A week or so ago, I attempted to tally up the number of current ACA exchange enrollees who will have to shop around for a new policy this fall whether they want to or not, due to their current plan being discontinued. As a reminder, there are three main reasons for this: a) the carrier is pulling out of the exchange in their county/state (Aetna, Humana, UnitedHealthcare); b) the carrier is going out of business entirely (4 co-ops); or c) the carrier will still have policies available but is dropping the one they're enrolled in (mainly PPOs).
In addition to the 1.69 million estimate from Aetna, UnitedHealthcare, Humana and the 4 Co-Ops which are shutting down in CT, OH, IL and OR, we can also add the following (thanks to Louise Norris for the assist on some of these):
Two weeks ago, on August 14th, I officially concluded my requested 2017 rate hike project. I've since gone back and made some adjustments to various states where carriers have either pulled out of the individual market or resubmitted revised rate hike requests, but I had enough preliminary data from all 50 states (+DC) to come to some initial conclusions.
I sorted out the states by three different criteria, looking for any noteworthy patterns: Federal vs. State-Based Exchanges; Transitional Policies allowed vs. NO Transitional Policies; and whether or not the state has expanded Medicaid under the ACA (whether "standard" Medicaid or via a custom waiver version, like Arkansas, Indiana and New Hampshire did).
My conclusion at the time was that there wasn't enough of a distinction in either of the first two criteria to draw any conclusions...but as for Medicaid expansion, I said:
Over at Politico, Rachana Pradhan and Paul Demko have an interesting article speculating on the potential for the ACA-as-a-GOP-campaign-issue to spring back to life again due to the one-two punch of major carriers dropping out of the exchanges and significant rate hikes being imposed for the 2017 Open Enrollment period. The fact that #OE4 kicks off (November 1st) just 1 week before election day (November 8th) adds some fuel to this thinking:
The potential sticker shock — coupled with the likelihood many consumers will have fewer choices next year after major insurers scale back their exchange participation — creates a potential political opening for Republican candidates, especially since the next Obamacare enrollment season starts one week before Election Day.
Here's a peek under the hood of what a royal pain in the ass it is to keep track of all this stuff, here's a comment exchange I had with several site regulars a couple of days ago:
Charles Gaba: Actually, I did find *one* useful item...it looks like quite a few of the carriers *resubmitted* their filings later in the summer (my data is currently based on the requests from April/May).
So, we still don't have *approved* rates but the *requests* can be updated...
Some of it is odd---Aetna said they're *staying* on the exchange in Virginia...but it shows up here as being *new* to the exchange, even though they're a) already listed for 2016 over atData.HC.gov and b) I already have an exchange-based filing for them with over 13,000 current enrollees and a 13% requested hike. Huh.
joe: Aetna's 2016 plans are sold under Innovation Health Insurance Company. They were going to introduce new Aetna Leap plans in 2017.
Believe it or not, Indiana's individual market situation is actually among the brighter spots this year. While three carriers are dropping off of of the ACA exchange market (and Physicians Health Plan is dropping off-exchange policies as well), they're also seeing the addition of a new carrier (Golden Rule), and one major carrier, Celtic, actually requested and received an average reduction in their monthly premiums, which is pretty rare this go around.
Unfortunately, the overall average approved statewide increase, while still lower than most of the other states so far, is actually slightly higher than the requested average. Every carrier got what they asked for with the exception of Indiana University, which asked for a 9.9% hike but was approved for a 14.9% increase. This bumped the statewide average up from 17.7% to 18.5%:
The average premiums range from an increase of 29 percent by Indianapolis-based Anthem Inc. to a decrease of 5.3 percent by Chicago-based Celtic Insurance Co.
Usually when state regulators publicize their approved rate changes for carriers on the independent market, they list the various carriers and the approved average rate changes for each. I then simply plug these into my existing spreadsheet and get a before/after comparison against how much the carriers actually requested.
In the case of illinois, it's a little trickier. Unless I'm missing something, the only official notice the IL DOI has released is this PDF, which--while including lots of useful info about rating areas and so forth--doesn't actually list the overall statewide average approved rate increases by carrier.
Instead, it lists the averages based on metal level, and even then doesn't list all of the plans, just selected ones: Lowest-price Bronze, Lowest and 2nd Lowest-price Silver, and Lowest-price Gold, like so:
Virginia was the very first state which I ran an estimated 2017 average requested rate hike for, way back in mid-April.
Since then, aside from Humana pulling out (leaving just 1,800 current enrollees to find a new policy), Virginia's ACA exchange market has actually been remarkably calm; the state somehow managed to escape the wrath of both UnitedHealthcare and Aetna relatively intact, with both carriers still participating in the state's exchange next year as of this writing.
There have, however, been a few other changes to some of the rate filings here and there, found via this updated PDF on the VA DOI website as of July 19th. The overall average requested hikes don't really change much, but do nudge a bit higher than I had previously estimated, from 17.5% to 18.4%:
Physicians Health Plan of Northern Indiana announced Tuesday that it will quit selling individual insurance coverage next year through the federal Affordable Care Act.
The nonprofit PHP becomes the second insurer to announce it is leaving the HealthCare.gov insurance marketplace that serves residents of northeast Indiana. UnitedHealthcare said last spring it would drop out of the exchange in most states, including Indiana.
Four other insurers offered individual policies through HealthCare.gov this year in the Fort Wayne area and apparently will continue to do so in 2017. Insurers had until Tuesday to notify the state of their plans, and all four are among federal marketplace filings the Indiana Department of Insurance submitted Tuesday to the Department of Health and Human Services.
Fort Wayne-based PHP said it is paying $1.20 in medical expenses for every dollar it receives in premium payments from HealthCare.gov customers and has lost millions of dollars on the policies.
Following announcements by for-profit commercial carriers Humana and United Healthcare, nonprofits Health Alliance Plan and Priority Health are notifying agents they are pulling all PPO plans for 2017 from the Michigan health insurance exchange, Crain's has learned.
HAP has already announced it is pulling eight Personal Alliance individual preferred provider plans for individuals from the exchange and four PPO plans in the open market next year. HAP will continue to offer HMO individual plans on and off the exchange.
"We believe that these (PPO) plans do not represent the best value for the consumer," said Mary Ann Tournoux, HAP's senior vice president and chief marketing officer, in a statement. "At this time of cost-consciousness, we believe our remaining plans are the most cost-effective and offer our members and consumers greater value for their hard-earned insurance dollar."
About a month ago, when I first plugged in the average requested 2017 rate hikes for Georgia's ACA-compliant independent market, I came up with an overall weighted average of around 27.7%. However, there was one major gap in the data: I had trouble finding Ambetter/Peach State's enrollment numbers or even their average rate hike request, so I reluctantly left them out of the calculation completely.
When Aetna announced that they were dropping out of the Georgia exchange-based independent market, I went back and removed them from the mix. Since Aetna's request had been 15.5% on a substantial share of the market, this meant that the rest of the statewide average shot up to 32.0%.
Today I was able to track down the missing Ambetter/Peach State data--both the average requested rate hike (around 8.0%) as well as the number of current enrollees impacted...around 73,000:
