I've said before that there are a few areas of the ACA which I simply don't consider myself knowledgable enough about to try and explain to others in depth. One of these is the so-called "Cadillac Tax" on high-end employer sponsored insurance policies. The other (well 3 others, really) are the "3R" programs which were set up to try and smooth out the transition period for insurance carriers for the first few years. The "3 R's" are "Risk Adjustment", "Reinsurrance" and "Risk Corridors".
Risk adjustment is a process that deters insurance plans from trying to attract healthy enrollees (“cherry picking”), and protects companies that may—by chance or because of their particular benefits—attract sicker than average customers (“adverse risk selection”). Though the Affordable Care Act bans carriers from turning people down or charging them more based on their health, the incentive to attract healthier enrollees remains because healthier customers increase profits by reducing companies’ payouts.
This is really more for budget wonks than healthcare wonks, but still kind of interesting: The Congressional Budget Office just issued their September 2015 Monthly Budget Review report. Since the fiscal year runs from October through September each year, this means that they're basically closing the books on 2015 from a budgetary POV:
The federal government ran a budget deficit of $435 billion fiscal year 2015, the Congressional Budget Office estimates—$48 billion less than the shortfall recorded in fiscal year 2014, and the smallest deficit recorded since 2007. Relative to the size of the economy, that deficit—at an estimated 2.4 percent of gross domestic product (GDP)—was slightly below the average experienced over the past 50 years, and 2015 was the sixth consecutive year in which the deficit declined as a percentage of GDP since peaking at 9.8 percent in 2009. By CBO’s estimate, revenues were about 8 percent higher and outlays were about 5 percent higher in 2015 than they were in the previous fiscal year. CBO’s deficit estimate is based on data from the Daily Treasury Statements; the Treasury Department will report the actual deficit for fiscal year 2015 later this month.
This is a pretty minor 2015 exchange enrollment update, and one of the last ones I'll be doing before the 2016 Open Enrollment period kicks off, but I should squeeze it in:
From October 1, 2013 to September 23, 2015, 166,789 people have enrolled in health insurance coverage through DC Health Link in private insurance or Medicaid:
24,663 people enrolled in a private qualified health plan,
120,739 people have been determined eligible for Medicaid, and
21,387 people enrolled through the DC Health Link small business marketplace (includes Congressional enrollment)
As always, the DC exchange insists on giving cumulative totals since 10/1/13 instead of the 2015-only numbers, which isn't particularly useful. However, by comparing it against their earlier update, I can figure out the difference since then:
From October 1, 2013 to June 7, 2015, 125,478 people have enrolled in health insurance coverage through DC Health Link in private insurance or Medicaid:
The tweet includes this graphic, which seems pretty clear cut to me:
I noted yesterday that 3 states (Maryland, Idaho and California) have already opened up window shopping to prospective 2016 enrollees.
However, it was my understanding that no one was allowed to actually enroll (ie, "select or renew a Qualified Health Plan") until 2016 Open Enrollment officially starts on November 1st.
Not sure why this is being treated as such a revelation this morning, but Public Policy Polling just released new, extensive national polling results, and among the various topics they asked about was this bit regarding the Affordable Care Act:
Evidence continues to mount that the Affordable Care Act is just not a liability for Democrats anymore. Nationally we find that 42% of voters support it to 40% who are opposed. Those numbers are in line with what we've found in most swing states where we've polled on it over the course of this year. It's a far cry from when we used to consistently find voters opposed to it by a 10-15 point margin nationally and in key states. One big reason for the change is that Democrats (73%) are more unified in their support of it than Republicans (70%) are in their opposition to it. There isn't the sort of pro GOP intensity gap on the issue that there used to be.
For all of the improvements made to the federal exchange website, HealthCare.Gov, last year (ie, reducing the number of account creation screens from over 70 to just 16; optimized formatting for smartphones; working properly in general), there were still several major features missing. According to a new AP story, at least two of these have been addressed for the 2016 Open Enrollment period starting November 1st:
Consumers shopping on the government's health insurance website should find it easier this year to get basic questions answered about their doctors, medications and costs, according to an internal government document.
A slide presentation dated Sept. 29 says HealthCare.gov's window-shopping feature is getting a major upgrade.
...Previously, it could take considerable digging to find out plan details. Now consumers would be able to enter their doctors, hospitals and medications as they browse online. When they go to compare plans, they would see whether those doctors, hospitals and drugs are covered.
As it happens, at least two other state-based exchanges have done so as well:
COVERED CALIFORNIA: It's pretty obscure for the moment, but if you click the "Shop & Compare Tool" link at the lower left-hand corner of the CoveredCA website, you'll be given the option to shop around for 2016 plans (you can also choose 2015 plans in case you've had a qualifying life change and need coverage for the last 2 months of this year, or even 2014 plans if you still need that information for tax purposes or whatever):
Two more health insurers in North Carolina are asking to increase their already-proposed rate increases.
UnitedHealthcare, which had requested an average rate increase of 12.5 percent, now is asking regulators to allow an an average increase of 20.4 percent. The range is 2.5 percent to 50.3 percent.
Humana had requested 11.3 percent and is now asking for an average of 24.9 percent.
Last month I wrote a quick post about the Montana individual market; with only 3 players, all of whom had requested >10% increases, it was pretty easy to plug the numbers in: 22.2%, 29.3% and 34.0%.
Commissioner Monica Lindeen's office says the average rate increase for all plans next year will range between 22 percent and 34 percent. For the popular Silver plan, the increase will range from $80 to $88 a month for a 40-year-old person.
Lindeen said Thursday the rates affect about 41,000 people. They don't include people who receive federal tax credits or those who have insurance through their employers.
The "good" news here is that the affected number is only 41K instead of the 76K I had on record. It's possible that the middle carrier had their rates changed, but overall it looks like the commissioner just signed off on the original requests, for a roughly 26% average increase.
When I ran the numbers for Georgia's individual market in August, I didn't have a whole lot to work with. The requested rate changes were only publicly available for carriers representing around 222,000 enrollees, out of a state-wide individual market of (likely) around 750,000. The weighted average increase for the companies I had data for was around 18.3%; all I knew about the rest of them is that they had asked for hikes of under 10%. My best ballpark estimate was that Georgia residents were likely looking at roughly a 10-13% increase overall.
Today I ran across an article in the Rome News-Tribune which gives some of the final, approved rate hike numbers for 2016...but just bits and pieces, nothing to hang your hat on:
Many Georgians buying individual or family health insurance will see double-digit increases in their premiums for 2016.
