While nearly 16.4 million Americans selected Qualified Health Plans (QHPs) via the federal and state ACA exchanges/marketplaces during the official 2023 Open Enrollment Period (along with an additional 1.2 million signing up for a Basic Health Plan (BHP) program in New York & Minnesota, which CMS continues to inexplicably treat as an afterthought in such reports), not all of them actually pay their first monthly premium (for January) for various reasons:
The good news about New Hampshire's health insurance market is that they're the only state without its own ACA exchange which produces publicly-accessible monthly reports on individual on-exchange market enrollment. The bad news is that they don't seem to publish the actual rate filings in an easy-to-read format, which means I'm left with the federal rate review website, which sometimes posts average rate requests which don't match up with the actual filings...but it's gonna have to do here.
With these two data sources in hand, New Hampshire's individual market carriers are asking for a weighted average increase of 3.1%. It's important to note that Anthem Health Plans and Matthew Thornton Health Plan are listed as separate carriers on the federal Rate Review website (with separate average rate requests), but on the state's monthly report, they're merged into a single listing.
Nevada used to be a state where the annual individual & small group rate filings were fairly transparent. They have a pretty easy-to-use searchable filing database which clearly lists the carriers, market, maximum & minimum rate changes and even includes the SERFF Tracking numbers for every filing.
Unfortunately, this year at least, most of that proves useless for my purposes. The average rate changes are posted, but the enrollment data is still hidden from public view--entering the SERFF Tracking Numbers still brings up nothing in the SERFF database, and the actuarial memos posted at RateReview.HealthCare.Gov are mostly redacted. As a result, I'm only able to enter enrollment data for one of the nine carriers on the Nevada individual market, and none on the small group market.
Interestingly, the one I have enrollment data for (Aetna Health of Utah) also has a curious discrepancy: The filing itself lists the average requested rate increase as being 6.97%, but on the RR.HC.gov site it only shows up as 1.36%. The other eight carriers all match up (or are within a tenth of a percentage point, anyway).
Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has 10 different carriers participating in the individual market.
One thing which sets Massachusetts (along with Vermont) apart from every other state is that their Individual and Small Group risk pools are merged for premium setting purposes.
Normally you would think this would make my job easier, since I only have to run one set of analysis instead of two...but until recently, it was surprisingly difficult to get ahold of exact enrollment data for each carrier on the merged Massachusetts market (and even more difficult to break out how many are enrolled in each market since they're merged...not that that's relevant to the actual rate changes).
Kentucky is yet another state where the actuarial memos are heavily redacted, making it difficult to acquire information such as the number of enrollees...which in turn makes it impossible to run a weighted average requested rate change for the individual or small group markets.
There are four carriers offering policies on the KY individual market (Anthem, CareSource, Molina and WellCare), with an unweighted average rate change request of 4.1%. Molina has provided an unredacted actuarial memo which includes their enrollment...but it's only 505 people, while KY's total indy market is likely closer to 75,000 or so including the off-exchange market.
While numerous other states have already done the same thing (and several more are in the process of doing so as well), Georgia's move to their own enrollment platform was especially noteworthy for two reasons:
First, because it represents as complete 180-degree policy turn from their prior attempts (over the course of several years) to eliminate any formal ACA exchange (federal or state-based) in favor of outsourcing it to private insurance carriers & 3rd-party web brokers.
Back in late 2021, Colorado launched their own new, state-based ACA financial subsidies on top of federal subsidies which have already been enhanced (at least through the end of 2025) via the American Rescue Plan and Inflation Reduction Act:
The financial help you can get to lower your out-of-pocket costs are healthcare discounts called Cost-Sharing Reductions. Connect for Health Colorado is the only place you can apply for financial help to lower the cost of private health insurance. Due to the American Rescue Plan, Coloradans are now eligible for more savings than ever before.
Consider a Silver plan if your Health First Colorado (Medicaid) coverage recently ended or your income is over the limit to qualify
Connect for Health Colorado launched a new state-funded program recently to provide even more healthcare savings to people shopping on the Marketplace for 2022 whose income is just over the limit to receive Health First Colorado (Medicaid) and who enroll in a Silver-level plan.
The IDOI will finalize its review of the 2024 ACA compliant filings both on and off the federal Marketplace by August 17, 2023. The Centers for Medicare and Medicaid Services (CMS) will issue the ultimate approval for the Marketplace plans sold in Indiana. CMS will issue its approval on or before September 20, 2023.
It's been over six weeks since the last time I checked in on how many Americans had lost Medicaid or CHIP coverage due to the ongoing Medicaid Unwinding process playing out nationally. At the time, "only" 612,000 people had been confirmed to have lost coverage purely due to procedural/red tape reasons (as opposed to others who lost coverage after being determined ineligible any longer).
The Kaiser Family Foundation (KFF) has taken up the mantle on this front, and the data so far, while still limited, is pretty much as bad as many healthcare advocates feared. Since then, a lot more data has been collected and the numbers have grown dramatically:
In April 2023, 94,151,768 individuals were enrolled in Medicaid and CHIP.
87,062,629 individuals were enrolled in Medicaid in April 2023, an increase of 348,055 individuals from March 2023.
7,089,139 individuals were enrolled in CHIP in April 2023, a decrease of 73,121 individuals from March 2023.
Since February 2020, enrollment in Medicaid and CHIP has increased by 23,276,699 individuals (32.8%).
Medicaid enrollment has increased by 22,982,836 individuals (35.9%).
CHIP enrollment has increased by 293,863 individuals (4.3%).
Medicaid enrollment likely increased due to the COVID-19 PHE and Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA), which started in March 2020 and ended on March 31, 2023.
