(as whoever posted the commercial to YouTube noted, "Seriously, who struts down the sidewalk munching on a jar of peanut butter?")
I've written quite a few times before about how the small group insurance market is sort of the odd man out when it comes to the Affordable Care Act. The SHOP exchanges have turned out to be mostly a dud (to the point that the HHS Dept. has only stated once just how many people are even enrolled in SHOP policies (and even that was missing some states; my best guesstimate is arouns 150,000 nationally).
That's a net increase of 12,277 people in just 9 days, or over 1,300 per day.
There are an estimated 375,000 Louisianans eligible for ACA Medicaid expansion. If they can enroll another 700/day, they'll have maxed out by New Year's Eve.
What are the actual old and new dollar amounts that we’re talking about here?
Remember, until now we’ve been talking purely about percentages … but that can be very misleading. In our hypothetical example, Acme is a new player on the market. They priced aggressively last year in order to steal customers away from the more familiar brand names, and managed to get 5 percent of the market; not bad.
Unfortunately, those customers turned out to be loss leaders – it’s costing them more to care for their enrollees than they’re being paid, so they jacked up their rates 25 percent this year, while Blue Cross is only raising theirs 6 percent (weighted).
HOWEVER, when you look at the average premium dollar amounts of each company, look what happens:
MIT health economist Jonathan Gruber was the Republican Party's favorite stock villian during the absurd King v. Burwell (formerly Halbig v. Burwell) Supreme Court saga which raged throughout the first half of 2015, in large part because of his tendency to have a bad case of diarrhea of the mouth when speculating about the reason why certain sections of the ACA were written the way they were.
From a pure, cold economic perspective, the debate going on between the dueling studies above is about how much the first is being cancelled out by the second.
The debate which should be going on from a human perspective is about whether more or fewer people are better or worse off health-wise and economically thanks to/due to the ACA than they would otherwise be without it.
Unfortunately, when it comes to healthcare, this is a nearly impossible task to measure properly.
For instance, let's take someone with cancer. Under the ACA, they're allowed to enroll in a policy which will cover their treatments. If they have a low income, they'll receive heavy APTC assistance and possibly CSR assistance.
Without the ACA, they'd be utterly screwed and would very likely go bankrupt trying to pay the full price for treatment, or die without it, or the first followed by the second.
In an effort to prevent more insurers from abandoning the Obamacare exchange in Tennessee, the state's insurance regulator is allowing health insurers refile 2017 rate requests by Aug. 12 after Cigna and Humana said their previously requested premium hikes were too low.
As of last week, five companies in Arizona had announced plans to pull out or pull back: Health Choice, United Healthcare, Humana, Blue Cross Blue Shield of Arizona and Health Net.
Well, there you have it: Across all 50 states (+DC), taking a bunch of caveats into account (see below), as far as I can estimate, the average premium rate increases being requested by health insurance carriers sits at right around 23% overall.
Off-exchange policies are included whenever possible, but only if they're ACA-compliant (grandfathered/transitional plans are in a different risk pool anyway). The ACA-compliant individual market totals roughly 18-19 million people nationally (11 million on-exchange, another 7-8 million off-exchange). Grandfathered/Transitional plans likely total around 2-3 million more.
Only individual market policies are included (there's a few states where the small group market has been merged with the individual market risk-pool wise, but I only include indy enrollees for purposes of weighting). The small group market was around 13.5 million people, according to Mark Farrah Associates.
Some carriers are pulling out of either specific counties or entire states next year, or are dropping certain plans while keeping others. There's no way of estimating the "average rate increase" for anyone who's losing their existing plan altogether.
Well, I've managed to put together estimates (some very rough, some pretty specific) of the weighted average requested ACA-compliant individual market rate hikes for 49 out of 50 states, along with the District of Columbia. This leaves just one state left: Minnesota. For whatever reason, I've been informed that Minnesota's requested rate filings won't be available to the public until September 1st, which is too late for my purposes...because by that point, many of the other states will have started releasing their approved rates for next year (in fact 3 of them--Oregon, New York and Mississippi--have already done so). Minnesota's approved rates will be posted on October 1st. It's always been my intent to lock down the requested rates for every state before the approved numbers are posted in order to run a comparison between what was asked for and what the final approved rate changes are.
Mississippi remains one of only two states which still don't have their 2017 Rate Filings posted over at HC.gov's Rate Review database. In addition, while Mississippi does use the SERFF system for other types of insurance, major medical doesn't appear to be among them. Finally, while the MS Dept. of Insurance does include a special website specifically designed for searching/comparing rate changes for health insurance policies...it doesn't appear to have been updated in awhile (the only recently listings are for obscure carriers which seem to be mostly offering short-term plans and other "mini-med" types of policies, not full ACA-compliant plans.
