Iowa

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don't list the 2022 Individual market filings at all, their Small Group market filing database is available but a year out of date, and they don't even list any of the ACA-compliant plan filings in the SERFF database.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.

Normally by early October I have the preliminary rate filings analyzed & posted for nearly every state and the approved rate changes for at least half of them. This year I'm lagging way behind for several reasons, some personal, some professional.

Having said that, I'm trying to play catch-up this week. Case in point, today I'm posting Iowa's preliminary individual and small group market filings for 2021.

Wellmark is dropping their premiums by a jaw-dropping 42% next year, which would normally be a huge story except that they only have around 3,000 Iowans enrolled to begin with (which may explain the massive rate drop, of course). Oscar Insurance appears to be expanding into the Iowa individual market, while Medica continues to hold nearly 95% of the market and is only raising premiums by around 2.5%. Overall, 2021 rates are essentially flat on averae.

The small group market is much the same...there's a bunch of carriers which only have a few dozen enrollees statewide, and four which hold over 90% of the market share (realistically more like 2-3 carriers depending on how you define UnitedHealthcare and Wellmark subsidiaries).

When I ran the numbers for Iowa's preliminary avg. 2020 unsubsidized individual market rate changes, I had to use an unweighted average reduction of around 3.3%. However, knowing the relative market share of each carrier can make a big difference.

Case in point: It turns out that Medica holds something like 97% of Iowa's ACA-compliant market...whcih means the 11.3% rate drop by Medica heavily weighs the overall average. Wellmark is raising their rates by about 4.7%, but that only nudges the statewide weighted average to a 10.8% reduction overall.

(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.

Pages

Advertisement