Some guy, November 5th, 2023:

Back in April, the Associated Press reported that the Biden Administration planned on opening up eligibility for ACA exchange, Basic Health Program, Medicaid & CHIP coverage to hundreds of thousands of Americans who have Deferred Action of Childhood Arrivals status:

President Joe Biden is set to announce that his administration is expanding eligibility for Medicaid and the Affordable Care Act’s health insurance exchanges to hundreds of thousands of immigrants brought to the U.S. illegally as children, according to two U.S. officials briefed on the matter.

Oh wow...this is a blast from the past. I'm gonna have to essentially repost much of a blog entry from August 2018 to provide the backstory:

[In 2017], Virginia residents experienced massive amounts of heartburn and ulcers as two major insurance carriers, Optima (Sentara Health) and Anthem (HealthKeepers) played musical chairs with both their 2018 rate filings and which areas of the state they offered plans on.

In May 2017, things didn't look too bad: Both Anthem and Optima were available in fairly large chunks of the state, and while Anthem wanted to raise rates an ugly 38% on average, Optima was only looking to increase rates by around 10-11%.

Ten years ago, during the very first ACA Open Enrollment Period, Oregon was one of 15 states which attempted to operate their own fully state-based marketplace SBM) under the new law, calling it "Cover Oregon."

Cover Oregon was, along with several of the other original SBMs in Nevada, Maryland, Hawaii and (surprisingly) Massachusetts, a complete and utter failure. They flushed a stunning $248 million down the drain on a website portal which, put simply...didn't work. Like, at all. From April 2014:

Cover Oregon poised to switch to federal insurance exchange

Alex Pettit, the state's top information-technology official, recommended Cover Oregon move to the federal exchange at an advisory committee meeting Thursday.

Oregon should pull the plug on the beleaguered Cover Oregon health insurance exchange and switch to the federal exchange, a technological advisory committee recommended Thursday.

The move is considered almost certain to be adopted by the Cover Oregon board, which meets Friday.

New York State of Health

I'm a bit late following up on this, but since New York State of Health isn't launching their 2024 ACA Open Enrollment Period until tomorrow anyway (Nov. 16th...every other state already started theirs on Nov. 1st or earlier), it's still timely.

Two weeks ago a Twitter follower of mine gave me a heads up:

The letter I received had the Essential Plan at 250%. My Navigator told me it was a mistake and pending approval? DM me for specifics

This is definitely cause for concern, since New York's Essential Plan is only available to NY residents who earn between 138 - 200% of the Federal Poverty Level ($29,160/yr for a single adult, $60,000/yr for a family of four).

Sure enough, they sent me the full letter they received from New York State of Health (personal info redacted, of course):

via the Centers for Medicare & Medicaid Services (CMS):

Thanks to the Biden-Harris Administration’s efforts to strengthen maternal health, an estimated 641,000 Americans annually are now eligible for essential care for a full year after pregnancy.

Well, it's not much, but we have our first official 2024 ACA Open Enrollment Period enrollment report, out of Connecticut:

Via Access Health CT's News/Press Releases page:

Stats as of November 10, 2023

Qualified Health Plans (QHP):

  • QHP Enrollment In 2023 Coverage: 11,319
  • 2024 OE Acquisition Summary: 3,081

Medicaid:

  • Completed applications/redeterminations processed through the integrated eligibility system: 7,283

It's my understanding that "Acquisition Summary" refers to CT residents who are brand-new enrollees (never enrolled via the exchange before).

The report was posted this morning so it obviously only includes enrollment data through yesterday (Nov. 9th).

It's worth noting that last year, Access Health CT reported enrolling 10,011 people through Nov. 10th (one extra day since Nov. 1st fell on a Tuesday last year).

OK, there isn't supposed to be a formal Open Enrollment Period report out for another week, but President Biden just tweeted out a pretty impressive topline number for the first week of the 2024 ACA Open Enrollment Period:

In the first week of Open Enrollment, 1.6 million people have signed up for a plan at HealthCare.Gov, including 301,000 new consumers – that’s a 50% increase from last year.

Join them by visiting HealthCare.Gov today.

— President Biden (@POTUS) November 9, 2023

This is excellent news, but it does bear some analysis even without any additional details being included.

Originally posted 9/13/23; updated 11/08/23

via the Washington Insurance Dept.:

Fourteen health insurers have been approved to sell in Washington's 2024 individual health insurance market.  Insurers requested an average increase of 9.11% but 8.94% was approved. How much premium someone pays will depend on the plan they select, the number of people covered, their age, whether or not they smoke and where they live. 

Originally posted 10/31/23; updated 11/08/23

Back in September, Amy Lotven of Inside Health Policy found an excellent scoop from a new CMS report hiding in plain sight:

New CMS data, quietly released in late August, show about 178,000 consumers chose a qualified health plan (QHP) through a state or federal exchanges after losing Medicaid and CHIP coverage in the first two months of the Medicaid unwinding. Those sign-ups through the end of May are more than three times the 54,000 enrollments that CMS reported in July, which reflected only the April numbers.

Originally posted 8/18/23; updated 11/08/23

West Virginia is yet another state where I'm unable to acquire unredacted actuarial memos and/or filing summaries in order to run weighted average rate changes, so I have to settle for unweighted averages. On the other hand, on the individual market, at least, WV only has three carriers and their requested rate changes for 2024 are in a very narrow range anyway (from flat to a 2.1% increase), so it doesn't matter much.

The good news is that West Virginia's individual market rates are only increasing by around 1% next year, one of the lowest avg. rate increases in the country.

The bad news is that West Virginia already has by far the highest unsubsidized individual market rates in the nation, at nearly $1,200 per month (second highest this year is Wyoming at $965/month).

In any event, small group market carriers are requesting an unweighted average increase of 9.6% overall.

UPDATE 11/08/23: State regulators increased the rate h ikes from 1.1% to 3.0% for CareSource, but otherwise left the other carriers on both markets as is.

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