacare. By also filing proposed rates in several other states, Aetna said it had preserved its options to participate in them as well next year. It declined to identify the potential new markets.

Massachusetts' total individual market was only around 72,000 people in 2014, but their ACA exchange had disastrous technical problems during the first ACA open enrollment period, causing tens of thousands of Baystaters to enter a sort of "limbo" status healthcare coverage-wise (the first version of the exchange couldn't properly confirm which enrollees qualified for APTC assistance, so only those paying full price were actually enrolled in exchange QHPs; those claiming APTC status were temporarily transferred over to state-based coverage until it could be sorted out, which took nearly a year in most cases). Fortunately, in 2015, the state got their act together and enrolled nearly 214,000 people in exchange-based policies this year.

New Hampshire has only 5 carriers offering individual market policies, all 5 of which will still be participating in the NH market next year as well. Two of the five (Community Health Options and Minuteman Health) are among the 7 surviving ACA-created Co-Ops.

Even so, NH is proving to be a very tricky state to estimate, because only one of the 5 carrier rate filings includes their actual current rate-impacted enrollment data. As a result, I've had to take my best shot at estimating the market share of the other four. The only way I could think of to do this was to look up the latest NH DOI 2016 QHP Monthly Membership Report. New Hampshire, to their credit, is one of the only states without their own state-based ACA exchange which still actually posts regular reports about how many residents are enrolled in ACA exchange policies. Furthermore, they even break these numbers out by metal level and carrier, making the relative market share easy to calculate.

North Dakota's total individual market was 49,000 people in 2014. Assuming a 25% increase since then, it should be roughly 61,000 today, some portion of which is composed of transitional/grandfathered enrollees. I'm going to assume (based on hard numbers from a few other states) that GF/TR enrollees make up perhaps 10% of the total, or 6,100. They enrolled 21,604 people in exchange plans this year, of whom 20,536 were still enrolled as of the end of March. Last year, Blue Cross Blue Shield of ND held roughly 29,000 enrollees total, with Medica making up another 4,800 or so.

All of the above numbers are important when attempting to estimate the weighted average rate hikes requested by ND carriers, because of the 3 operating on the individual market (BCBS, Medica and Sanford), only one of them, Medica, has provided their actual 2016 enrollment tally (7,329).

Donald Trump, July 29th, 2015:

Billionaire businessman Donald Trump on Wednesday offered a glimpse into his presidential platform on healthcare, saying he would replace ObamaCare with “something terrific.”

“It’s gotta go,” Trump said of ObamaCare in an interview Wednesday with CNN. “Repeal and replace with something terrific."

Donald Trump, August 5th, 2016:

.@realDonaldTrump on Obamacare: "It'll be terminated and replaced with something." pic.twitter.com/2nVF7mPlTS

— POLITICO (@politico) August 5, 2016

Apparently his latest budget analysis has forced him to remove the "terrific" part of the "something".

That is all. Carry on.

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