Oklahoma is an example of how frustrating this rate review stuff can be, even when there's only a handful of companies involved and much of the data is easily accessible.
According to RateReview.Healthcare.Gov, Oklahoma only has a single company asking for rate hikes greater than 10%: Blue Cross Blue Shield of OK.
The main listing gives the requested rate increase as a jaw-dropping 43.95%...but the description below it says that "the range of rate increases by product is 22% to 34%".
Now, there are two additional BCBSOK listings on the Rate Review site which do appear to be included in the first one (all 3 list the total "members affected" as exactly 137,506)...but the other two have 22.64% and 33.83% listed as the "official" requested rate increase, both of which are still well below 44%.
How on earth you can have the individual product rate hikes range from 22-34% but average 43.95%, I have no idea. Obviously I'm missing something here.
West Virginia is pretty easy to calculate. Their total 2014 individual market was only 42,225 people (including "grandfathered" plans...WV did not allow "transitional" policies to be extended beyond 2013), and they had 33,421 people select exchange-based QHPs during the 2015 open enrollment period, of whom 31,106 were still effectuated as of 6/30/15.
Assuming about 5% are "grandfathered" (and not part of this risk pool), and assuming their total individual market grew by about 20% this year (this has been typical of many other states), that means they should have around 48,000 ACA-compliant enrollees at the moment (31K exchange-based plus another 17K or so off-exchange).
The Massachusetts Health Connector just held their monthly board meeting this morning, and have released the August dashboard report with a whole mess of demographic data for Baystate-obsessed nerds to revel in.
Effectuated QHPs have reached 175,605 enrollees...a whopping 35,065 higher (25%) than at the end of Open Enrollment.
While the national effectuation number is 2.3% lower or so today than it was in March (9.95 million vs. 10.19 million), in Massachusetts it's 42% higher. There's two main reasons for this, both connected to "ConnectorCare", which is unique to Massachusetts. ConnectorCare consists of the same low-end Qualified Health Plans that anyone can purchase (ie, they're still counted as QHPs in the national tally), except that in addition to the federal Advanced Premium Tax Credits (APTC), enrollees in ConnectorCare also receive additional state-based financial assistance, making them even more attractive to enrollees. In addition, however, unlike "normal" APTC or Full Price QHPs, which are limited to the official open enrollment period for most people, ConnectorCare enrollment, like Medicaid/CHIP, is open year round. That makes a dramatic difference, as you can see below; the vast bulk of the net QHP enrollment increase since March is thanks to ConnectorCare additions.
In addition, MA is the only state I know of which actively reports their attrition numbers--that is, so far this year they've had just 16,874 people drop their QHP policies, meaning a total of 192,479 people have selected a plan and paid at least their first monthly premium.
Assuming a 90% payment rate (confirmed for Massachusetts back in April), this also suggests that the cumulative QHP selection total should be roughly 213,000 people to date, which is only significant to me and The Graph.
But wait, there's more! Look below and you'll see a whole mess of pie charts, bar charts and line charts, breaking out everything from Metal Level selections and Market Share by Provider to SHOP enrollments (5,486 lives covered as of September 1st) and even Dental Plans!
PROVIDENCE, RI- HealthSource RI (HSRI), Rhode Island’s state-based health benefits exchange, reported today the percentage of Rhode Islanders lacking health insurance has been reduced by more than half since 2012, according to results of a robust, state-wide survey commissioned by HSRI. The Health Information Survey (HIS) showed a drop in the uninsured rate from 11 percent in 2012 to five percent in 2015 (margin of error of +/- one percent.) The comprehensive HIS survey of 5,000 households and more than 12,000 individual Rhode Islanders shows similar trends to other national surveys released in recent weeks.
As of 2014, key provisions of the Patient Protection and Affordable Care Act (PPACA) resulted in the establishment of health insurance exchanges in each state and changed how insurers determined health insurance premiums. Individual market consumers generally had access to more health plans in 2015 compared to 2014, and in both years the lowest-cost plans were available through exchanges in most of the 1,886 counties GAO analyzed in the 28 states for which it had sufficiently reliable data for plans offered either on or off an exchange. In addition, consumers in most of the counties analyzed had six or more plans to choose from in three of the four health plan metal tiers (bronze, silver, and gold) in both 2014 and 2015, and the percentage of counties with six or more plans in those metal tiers increased from 2014 to 2015. Consumers had fewer options regarding platinum plans, although the availability of platinum plans generally also increased from 2014 to 2015. The lowest-cost plan available in a county was available on an exchange in most counties. For example, among the 1,886 counties analyzed, GAO found that the lowest-cost silver plan for a 30-year-old was available on an exchange in 63 percent of these counties in 2014 and in 81 percent of these counties in 2015—an increase of 18 percentage points.
Yesterday I noted that the "sequel" (in spirit, not in actuality) to the King v. Burwell federal case, House v. Burwell, has been given the green light to proceed by a federal judge...or at least the part of the lawsuit most relevant to this site and most everyday people:
A federal judge ruled on Wednesday that House Speaker John Boehner's lawsuit over the implementation of Obamacare can move forward, setting the stage for another high-stakes legal battle over President Obama's signature legislative accomplishment.
The suit, brought by Speaker of the House John Boehner and the House Republicans, has two major components: Attacking the Obama administration for delaying implementation of the Employer Mandate portion of the ACA by a year (which was done because most businesses needed more time to prepare for this provision, and which is doubly stupid because the GOP has voted to repeal the entire law dozens of times anyway); and attacking the administration for implementing the Cost Sharing Reduction provision, which they claim the administration wasn't specifically authorized to do.
I posted about this back on July 3rd, just a week after the historic King v. Burwell Supreme Court ruling, which put the Constitutional seal of approval on the ACA's Advance Premium Tax Credits (otherwise known as the Federal Tax Subsidies) for over 6 million people across the 3 dozen Healthcare.Gov states.
The short version is that there's Yet Another lawsuit winding its way through the federal court system: House vs. Burwell. This is the one which is being brought by John Boehner and the House Republicans against the Obama administration. Here's the recap.
As I understand it, there's 3 main issues at hand:
9 of the 20 states which saw an increase in effectuated enrollees from 3/31 to 6/30 are state-based exchanges (remember, there's only 14 of these).
26 of the 30 states (+DC) which saw a decrease in enrollees are Healthcare.Gov states (mainly due to the 306,000 enrollees terminated due to legal residency issues).
The highest off-season increase: Massachusetts, which saw a 20.7% increase in enrollees mainly due to their policy allowing year-round enrollment in "ConnectorCare" QHP policies.
The worst off-season decrease: Mississippi, which lost 9.3% of their effectuated enrollees during the quarter.
Colorado's June number is listed as being identical to their March number because CMS was unable to verify their June enrollment and simply copied the March number over. Their unofficialJune 30 figure is 134,200, or about 9.1% higher than it was on 3/31.
The percent of enrollees with APTC (Advanced Premium Tax Credits) has dropped slightly, from 85% in March to 83.7% in June.
The percent of enrollees with CSR (Cost Saving Reduction) has also dropped a bit, from 57.4% to 56%
Both of these suggest that the bulk of those who have been kicked off for proof-of-legal-residency issues tend to be lower-income, which makes sense. Update: Andrew Sprung notes that some people may have lost their tax credits or CSR assistance without losing their policies if they reported an income change or if their original income claims can't be verified, so perhaps not).
The average federal tax credit amount has also gone down very slightly ($272/month to $270).
The Metal Level ratio, however, hasn't shifted at all; it remains 1% Catastrophic, 21% Bronze, 68% Silver, 7% Gold and 3% Platinum.
For months now, I've been operating on the assumption that the total number of currently effectuated private ACA exchange policies has been roughly 10.3 - 10.4 million, give or take. This was based on a combination of last year's enrollment pattern, the 214,000 additional people who selected QHPs during the #ACATaxTime special enrollment period, as well as assorted state-level enrollment updates out of California, Maryland and a few other state-based marketplaces.
Last year, GOP Governor Tom Corbett pushed through a poorly-conceived, overly-cumbersome "Republican alternative" Medicaid expansion program called Healthy PA, which didn't go into effect until late in the year. He was defeated by Democrat Tom Wolf, who vowed to scrap the "alternative" version and simply expand Medicaid to residents below 138% of the Federal Poverty Level, as the ACA had intended.
Department of Human Services Sec. Ted Dallas Tuesday announced the end of the transition from Healthy PA to traditional Medicaid expansion—known as HealthChoices in Pennsylvania—as the last of the expansion insurance plans took effect.
According to Sec. Dallas, 440,000 Pennsylvanians are enrolled in Medicaid expansion insurance plans with the last group of enrollees coming out of Healthy PA’s primary coverage options into Medicaid expansion.
“With that last group of folks moving over, the Medicaid expansion is now complete,” Sec. Dallas told reporters.
