Indiana

Indiana

I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For the various enrollment data, I'm using data from Medicaid.gov's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In some states I've been able to get more recent enrollment data from state websites and other sources.

Today I'm presenting Indiana. For enrollment data from January 2021 on, I'm relying on adjusted estimates based on raw data from the Indiana Family & Social Services Administration.

Indiana

 Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.

Here's Indiana:

The Indiana Insurance Dept. has posted their 2021 individual & small group rate filings to the SERFF database. Nothing terribly noteworthy other than the average requested rate increase is unusually high for 2021 compared to most other states so far (10.2%, mainly via Celtic), and it looks like a second division of UnitedHealthcare is offering policies on the small group market next year:

Back in early July, the Indiana Insurance Dept. posted the preliminary requested 2020 rate increases for the carriers participating in the ACA-compliant individual market. Technically there's three carriers there (CareSource Indiana, Celtic/Ambetter and Anthem), though Anthem only has 4 (yes, four) people enrolled in off-exchange policies total.

At the time, the IN DOI stated that the requested rates came in at an average premium increase of 9%:

INDIANA 2020 ACA FILINGS

The overall average rate increase for 2020 Indiana individual marketplace plans is 9.0%. CareSource and Celtic (MHS/Ambetter) have filed to participate in the 2020 Indiana Individual Marketplace. The Department of Insurance anticipates that all 92 counties in Indiana will be covered by both CareSource and Celtic (MHS/Ambetter).

Anthem has filed to offer a 2020 Off-Marketplace plan in Indiana. This plan is a catastrophic plan and is offered only in Benton, Jasper, Newton, Warren and White Counties.

(SIGH) OK, apparently the Kaiser Family Foundation has been working on the same project as I have for the past couple of weeks, so most of this is no longer "exclusive". HOWEVER, I have additional details including individual carrier breakouts and projections for potential 2019 rebates, so there's that...

MLR rebate payments for 2018 are being sent out to enrollees even as I type this. The data for 2018 MLR rebates won't be officially posted for another month or so, but I've managed to acquire it early, and after a lot of number-crunching the data, I've recompiled it into an easy-to-read format.

This Just In from the Indiana Insurance Dept...

INDIANA 2020 ACA FILINGS

The overall average rate increase for 2020 Indiana individual marketplace plans is 9.0%. CareSource and Celtic (MHS/Ambetter) have filed to participate in the 2020 Indiana Individual Marketplace. The Department of Insurance anticipates that all 92 counties in Indiana will be covered by both CareSource and Celtic (MHS/Ambetter).

Anthem has filed to offer a 2020 Off-Marketplace plan in Indiana. This plan is a catastrophic plan and is offered only in Benton, Jasper, Newton, Warren and White Counties.

Filing a rate does not guarantee it will be approved for use on the Marketplace, nor does the filed rate guarantee to be the final rate. Therefore, the Department of Insurance is not able to ascertain the amount of any final rates at this time. The state has until September 24, 2019 to review and submit dispositions to U.S. Department of Health and Human Services.

Back in June, Indiana's 3 individual market carriers submitted their requested 2019 ACA rate changes, which averaged around 5.1%. At the time I also pegged the impact of #ACASabotage on 2019 rates (mandate repeal + #ShortAssPlans) at around 13 percentage points.

This week I've found Indiana's approved 2019 rate changes for the individual and small group markets. State regulators cut the overall average increase for the individual market in half, to just 2.6%:

The Indiana Insurance Dept. has released the preliminary rate requests for 2019 insurance policies on the ACA individual and small group markets.

Like last year, there's only three carriers participating in Indiana's individual market: CareSource and Celtic (aka Ambetter) will again be available both on and off the ACA exchange, while Anthem will only be offering a single Catastrophic plan on the off-exchange market in just five counties:

The overall average rate increase for 2019 Indiana individual marketplace plans is 5.1%. CareSource and Celtic (MHS/Ambetter) have filed to participate in the 2019 Indiana Individual Marketplace. The Department of Insurance anticipates that all 92 counties in Indiana will be covered by one or more insurance company. CareSource plans to cover 79 counties. Celtic (MHS/Ambetter) plans to increase its coverage from 43 counties in 2018 to all 92 counties in 2019.

Anthem has filed to offer a 2019 Off-Marketplace plan in Indiana. This plan is a catastrophic plan and is offered only in Benton, Jasper, Newton, Warren and White Counties.

I don't have much to add here. This is sad and depressing to watch unfold.

Indiana Adds Work Requirement To Medicaid, Will Block Coverage If Paperwork Is Late
PHIL GALEWITZ

Indiana on Friday became the second state to win federal approval to add a work requirement for adult Medicaid recipients who gained coverage under the Affordable Care Act. A less debated provision in the state's new plan could lead to tens of thousands of people losing coverage if they fail to complete paperwork documenting their eligibility for the program.

The federal approval was announced by Health and Human Services Secretary Alex Azar in Indianapolis.

Medicaid participants who fail to promptly submit paperwork showing they still qualify for the program will be locked out of enrollment for three months, according to updated rules.

Protect Our Care is a healthcare advocacy coalition created last December to help fight back against the GOP's attempts to repeal, sabotage and otherwise undermine the Affordable Care Act. This morning they released a report which compiled the approved 2018 individual market rate increases across over two dozen states.

Needless to say, they found that the vast majority of the state insurance regulators and/or carriers themselves are pinning a large chunk (and in some cases, nearly all) of the rate hikes for next year specifically on Trump administration sabotage efforts...primarily uncertainty over CSR payment reimbursements and, to a lesser extent, uncertainty over enforcement of the individual mandate penalty.

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