Iowa

Back in November, I noted that Georgia, one of the ten states STILL refusing to expand Medicaid coverage to hundreds of thousands of low-income residents a decade after they could have done so under the ACA, may finally be coming around...albeit via a rather silly & inefficient method. via the Atlanta Journal-Constitution:

Could Georgia adopt an Arkansas-style Medicaid plan?

Senior Republicans see an opening for a health care overhaul

Key Republicans say they’re open to legislation that would add hundreds of thousands of poor Georgians to the state’s Medicaid rolls — and bring in billions of federal dollars to subsidize it — as part of a compromise to roll back hospital regulations.

Originally posted 8/08/23; updated 11/03/23

Here's the preliminary 2024 rate filings for Iowa's individual & small-group markets. Unfortunately, I only have the enrollment data for the two smaller carriers on the individual market (and for only one carrier on the small group market). Oddly, while the Iowa Insurance Dept. has detailed rate filings for Medica and Oscar, it doesn't have one for Wellmark posted...and on the small group market, they only have publicly-available filing documentation for two of the eleven carriers.

Interestingly, CareSource Iowa, which only joined the state's individual market this year, appears to be dropping out of it again in 2024...or at least they don't have a listing showing up at RateReview.HealthCare.Gov as of this writing. Similarly, Aetna seems to be dropping out of the small group market as well.

In any event, based on my estimate of Iowa's total ACA-compliant individual market, I can make an educated guess as to the former's weighted average, which should be roughly a 5.7% drop in premiums.

via the Iowa Health & Human Services Dept.:

The Children’s Health Insurance Program (CHIP) is offered through the Healthy and Well Kids in Iowa program, also known as Hawki. Iowa offers Hawki health coverage for uninsured children of working families.

No family pays more than $40 a month. Some families pay nothing at all. A child who qualifies for Hawki health insurance will get their health coverage through a Managed Care Organization (MCO).

Currently, only children up to 19 years old in families earning up to 302% of the Federal Poverty Level (FPL) are eligible for Iowa's CHIP program (Hawk-I). That's roughly $60K/year for a single parent with one child, or around $91K/yr for a family of four. Again, only the children are eligible, not the parents or guardians.

Iowa

Here's the preliminary 2023 rate filings for Iowa's individual & small-group markets. Unfortunately, I only have the enrollment data for the two smaller carriers on the individual market (and none for the small group market), but based on my estimate of Iowa's total ACA-compliant individual market, I can make an educated guess as to the weighted average, which should be roughly 2.0%.

Unfortunately I can't do the same for the small group market; for that, the unweighted average rate increase is around 5.1%.

I should also note that Iowa also has 35,400 residents still enrolled in pre-ACA ("transitional" or "grandmothered") medical policies, with nearly all of them being via Wellmark: 

Iowa

Back in August, I analyzed the preliminary rate filings for the 2022 individual & small group markets in Iowa. At the time, I was unable to run a weighted average due to only having the enrollment data for one of the three individual market carriers (and none of the small group market).

At the time, the unweighted average rate change for the individual market came in at +0.7%, while small group plans averaged out at +0.9%. Unfortunately, this isn't terribly useful since it assumes every carrier has the same market share.

More recently, Iowar regulators have approved the rate filings (with almost no changes at all)...and the SERFF database now includes the Unified Rate Review Templates for every carriers, which allows me to fill in the enrollment of each in both markets. This lets me run the weighted average rate changes.

With that data, individual market plans are going up 6.6% for unsubsidized individual market enrollees and 1.2% for small group plans on average:

Iowa

(sigh) Unfortunately, the Iowa Insurance Department is pretty much useless when it comes to individual & small group market rate filing transparency. I can't find any press releases or statements about the 2022 rate filings, they don't list the 2022 Individual market filings at all, their Small Group market filing database is available but a year out of date, and they don't even list any of the ACA-compliant plan filings in the SERFF database.

The only way I was able to find the rate changes was by using the federal Rate Review website, and even then, the actuarial memos are all heavily redacted, making it impossible to know what the enrollment for each carrier si (with one exception: Wellmark Health Plan reported having 32,000 ACA-compliant individual market enrollees as of March 2021).

Iowa

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 Iowa. For enrollment data from January 2021 on, I'm relying on adjusted estimates based on raw data from the Iowa Dept. of Human Services.

Iowa

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 Iowa. 

UPDATED 5/29/21: In addition to updating the data as of 5/29, I've also changed the Y-Axis scale to match every other state (it now runs from 0 - 70% for consistency).

Gold Bars

NOTE: This is an updated version of a post from a couple of months ago. Since then, there's been a MASSIVELY important development: The passage of the American Rescue Plan, which includes a dramatic upgrade in ACA subsidies for not only the millions of people already receiving them, but for millions more who didn't previously qualify for financial assistance.

Much has been written by myself and others (especially the Kaiser Family Foundation) about the fact that millions of uninsured Americans are eligible for ZERO PREMIUM Bronze ACA healthcare policies.

I say "Zero Premium" instead of "Free" because there's still deductibles and co-pays involved, although all ACA plans also include a long list of free preventative services from physicals and blood screenings to mammograms and immunizations with no deductible or co-pay involved.

Much has been written by myself and others (especially the Kaiser Family Foundation) about the fact that millions of uninsured Americans are eligible for ZERO PREMIUM Bronze ACA healthcare policies.

I say "Zero Premium" instead of "Free" because there's still deductibles and co-pays involved, although all ACA plans also include a long list of free preventative services from physicals and blood screenings to mammograms and immunizations with no deductible or co-pay involved.

If you have a fairly healthy year, you really could go the entire year without paying a dime in healthcare costs while still taking advantage of many of these free services, and also having the peace of mind that in a worst-case scenario, at least you wouldn't go bankrupt. Not perfect, but a lot better than going bare especially since you wouldn't pay a dime in premiums.

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