Kentucky

 

I haven't written much about the ACA's Basic Health Plan (BHP) program for awhile, aside from noting that it's well past time for the Centers for Medicare & Medicaid Services (CMS) to start including BHP enrollment in their official Open Enrollment Period reports, seeing how over a million people in Minnesota & New York now have healthcare coverage via BHP policies.

As a refresher, here's Louise Norris' summary explainer:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

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Every year since the very first ACA Open Enrollment Period (OEP) in 2013-2014, at least a few of the state-based exchanges (and sometimes the federal exchange) have made last-minute deadline extensions. It's actually turned into a bit of a running joke with me.

The 2022 OEP has been no exception: Already during the 2022 OEP we've seen IdahoNew MexicoConnecticut and Kentucky bump out their December deadline (for January coverage).

Sure enough, a couple of days ago the Kentucky exchange, kynect, posted the following:

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This one isn't surprising; via kynect:

Enrollment Period Deadline Extension

​Natural Disaster and Technical Issues

Due to the December 11th natural disaster throughout the Commonwealth and reports of technical issues during Open Enrollment, a Special Enrollment Period (SEP) for kynect health coverage is now available to impacted residents.

A Special Enrollment Period allows enrollment dates to be extended or added. Prior to this Special Enrollment Period announcement, the deadline to enroll for a Qualified Health Plan with coverage starting January 1st, 2022 was December 15th, 2021.

The Special Enrollment Period will be granted for citizens with the following circumstances:

  • ​​​​Any person who attests that their ability to enroll in a Qualified Health Plan was affected by severe weather in December 2021.
  • ​​ ​​​​​Any person who attests that they encountered system errors, including long wait times with the call center, that prevented them from enrolling in a Qualified Health Plan prior to December 15th, 2021.​​​

Taking the Special Enrollment Period

Kentucky

Well, this was inevitable: I got so far behind on my annual ACA rate filing project that the final/approved rates have started to be released before I even get around to some of the preliminary/requested rate filings.

The Kentucky Insurance Dept. has posted both the requested and approved 2022 rate filings for the individual and small group markets, and in addition to drastically slashing the average premiums for Anthem's individual market offerings and Aetna's small group offerings, there's also two new entrants into Kentucky's individual market: Molina and WellCare.

Overall, individual rates are dropping by around 3.8% on average (the carriers had requested a 2.7% increase), while small group market plans are increasing by 10.4% on average (very close to the 10.7% average request).

Kentucky

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 Kentucky. For enrollment data from January 2021 on, I'm relying on adjusted estimates based on raw data from the Kentucky Cabinet for Health & Family Services.

Kentucky

 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 Kentucky:

Note: The CDC lists ~115,000 Kentucky residents (6.7% of the total fully vaccinated) whose county of residence is unknown.

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Way back in October 2013, when the first ACA Open Enrollment Period (OEP) launched, there were infamously massive technical problems with the federal exchange (HealthCare.Gov) as well as some of the state-based exchanges (such as those in Massachusetts, Maryland, Oregon, Nevada and Hawaii).

Over the next few years, some of those exchange websites were replaced with brand-new ones (MA & MD). Some of the states scrapped theirs altogether and moved onto the mothership at HC.gov (OR, HI & NV, although Nevada has since split back off onto their own exchange again, and seems to have gotten it right this time).

In early August, the Kentucky Insurance Dept. posted preliminary 2021 rate filings for the individual and small group markets. At the time, the carriers were requesting average increases of 11.6% on the individual market (unusually high this year) and 9.7% for the small group market.

More recently, they posted the approved 2021 rate changes, and the individual market hikes have been cut by more than half, to just a 5.0% increas on average.

Small Group plans have also been shaved down slightly, from a 9.7% average increase to 8.8%.

The Kentucky Insurance Dept. has posted KY's preliminary 2021 rate filings for the individual and small group markets, and the requested average rate increases for both are unusually high compared to the other states which have submitted their filings so far. In another unusual development, most of the carriers on each market are being pretty specific about the impact (or lack thereof) on their 2021 rate filings from the COVID-19 pandemic (I only have UnitedHealthcare posted once but they account for three of the seven small group carriers listed.

Anthem Health Plans of KY (individual market):

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