With the 2020 Open Enrollment Period rapidly approaching (it actually kicks off on October 15th in California, and on November 1st in every other state + DC), it's important to keep in mind that many people who didn't qualify for financial assistance in 2019 may qualify in 2020...and in some cases that could mean a difference of thousands of dollars due to how the ACA subsidy formula works and other factors.
First, a refresher on how the ACA formula works for Individual Market enrollees (that is, people who are looking to buy health insurance for themselves and/or their family who don't receive it through their employer, Medicare, Medicaid, CHIP or some other source).
Getting ready for MNsure's open enrollment period: what to know and how to prepare
Open enrollment runs November 1 through December 23, 2019
ST. PAUL, Minn. — The MNsure open enrollment period begins in less than one month. To ensure Minnesotans are prepared to shop and enroll in coverage starting November 1, MNsure is highlighting some important information:
Open enrollment is shorter this year — don't miss out on coverage
MNsure's open enrollment period for 2020 health and dental coverage will be seven weeks long — beginning November 1, 2019, and ending December 23, 2019. Minnesotans should note that open enrollment is shorter than previous years and all those who enroll during open enrollment will have a start date of January 1, 2020.
MNsure assisters are ready to help — schedule an appointment today
MNsure has a statewide network of expert assisters who can help Minnesotans apply and enroll, free of charge. The assister can be a navigator or a broker.
The South Carolina Insurance Dept. released their final/approved 2020 Individual and Small Group Market premium rate changes a few days ago.
Previously, I only had the unweighted averages, which were a 1.9% decrease on the Indy market and an 11% increase for small group enrollees...but SCDOI has included the weighted averages for each in their approved numbers: A 3.9% drop and 7.6% increase respectively.
It's also worth noting that the Individual market is growing from three carriers to five next year--both Bright Health Co. and Molina Healthcare are joining the South Carolina market for the first time.
I honestly haven't written or read much about this since I wrote about it in April, but the Colorado government is making good on its promise to put forward a serious Public Option proposal.
While Washington is technically the first state to create their own state-based Public Option, the reality is that while I do give them plenty of credit for getting the ball rolling (their PO is scheduled to go into effect starting in January 2021), what they're doing isn't quite what most people have in mind when they think of a PO.
Washington is essentially outsourcing administration of a healthcare plan to an existing carrier, with the state government negotiating the provider network and reimbursement rate levels...which have been set to 160% of Medicare rates. There's nothing wrong with this, and it's an important move forward...but it's only expected to shave perhaps 5-10% at most off of costs because any negotiated rate settings are partly cancelled out by the cost of the private carrier doing the administration.
This Just In, via the New Jersey Dept. of Banking & Insurance...
NJ Department of Banking and Insurance Releases Health Plan Rates
On Average, NJ Individual Market Rates for 2020 Remain 1.4% Lower Than 2018
The New Jersey Department of Banking and Insurance today released rates for health insurance plans in the individual market effective January 1, 2020. On average, rates for 2020 will remain 1.4 percent lower than they were in 2018, due to policy actions taken by the Murphy Administration to stabilize the insurance market.
OK, hold up, read that again: 1.4% lower than 2018 premiums, not 1.4% lower than 2019. That's kind of an important distinction. Don't get me wrong, this isn't a bad thing to note, but it's not that impressive considering some other states are seeing rate reductions from 2018. Of course, there's a lot of factors at play which vary from state to state as well.
In case anyone's wondering why I haven't posted anything yet today (I have a huge backlog, believe me!), I'm prepping to moderate a Healthcare Town Hall this evening with my state Representative Mari Manoogian (along with her neighboring House member, Kyra Harris Bolden). The topic? Prescription Drugs:
Please join Representatives Mari Manoogian and Kyra Harris Bolden for a town hall discussion to rein in the runaway cost of prescription drugs. No one should have to choose between paying for their medications and putting food on the table.
A huge part of the controversy about "pure" Medicare for All is tied to the fact that nearly 50% of the population (roughly ~160 million Americans, give or take) currently receives healthcare coverage via their employer. Some of this Employer-Sponsord Insurance (ESI) is pretty damned good, while some of it kind of sucks, but that's how our absurd system currently works for good or bad.
Anyway, most employers cover the bulk of the premiums for their enrollees...but a lot of people (my guess is the vast majority) either have no clue that they do so or at best have no idea how much of their monthly premiums are covered for them by the employer.
Normally I write two separate annual premium rate change filing entries for each state: One when the preliminary/requested rate filings are submitted, and another one when the final/approved rates are published.
In the case of California, it turns out that the rate rview/negotiation process is...more complicated. The press release/report released by Covered California back in July referred to preliminary 2020 premiums only, but it turns out that Covered California exchange personnel had already completed all their negotiations before posting any numbers.
It also turns out (thanks to "Dena M." aka @HealthEDena) that in California, insurance policy premiums are not reviewed/approved by the state insurance department...but by an entirely different department called the Dept. of Managed Health Care, or DMHC.
President Trump is scheduled to issue an order Thursday that expands the private-sector version of Medicare, as he slams some Democratic presidential candidates’ plans to build the program into a government-financed health system.
The order will direct federal health officials to make a set of changes to Medicare Advantage, the private managed care plans currently enrolling 22 million people — one-third of the participants in the federal insurance program for Americans who are 65 and older or have disabilities.
Back in early July, the Indiana Insurance Dept. posted the preliminary requested 2020 rate increases for the carriers participating in the ACA-compliant individual market. Technically there's three carriers there (CareSource Indiana, Celtic/Ambetter and Anthem), though Anthem only has 4 (yes, four) people enrolled in off-exchange policies total.
At the time, the IN DOI stated that the requested rates came in at an average premium increase of 9%:
INDIANA 2020 ACA FILINGS
The overall average rate increase for 2020 Indiana individual marketplace plans is 9.0%. CareSource and Celtic (MHS/Ambetter) have filed to participate in the 2020 Indiana Individual Marketplace. The Department of Insurance anticipates that all 92 counties in Indiana will be covered by both CareSource and Celtic (MHS/Ambetter).
Anthem has filed to offer a 2020 Off-Marketplace plan in Indiana. This plan is a catastrophic plan and is offered only in Benton, Jasper, Newton, Warren and White Counties.
