I feel kind of stupid posting this in the aftermath of not one, but two massacres in El Paso, TX and Dayton, OH (at least one of which was a clear case of white nationalist terrorism inspired and encouraged by Donald Trump), but I was bout 80% done with this last night and this is part of my job, so here it is.
Gov. Tony Evers today announced that 2020 rates on Wisconsin’s individual health insurance market will be 3.2 percent lower on a weighted average compared to 2019 rates. This encouraging news further demonstrates that the individual market is stabilizing and Wisconsin residents are able to access more affordable coverage options.
The rate decrease also highlights the positive impact of that the Wisconsin Healthcare Stability Plan (WIHSP), or the state’s reinsurance program, is having on the individual market. WIHSP was fully funded in the recently signed 2019-2021 state biennial budget. Without the WIHSP, rates in the individual market were expected to increase by 9 percent in 2020.
Both evenings of the Detroit Democratic Debates earlier this week started off with half-hour segments on healthcare policy. I meant to do write-ups about both of them but for one reason or another never got around to it until now. Tons of other healthcare wonks have already written their own think pieces by now, so I'm not going to go back and rehash the whole thing at this point.
HOWEVER, there's one quote which made my jaw drop, and it doesn't come from any of the Big Four (Biden, Warren, Harris or Sanders). It comes from Hawaii Representative Tulsi Gabbard...and it didn't even come during the debate itself, but afterwards in the "Spin Room" (they actually call it that) with Anderson Cooper.
Federal Government Announces 2020 Premium Rates
Website details proposed decreases for health plans to be sold in NH
CONCORD, NH – The federal government has published information on proposed rates for New Hampshire’s health insurance exchange (HealthCare.gov) in 2020.
The New Hampshire Insurance Department looks at premiums each year from a market-wide perspective, comparing the median premium for an on-exchange silver-level plan covering a 40-year-old non-tobacco-user. For 2019, the median premium at this level was $440; the median premium at this level for 2020 would be $429, based on the carriers’ proposed rates. If these rates are ultimately approved, this would represent a 2.5% decrease between next year’s and this year’s median premium in the individual market.
Missouri has also released their preliminary 2020 Individual and Small Group market premium rate change filings. For the most part they're following the same pattern as most other states this year with modest increases or decreases and a statewide weighted average decrease of 1.8% year over year. On average, unsubsidized ACA enrollees should pay about $11/month less next year than they are today.
However, what is noteworthy is that not one, not two but three new insurance carriers are entering the MO individual market this fall, bringing the total up to seven operating statewide: Cox Health Systems, Oscar Insurance (which was cofounded by Jared Kushner's brother, FWIW) and SSM Health Insurance.
The Small Group market, meanwhile, is looking at roughly 6.9% premium increases, although this could be a bit off since I had to use the 2018 enrollment number for UnitedHealthcare, which also happens to have the largest market share of the six companies in that market:
Proposed rate change averages for health insurance are available to the public for review
Consumers who shop for health insurance in the individual market, can now view new rate information for Plan Year 2020 on the Nevada Division of Insurance website.
Based on the rate submissions the Division has received for 2020 plans, there are three insurance companies that submitted proposed rates for plans on the Silver State Health Insurance Exchange (Exchange): Health Plan of Nevada, SilverSummit, and HMO Colorado, with up to 26 individual health plans to choose from. The proposed average increase is 0.5% for those health insurance plans sold On-Exchange through Nevada Health Link.
As I've explained before, Section 1332 of the ACA itself gives individual states the right to petition to make changes in how the law works in their state. The idea is that, as President Obama noted himself, if a state can come up with ways to make the ACA provide coverage which is at least as comprehensive to at least as many people as it already does, without increasing the federal deficit, go for it.
There've been a couple dozen 1332 waivers which have made it at least partway through the development process; some failed along the way, some were completed but then rejected by CMS, and some have been approved. The most common type of approved 1332 waiver, in nearly a dozen states now, is for reinsurance, which is a wonky way of leveraging state dollars to reduce premiums for unsubsidized ACA enrollees.
If you're wondering why you've only heard about "reinsurance waivers" over the past year or two, there's two reasons.
The Department of Insurance received preliminary 2020 health plan information from insurance carriers on June 1 and began reviewing 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 2020 increase information. The public is invited to provide comments on the rate changes. Please send any comments to Idaho Department of Insurance.
NOTE: This post re. North Carolina's 2020 individual market premium rate change is incomplete because it only includes one of the three carriers participating in NC's market (Blue Cross Blue Shield of NC). The rate change requests for Cigna and Centene haven't been released yet.
Normally I'd wait until I had data for the other two as well, but BCBSNC held around 95% of the state's Individual Market share last year, with Cigna holding the other 5% (Centene was a new entry to the market, so they didn't have any of it). I don't know how much the relative share has changed this year, but I'm assuming that BCBSNC still holds the lion's share of the total.
Blue Cross NC is decreasing 2020 Affordable Care Act (ACA) rates by an average of 5.2 percent for plans offered to individuals and an average of 3.3 percent for plans offered to small businesses with one to 50 employees. With this reduction, we take 238 million steps towards more affordable care in North Carolina.
The good news about the Ohio Insurnace Dept. is that they make it easy to find out which insurance carriers are participating on the ACA market and what the overall, weighted premium change is statewide.
The bad news is that they don't break out that statewide average by carrier rate changes, nor do they make it easy to find out the actual enrollment in the individual carriers...even on the SERFF database, they don't post the relevant filing forms until much later in the year, and tend to redact the critical data.
Still, the big number in the Buckeye State is a 7.0% average premium decrease year over year for 2020:
Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Pennsylvania Insurance Department for review and approval before plans can be sold to consumers. The Department reviews rates to ensure that the plans are priced appropriately -- that is, they are neither excessive (too high) nor inadequate (too low) -- and are not unfairly discriminatory.
Rates reflect estimates of future costs, including medical and prescription drug costs and administrative expenses, and are based on historical data and forecasts of trends in the upcoming year. In its review, the Department considers these factors, as well as factors such as the insurer's revenues, actual and projected profits, past rate changes, and the effect the change will have on Pennsylvania consumers. For more information on this process, watch our How Are Health Insurance Rates Decided?Opens In A New Window video.
