Kentucky

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.

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):

Michigan:

Governor Whitmer Announces Statewide Closure of All K-12 School Buildings; School building closures will last Monday, March 16 through Sunday, April 5

Today, Governor Gretchen Whitmer announced that in order to slow the spread of Novel Coronavirus (COVID-19) in Michigan, she is ordering the closure of all K-12 school buildings, public, private, and boarding, to students starting Monday, March 16 until Sunday, April 5. School buildings are scheduled to reopen on Monday, April 6. 

As of tonight, the number of presumptive positive cases of COVID-19 in Michigan is 12. 

Elections matter.

True to his word, newly-inaugurated Democratic Kentucky Governor Andy Beshear has indeed eliminated the state's controversial and much-litigated Medicaid work requirement provision for the 400,000 state residents who are on the low-income healthcare program thanks to the Affordable Care Act:

Former Republican Gov. Matt Bevin’s controversial plan to impose work requirements and monthly premiums for many Kentucky Medicaid recipients is no more, Democratic Gov. Andy Beshear announced Monday.

(Monday = Last Monday; this is from a week ago)

In one of his first major moves as the 63rd governor of Kentucky, Beshear signed an executive order Monday rescinding Bevin’s Kentucky HEALTH plan, which sought to impose strict work requirements for able-bodied, working-age adults. It would have ended health coverage for an estimated 95,000 Kentuckians.

In 2015, Republican Matt Bevin campaigned for governor on two major healthcare-related platforms:

  • Eliminate the state's perfectly-functioning, award-winning, highly-praised and beloved ACA exchange, "kynect" for no particular reason other than spite.
  • Eliminate the state's ACA Medicaid expansion program, which as of this writing provides around 480,000 low-income Kentuckians with healthcare coverage.

For some inexplicable reason, voters in Kentucky elected him regardless. Once he got into office, he did indeed make good on the first promise, shutting down the state's perfectly good ACA exchange platform and shifting KY to the federal exchange at HealthCare.Gov.

When it came to eliminating Medicaid expansion, on the other hand, he found it to be a little bit tougher than expected; actually pulling the plug on nearly half a million people's healthcare coverage proved to be a tougher nut to crack than he thought.

As I've noted several times recently, the "break off of HealthCare.Gov & establish your own state-based ACA exchange" train continues to pick up steam, with the following states having committed to either firing up their own, separate exchange website platform or at the very least going halfway by establishing their own exchange entity (which includes a board of directors, their own marketing/outreach budget, the ability to dictate which plans are allowed onto the exchange and so forth) if they haven't already done so.

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.

But that's not all! In addition to the actual 2018 MLR rebates, I've gone one step further and have taken an early crack at trying to figure out what 2019 MLR rebates might end up looking like next year (for the Individual Market only). In order to do this, I had to make several very large assumptions:

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