One of the most important provisions of the Inflation Reduction Act, passed with only Democratic votes in the U.S. House last summer, was this one: After decades of prior attempts, it finally allows the Centers for Medicare & Medicaid Services (CMS) to actively negotiate the price of at least some prescription drugs. As explained by the Kaiser Family Foundation:
The Inflation Reduction Act of 2022 (the Act), signed into law by President Biden in August 2022, includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government. One of the Act’s key drug-related policies is a requirement for the Secretary of Health and Human Services (HHS) to negotiate prices with drug companies for certain drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028). This new requirement is the culmination of years of debate among lawmakers over whether to grant the federal government the authority to negotiate drug prices in Medicare.
SIOUX FALLS, S.D. (Dakota News Now) - Although Medicaid expansion in the state of South Dakota doesn’t take effect for another month, the window to apply opened on Thursday. A kickoff event was held for advocates and patients to review the benefits for those who qualify.
“Today has been long overdue. No one should have to choose between bankrupting their family and getting the health coverage they need,” said Dr. Dan Johnson from the American Cancer Society.
After the hard work of gathering petition signatures and talking to voters, Medicaid expansion advocates are celebrating enrollment opening for South Dakota residents.
...Over 50,000 people will be eligible for Medicaid, as voters approved Constitutional Amendment D last November. Erik Nelson, an advocate with AARP, has had positive conversations with the state handling the logistics of enrollment.
...Even if applicants don’t have their application completed by the July 1 effective date, a plan is in place.
The Michigan Dept. of Financial Services hasn't issued any press release yet, but nearly all 2024 preliminary rate filings for the MI individual and small group markets are available via the SERFF database.
The only one missing as of today is UnitedHealthcare Community Plan, Inc.; they have most of their 2024 forms on record but there's no Actuarial Memo or URRT form included for the individual market, so I can't seem to find their actual requested rate changes or their enrollment as of March 2023.
In any event, I'm not seeing anything too odd here. Unlike other states with preliminary filings so far this year, Michigan carriers are seeking a fairly reasonable 5.6% average rate hike on the individual market and 7.0% for the small group market.
It's worth noting that two of the three indy market carriers asking for double-digit rate hikes (Alliance and HAP) both only offer off-exchange policies. The third, MacLaren, is also pulling out of the small group market entirely. It's also possible that Humana is dropping out of the small group market, although I'm not sure about that one.
Ouch. Via the New York Dept. of Financial Services, the preliminary, weighted average rate increases being requested for individual market health insurance policies for 2024 are looking pretty ugly indeed: 20.9% overall according to DIFS. I get a slightly lower weighted average of 20.7%, but it still ain't pretty.
Two of the highest increases are for carriers which are only offering policies off-exchange next year and which have fewer than 100 enrollees each anyway; I assume they're both winding down their operations in the state. There are also two carriers which appear to be leaving the NY individual market entirely this year.
As for the rest, they range from requested average increases of "only" 13.3% for MVP to a stunning 52.7% rate hike by Emblem (HIP). The justification summaries are below the table.
It's important to remember that these are not final rate increases--New York in particular has a tendency to slash the requested rate hikes down significantly before approving them:
Friday Health Plans, Inc., the parent company of Friday Health Plan of Colorado, ,Inc. (HMO), has announced that it will begin to wind down its business activities throughout the country, working in close conjunction with state regulators, including the Colorado Division of Insurance.
In recent months, it became apparent that the parent company would need to raise substantial capital to continue. Friday was ultimately unable to raise that capital and on June 1, Friday Health Plans, Inc. (Parent) stated publicly that they would begin to wind down.
This post has a long intro, but please bear with me...
Back in 2018, after the then-Republican controlled Congress zeroed out the ACA's federal "individual mandate penalty" (officially the "shared responsibility penalty"), I posted both a video and slideshow explainer about what this penalty was and why it was included in the ACA in the first place.
...Well, just one day after the Bright Healthcare bombshell news broke, Texas-based health insurance broker Jenny Chumbley Hogue sounded the alarm on another large carrier bailing on Texas next year:
And its confirmed. Email received from Friday. Buckle up folks! Individual OEP in Texas is going to be a bumpy ride! https://t.co/AMNJ4rPyr3
SACRAMENTO, Calif. — Covered California launched a virtual media tour on Wednesday to spread the word about the upcoming Medi-Cal to Covered California Enrollment Program and how it will help keep Californians covered.
...Well, just one day after the Bright Healthcare bombshell news broke, Texas-based health insurance broker Jenny Chumbley Hogue sounded the alarm on another large carrier bailing on Texas next year:
OLYMPIA, Wash. — Fourteen health insurers filed an average requested rate increase of 9.11% for Washington's individual health insurance market. The proposed plans and their rates are currently under review and final decisions will be made this fall.
"Nearly 250,000 people in Washington state get their health coverage through our individual market,” said Insurance Commissioner Mike Kreidler. “I'm pleased that so many insurers are filing plans again and to see such healthy competition. Now, we'll spend the next few months closely reviewing the companies' requests and the assumptions they’re making to be sure any rate change is justified.”
