As noted earlier, I've been a bit lax with posting for a few days as I've worked on my latest 2-part video explainer about risk pools and #ShortAssPlans.
However, there's been a lot going on, so I figured I should try and at least do a quick update on a few items. First up: Medicaid expansion!
Here in my home state of Michigan, I've written several posts about how the GOP-controlled state legislature trying to shove through a draconian "work requirement" bill for Healthy Michigan, our name for ACA Medicaid expansion program which has been working just fine, thank you very much, for nearly 5 years now. The bill easily passed the state Senate (where the GOP holds a supermajority), and is now under consideration by the state House (where they have a smaller but still solid majority at the moment). The good news is that GOP Governor Rick Snyder--who championed passage of Healthy Michigan in the first place and seems to think it's fine mostly the way it is--is likely to veto the senate version of the bill. The bad news is that it might simply be tweaked somewhat by the House.
According to the CMS/ASPE 2016 Final Enrollment Report, during the 2016 Open Enrollment Period, Louisiana enrolled 214,148 people in exchange-based Qualified Health Plans.
Most states dropped a bit year over year in 2017 in large part due to the Trump administration cutting off outreach/marketing during the critical final week, but Louisiana saw the worst year over year drop. Why? Well, the most obvious reason was pretty simple: The state expanded Medicaid halfway through the year.
In the wake of a windstorm that knocked out power to more than 400,000 Mainers, federal officials have agreed to give Mainers more time to enroll for health care under the Affordable Care Act.
U.S. Sen. Angus King sent a letter to the Centers for Medicare and Medicaid Services in November requesting an extended deadline for Mainers who spent the better part of a week in the dark without internet or computer access. On Friday, King shared the agency’s reply, which said Mainers likely would qualify for a special enrollment period, extending their enrollment deadline.
“CMS recognizes that certain exceptional circumstances, including a natural disaster such as a severe windstorm, can prevent an individual from enrolling in coverage before an open enrollment period expires,” CMS Administrator Seema Verma said in her reply to King.
Maine voters on Tuesday decided to expand Medicaid to cover more low-income adults, becoming the first state to do so through a referendum.
Support for the ballot measure was up by more than 18 points with 64 percent of precincts reporting about 10 p.m. when it was called by NBC affiliate WCSH and The Associated Press.
The results in Maine, one of 19 states that rejected Medicaid expansion under the Affordable Care Act, comes as other Republican-led states like Utah and Idaho eye similar ballot measures.
Advocates of Medicaid expansion in Maine successfully petitioned the state to include a question on this year’s ballot following several failed legislative efforts to expand the program.
More to the point, however: What other significance does not including CSR funding have?
...That means that even if there's a last minute change to the bill, at this point, CSR payments are virtually certain not be guaranteed next year.
...I wouldn't be at all surprised to see more 11th-hour drop-outs next week. Donald Trump and the Republican Party's open sabotage of the ACA will likely bear even more fruit.
Anthem leaving Maine ACA marketplace, citing uncertainty
Anthem Blue Cross Blue Shield has withdrawn nearly all of its offerings from Maine’s Affordable Care Act health insurance marketplace, and the insurer is citing market uncertainty and volatility as the reasons.
The state of Maine's insurance regulatory agency has announced the approved 2018 individual market rate hikes for the three carriers operating in the state. Louise Norris beat me to the punch:
Regulators in Maine published rate proposals for the three Maine exchange insurers in June, and finalized the rates in early September. Insurers proposed two sets of rates: one that assumes cost-sharing reduction (CSR) funding will continue, and another that assumes the federal government will not fund CSRs in 2018.
The Maine Bureau of Insurance initially rejected all three insurers’ rate proposals on August 10, and asked them to submit new rates. The revised rate filings were then approved on September 1. These average approved rate increases all assume that CSR funding will continue in 2018:
The good news for me out of Maine is that they've released the filings for all three individual market carriers for 2018 (Aetna has around 1,000 enrollees but they're leaving the individual market entirely), and all three include the exact number of current enrollees, making the average rate hike request simple enough on the surface: 21.2% for Anthem, 39.7% for Harvard Pilgrim (HPHC) and 19.6% for Maine Community Health Options (one of the few remaining ACA-created CO-OPs*), for a weighted average unsubsidized increase request of 25.2%.
*UPDATE: My mistake! I accidentally confused MCHO with Evergreen Heatlh of Maryland, which is in the process of converting itself from a Co-Op into a private carrier! Thanks to Louise Norris for the catch!
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
Normally I post screenshots from the revised/updated SERFF filings and/or updates at RateReview.HealthCare.Gov, but it takes forever and I think I've more than established my credibility on this sort of thing, so forgive me for not doing so here. Besides, #OE4 is approaching so rapidly now that this entire project will become moot soon enough, as people start actually shopping around and finding out just what their premium changes will be for 2017.
The other reason I'm not too concerned about documenting the latest batch of updates/additional data is because in the end none of it is making much of a difference to the larger national average anyway; no matter how the individual carrier rates jump around in various states, the overall, national weighted average still seems to hover right around the 25% level.
Still, for the record, here's the latest...in four states (Iowa, Indiana, Maine & Tennessee) I've just updated the requested and/or approved average increases. In the other four (Massachusetts, Montana, North & South Dakota) I've added the approved rate hikes as well.
Since then there have been two major changes: First, Aetna, which had been planning on entering the Maine ACA exchange, infamously pulled a complete 180 and not only decided not to expand, but actually pulled out of the exchange in most of the states they're already in. This doesn't really impact Maine since they were only available off-exchange anyway. The second change does, however: Several of the carriers submitted revised requests, pushing the average up higher, to 23.9%.
