Hmmmm...Vermont's filings are usually pretty easy to average because a) they don't redact any of their filing data; b) they make the forms easy to access; and c) they only have two insurance carriers operating in the individual or small group markets anyway (in fact, it's the same two carriers in both markets).

This year, however, there's an odd discrepancy going on between what I had originally reported as the preliminary 2023 rate filings and what's showing up as the preliminary filings under the approved rate changes.

Back in May, the preliminary individual market rate filings were +12.3% for Blue Cross Blue Shield of Vermont and +17.4% for MVP, for a weighted average increase of 14.7%, while the small group filings averaged out to +14.6%.

This was also reported by Liora Engel-Smith of VT Digger at the time:

Medicaid

As I (and many others) have been noting for many months now, the official end of the federal Public Health Emergency (PHE), whenever it happens, will presumably bring with it reason to celebrate...but will also likely create a new disaster at the same time:

What goes up usually goes back down eventually, and that's likely to be the case with Medicaid enrollment as soon as the public health crisis formally ends...whenever that may be.

Well, yesterday Ryan Levi and Dan Gorenstein of of the Tradeoffs healthcare policy podcast posted a new episode which attempts to dig into just when that might be, how many people could be kicked off of the program once that time comes and how to mitigate the fallout (I should note that they actually reference my own estimate in the program notes):

Georgia

Georgia's health department doesn't publish their annual rate filings publicly, but they don't hide them either; I was able to acquire pretty much everything via a simple FOIA request. Huge kudos to the GA OCI folks!

A few years ago, Georgia's GOP Governor, Brian Kemp, put in a request to the Centers for Medicare & Medicaid Services (CMS) for what's known as a Section 1332 State Innovation Waiver. If approved, these waivers allow individual states to modify how the ACA operates in their state as long as they can prove that the changes would a) cover at least as many residents b) at least as comprehensively without c) increasing federal spending in the process.

Covered California Logo

via Covered California:

Covered California Executive Director Jessica Altman commended President Joe Biden’s administration for finalizing the proposed fix to the “Family Glitch,” an issue that had prevented millions of Americans with unaffordable employer health insurance from getting marketplace coverage through the Affordable Care Act.

“Covered California supports this proposed rule change, which will build on the Affordable Care Act’s vision and intent to expand access to affordable health insurance, by opening the door of coverage to millions of Americans.

This is a new era for the Affordable Care Act, as Covered California prepares to enter its 10th open enrollment period, with increased financial help available for those who need coverage as well as our 1.7 million enrollees.

Rhode Island

Via the SERFF database, it looks like Rhode Island's two individual market carriers have had their 2023 individual market rate changes finalized. Blue Cross Blue Shield is increasing rates lower than they originally requested (3.1% instead of 9.6%), while Neighborhood Health Plan rates are increasing more than they originally asked for (8.3% vs. 6.9%).

Overall weighted average increase: +6.1%, down from +8.0%.

Unfortunately I can't find the final rate change filings for the small group market yet.

Oregon

via the Oregon Division of Financial Regulation:

Salem – People who purchase their own health insurance, as well as those in the small group market, can view the final rate decisions for the 2023 health insurance plans, which have been released by the Oregon Division of Financial Regulation. The division reviews and approves rates through a detailed and transparent process before they can be charged to policyholders.

The division conducted a rigorous review, including holding public hearings and taking public comments, to reach the final decisions. The division published preliminary decisions in July before the public hearings. In the public hearings, members of the public, health insurance companies, and the division have the opportunity to further review and analyze the preliminary decisions.

Montana

The Montana Insurance Dept. has published the final/approved (unsubsidized) premium rate changes for 2023 in both the individual and small group markets:

Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Montana State Auditor’s Department of Insurance for review and before plans can be sold to consumers.

What is a rate review?

The rate review process, established by the Montana Legislature in 2013, does not give the Commissioner the authority to disapprove rates or prevent them from taking effect. It does give the commissioner the chance to review the factors insurance companies use in setting rates.

If the commissioner finds a rate increase to be excessive or unjustified, the insurer can voluntarily lower the rate increase. If the insurer decides to use the rate anyway, the commissioner will issue a public finding announcing that the rate is unjustified.

What does the department consider?

Indiana

The Indiana Insurance Dept. has quietly posted their final/approved 2023 health insurance premium rate changes for both the individual and small group markets:

INDIANA 2023 ACA FILINGS

The overall average rate increase for 2023 Indiana individual marketplace plans is 5.7%.

The IDOI will finalize the review of the 2023 ACA compliant filings both on and off the federal Marketplace by August 18, 2022.

  • The medical trend increase ranges from 5.1-10.2%. This varies depending on networks and experience of each carrier.
  • The premium averages shown consist of a combination of catastrophic, bronze, silver, gold and platinum plans. The premium is reflected as an average; individuals may experience a rate increase or decrease dependent on the plan selection or auto-enrollment process.
  • Within each metal level there are numerous plans with various cost sharing methods.

There's been no change to any of the rate filings on the individual market.  A few of the small group market carriers were shaved down a bit.

COVID-19 Vaccine

via the FDA this morning:

Coronavirus (COVID-19) Update: FDA Authorizes Moderna and Pfizer-BioNTech Bivalent COVID-19 Vaccines for Use as a Booster Dose in Younger Age Groups

Today, the U.S. Food and Drug Administration amended the emergency use authorizations (EUAs) of the Moderna COVID-19 Vaccine, Bivalent and the Pfizer-BioNTech COVID-19 Vaccine, Bivalent to authorize their use as a single booster dose in younger age groups. The Moderna COVID-19 Vaccine, Bivalent is authorized for administration at least two months following completion of primary or booster vaccination in children down to six years of age. The Pfizer-BioNTech COVID-19 Vaccine, Bivalent is authorized for administration at least two months following completion of primary or booster vaccination in children down to five years of age. 

Idaho

Via the Idaho Insurance Dept:

Idaho Rate Review Individual

The Department of Insurance receives preliminary health plan information for the following year from insurance carriers by June 1 and reviews the proposed plan documents and rates for compliance with Idaho and federal regulations.The Department of Insurance does not have the authority to set or establish insurance rates, but it does have the authority to deem rate increases submitted by insurance companies as reasonable or unreasonable. After the review and negotiation process, the carriers submit their final rate increase information.The public is invited to provide comments on the rate changes. Please send any comments to Idaho Department of Insurance.

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