Colorado

When it comes to how many people are currently enrolled in effectuated Qualified Health Plans (QHPs) via the assorted ACA exchanges, I'm continuing to get completely different numbers from the actual exchanges as I am from the major insurance companies. To recap:

  • According to 8 of the state-based exchanges (CO, CT, DC, ID, MD, MA, MN & WA), effectuated enrollments as of the end of September were up 2.7% from the end of June (or down just 0.1% if you disregard Massachusetts, which has some special circumstances).
  • However, the quarterly financial reports from 8 major insurance carriers claim that private exchange enrollments in September were down around 7.9% since the end of June.

This discrepancy continues with the release of the Colorado exchange's October enrollment report. As you can see, when you add up the effectuated tax credit enrollees (APTC/CSR) (78,670) and the full-price enrollees (64,485) as of October 31st, they total 143,155 people.

...which is 1,304 more than the 141,851 effectuated enrollees reported as of the end of September.

Like HealthCare.Gov (for 37 states) and Minnesota have done already, Colorado's insurance commissioner is also letting state residents know about the importance of shopping around for their insurance policy for 2016:

Health insurance premiums will increase on average 7 percent in Colorado in 2016, according to statistics compiled by the state division that reviewed and approved plans for the coming year.

...Consumers who purchased through Connect for Health Colorado, the state health insurance exchange, in 2015 who aren’t eligible for tax credits will see an average increase of 12 percent if they simply renew their current plan for 2016.

With all the bad news about the Colorado Dept. of Insurance pulling the plug on CO HealthOP a week or so ago, here's some (relatively) good news out of the Centennial State (and yes, I had to look that up to find out what Colorado's nickname is).

Colorado was one of the first states I included in my 2016 Weighted Average Rate Hike Project. At the time, I only had requested rate changes available, and was missing the requests and/or actual enrollment numbers for several insurance carriers. As a result, my estimate of the average requested rate hike came in at 13.1%, but was pretty fuzzy.

When I updated my #OE3 state-level enrollment projections yesterday, I came across this official projection for #OE3 from Your Health Idaho's Sept. 18th board meeting minutes:

Rep. Rusche asked what our target enrollment is for this cycle and what barriers we see in making those targets. Mr. Kelly said the team is focused on the 80% goal of 92,000 as our enrollment target.Premium increases are a potential barrier. Net premium is a relatively small increase for most consumers, and each consumer will experience something different depending Page 5 of 14 on their plan, their location, their carrier, etc. We feel that while the premiums are increasing the relatively small net premium increase will mitigate this barrier to a large degree.

When I asked for clarification, they informed me that:

We currently have 86,659 effectuated enrollments with Your Health Idaho, as of September 15. The 92,000 would also refer to effectuated enrollments.

Just 3 days ago, Colorado HealthOP was stunned by the announcement by the state insurance division that they were pulling the plug on the ACA-established CO-OP:

Dear Member,

It is with a heavy heart that I write to you today. This morning, the Colorado Division of Insurance (DOI)announced Colorado HealthOP will not be selling plans through the Connect for Health Colorado marketplace.

Please be assured that, as a Colorado HealthOP member, your coverage will remain in effect through December 31, 2015, so long as you continue to pay premiums. In two weeks, on November 1, 2015, the Connect for Health Colorado marketplace will open and you will have the opportunity to find another health insurance provider that will begin coverage for you on January 1, 2016.

Needless to say, we are astonished and disappointed by the DOI’s decision. We believe it is both irresponsible and premature.

As I noted in the update to my post on the "Transitional Policy" decision a few days ago, the ACA's CO-OP program had a lot going against it from the get-go:

The program has been under siege from the start, including from the insurance industry. Before the law’s passage, government grants to help them get going were switched to loans. None of that money could go for advertising — a wounding rule for new insurers that needed to attract customers. Moreover, the amount available was cut from $10 billion to $6 billion and then later, as part of the administration’s budget deals with congressional Republicans, to $2.4 billion. Federal health officials abandoned plans for a co-op in every state.

So, let's see here: You're trying to create start-ups to enter an existing, mature market which is already dominated by major, behemoth-sized competitors which have almost unlimited funds. Naturally it makes total sense to a) make the seed money a loan with a tight payback time table; b) prevent them from advertising in a saturated market; and c) slash their budget by 75%.

In spite of all of this, and even in spite of any impact from the decision to allow relatively healthy, low-risk enrollees to stay on transitional policies (which the CO-OPs had none of, since they were brand-new) through their competitors, 23 out of 24 of the CO-OPs did manage to survive the first full year (CoOportunity of Iowa/Nebraska didn't even make it that far), and a few of them (Community Health Options of Maine and New Hampshire, as well as (last I heard) Consumers' Choice Health Plan of South Carolina) actually do quite well the first year.

Colorado's official QHP selection total as of 2/21/15 was 140,327, and as of the end of April, it was up to 146,506...of which 129,055 were actually effectuated as of 4/30.

While their reports have always been comprehensive, they were also a bit confusing. Thankfully, starting with their June report, they've made the appropriate data points a bit more obvious. While the QHP selection total is still confusing, the effectuated number (which is really more relevant at this point) is the combination of APTC/CSR + non-APTC/CSR enrollees, or 74,583 + 59,617 = 134,200 people as of the end of June.

Colorado's official QHP selection total as of 2/21/15 was 140,327, and as of the end of April, it was up to 146,506...of which 129,055 were actually effectuated as of 4/30.

While their reports have always been comprehensive, they were also a bit confusing. Thankfully, starting with their June report, they've made the appropriate data points a bit more obvious. While the QHP selection total is still confusing, the effectuated number (which is really more relevant at this point) is the combination of APTC/CSR + non-APTC/CSR enrollees, or 74,583 + 59,617 = 134,200 people as of the end of June.

Colorado's official QHP selection total as of 2/21/15 was 140,327, and as of the end of April, it was up to 146,506...of which 129,055 were actually effectuated as of 4/30.

While their reports have always been comprehensive, they were also a bit confusing. Thankfully, starting with their June report, they've made the appropriate data points a bit more obvious. While the QHP selection total is still confusing, the effectuated number (which is really more relevant at this point is the combination of APTC/CSR + non-APTC/CSR enrollees, or 74,583 + 59,617 = 134,200 people as of the end of June.

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