The Idaho Insurance Dept. has posted the preliminary rate filings for the 2021 Individual and Small Group markets:

The Department of Insurance receives preliminary health plan information for the following year from insurance carriers by June 1 and reviews the proposed plan documents and rates for compliance with Idaho and federal regulations. The Department of Insurance does not have the authority to set or establish insurance rates, but it does have the authority to deem rate increases submitted by insurance companies as reasonable or unreasonable. After the review and negotiation process, the carriers submit their final rate increase information. The public is invited to provide comments on the rate changes. Please send any comments to Idaho Department of Insurance.

Back in April, in the midst of the earlier stages of the COVID-19 pandemic sweeping through much of the nation, there was a loud outcry for the various ACA health insurance exchanges, including the federal exchange at HealthCare.Gov which hosts enrollment for over 3 dozen states, to re-open enrollment to anyone who missed the official Open Enrollment Period which had ended several months earlier.

Eventually, twelve of the thirteen state-based exchanges did just that, launching COVID-19-specific Special Enrollment Periods of varying time periods for any resident who would normally be eligible to enroll during Open Enrollment to do so. Many of those SBEs would go on to extend the deadlines of their SEPs by a month...or two months...or even more. As of this writing, in fact, California, Maryland, New York and the District of Columbia are are still offering "open" COVID-19 SEPs.

Way back in May (a lifetime ago), Vermont was among the first states to publicly post their preliminary 2021 rate filings for their combined individual & small group market. At the time, the carriers were requesting an average 6.8% rate increase, and noted that they had no clue how much to tack on to cover themselves for the COVID-19 factor...or to even reduce rates because of it.

This week, the Vermont insurance regulatory board issued their final decisions about both BCBS of Vermont and MVP Health Plan, and cut down on each of their requested increases by several points (h/t Louise Norris for the links):

Hmmm...back in June, the New York Dept. of Financial Services published the preliminary 2021 rate filing requests for the individual & small group markets. As I noted at the time:

Hmmmm....some of these seem suspiciously high, at least as compared to the handful of other states which have released their preliminary requests so far, but we'll have to see...

Well, today the NY DFS issued the approved 2021 rates for both markets, and sure enough, they've been reduced pretty significantly:

DFS ANNOUNCES 2021 HEALTH INSURANCE PREMIUM RATES, PROTECTING CONSUMERS DURING COVID-19 PANDEMIC

Republican Senator Cory Gardner is up for re-election this fall, and he's in major trouble. Various polling over the summer has him trailing his Democratic opponent, former CO Governor John Hickenlooper, by around 6 points on average.

Gardner is underwater for many reasons, many of which have to do with his repeated attempts to repeal the Affordable Care Act...most recently by voting for the "Skinny Repeal" bill the summer of 2017 which was nipped in the bud by a single vote thanks to John McCain's famous "thumbs down" vote.

Just a few days after the previous COVID-19 Special Enrollment Period expired, NY Governor Andrew Cuomo has ordered NY State of Health to reopen their SEP through September 15th:

Governor Andrew M. Cuomo today announced that the Special Enrollment Period for uninsured New Yorkers will be extended for another 30 days, through September 15, 2020, as the State continues to provide supportive services during the COVID-19 public health crisis. New Yorkers can apply for coverage through NY State of Health, New York State's health insurance marketplace, or directly through insurers.

"While we've crushed the curve of the virus, we are still in challenging times for hard-working families throughout the state who need access to quality, affordable health care," Governor Cuomo said. "The state has maintained low infection rates and is moving in the right direction, but we know we're not out of the woods yet. By offering this special enrollment period, we're making sure New Yorkers who need affordable and at times live-saving health care coverage can get it."

Back in March I noted that while the U.S. Supreme Court has indeed agreed to hear the Texas Fold'Em lawsuit to strike down the Affordable Care Act (aka "Texas vs. Azar", aka "Texas vs. U.S.", aka "CA vs. TX") sometime this fall, the odds of actually getting a final decision in the case from SCOTUS before the November election (or even before either Trump or Biden are sworn into office in January) is extremely unlikely:

The ACA case was granted. It will be heard this coming term.

— Nicholas Bagley (@nicholas_bagley) March 2, 2020

#SCOTUS grants petition filed by California & other states, as well as petition filed by Texas on whether individual mandate can be separated from rest of ACA. Argument is likely in the fall, w/decision to follow by June 2021.

It was just a few weeks ago that the Montana Insurance Department posted the preliminary 2021 rate filings for the individual & small group markets. At the time, the individual market carriers were requesting a 3.2% average rate increase, while the small group carriers wanted a 2.4% bump.

Unfortunately, the actual actuarial filing memos ("Part II Justification") weren't available as of this writing, so I couldn't tell whether there's any COVID-19 impact specifically mentioned or not. Montana is one of the states with the fewest casese of COVID per capita, so I wasn't expecting much, but it would be nice to know.

Today I checked again and it looks like they've not only posted the Actuarial Memos (which don't mention COVID-19 at all, as I expected), but it also looks like Montana is the first state to publish their final/approved 2021 rate changes as well. They also modified the estimated enrollment numbers somewhat. Here's what it looks like now:

Alabama

The bad news is that I still can't find any official 2021 rate filings at the Alabama Insurance Dept. website.

The good news is that both of last years' individual market carriers (Blue Cross Blue Shield and Bright Healthcare) do have listings for 2021 in the SERFF database.

The bad news is that those listings don't include actual rate filings, just some other forms.

The good news is that rate filings for every state appear to be available at RateReview.HealthCare.Gov this week.

The bad news is that the filings at RR.HC.gov appear to be incomplete so far; BCBS is listed but Bright isn't (and since I do have other forms for Bright being listed in 2021, I'm pretty sure it's not because they're pulling out of the Alabama market).

Welcome to the latest chapter in the long, epic CSR Lawsuit Saga which has been slogging along for six years now.

Here's a quick recap (again):

  • The ACA includes two types of financial subsidies for individual market enrollees through the ACA exchanges (HealthCare.Gov, CoveredCA.com, etc). One program is called Advance Premium Tax Credits (APTC), which reduces monthly premiums for low- and moderate-income. The other is called Cost Sharing Reductions (CSR), which reduces deductibles, co-pays and other out-of-pocket expenses for low-income enrollees.
  • In 2014, then-Speaker of the House John Boehner filed a lawsuit on behalf of Congressional Republicans against the Obama Administration. They had several beefs with the ACA (shocker!), including a claim that the CSR payments were unconstitutional because they weren't explicitly appropriated by Congress in the text of the Affordable Care Act (even though the program itself was described in detail, including the payment mechanism/etc.)

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