Maryland

With all the concern over the rapidly spreading coronavirus epidemic and how uninsured people in particular can be expected to pay for testing and treatment of the disease, Andrew Sprung and Dave Anderson have reminded me that uninsured residents of California, the District of Columbia and Maryland may still be able to get covered via their respective ACA exchanges.

CALIFORNIA: You have until April 30th: (June 30th...see update below)

New Special-Enrollment Period Announced

Covered California also announced that effective Feb. 18 it will establish a special-enrollment period for those who were unaware of the state penalty or the new financial help. Consumers who fall into those categories, or who are currently insured off exchange (directly through an insurer) and want to switch to Covered California to benefit from the new state subsidies, will have through April 30 to sign up for coverage.

As I've noted before, Maryland is already offering a SEP for uninsured residents to #GetCovered when they file their state taxes by checking off a box, but today they went one step further and created an official Coronavirus SEP as well, which is open to any eligible uninsured residents whether they're utilizing the "check the box" tax form option or not:

Coronavirus emergency launches one-month special enrollment period

As part of the state’s overall response to the coronavirus, and in an effort to prioritize health and safety, Maryland Health Connection opened a new special enrollment period for uninsured Marylanders.

When will the special enrollment period begin?

  • The coronavirus emergency special enrollment period will begin Monday, March 16, and end Wednesday, April 15. Coverage will begin April 1, 2020, regardless of when a health plan is selected during that time period.

How do I enroll?

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. 

Last year, Maryland passed a very clever new law to help expand healthcare coverage through the state's ACA exchange and ACA Medicaid expansion without requiring any additional financial subsidies:

Maryland would use state tax forms to identify uninsured residents and refer them to options for no-cost or low-cost health care under a bill moving forward in the General Assembly.

The bill, if approved, would add a question on state tax returns asking taxpayers if they have health insurance. Those who answer that they don’t have health insurance would be referred to the state's Medicaid program or the health exchange, where individuals can buy health insurance plans.

...Dorn explained to me that the way it would work is much more than that: The state tax returns would include a new line where uninsured filers would be required to check off one of two boxes:

Last March, I wrote about a clever and absurdly simple (on the surface) bill being passed through the Maryland state legislature which could result in the state lowering their uninsured rate substantially...by up to as many as an estimated 120,000 people:

In early 2018, Maryland state legislators introduced a bill which included a twist on the coverage mandate penalty--those who failed to sign up had another option: They could either pay the penalty or they could choose to have the penalty amount be used to automatically enroll them in the lowest-cost insurance policy available. If they qualified for ACA subsidies, those would even be baked into the equation as well. This was a clever way of softening the blow, while also increasing enrollment and helping out the ACA risk pool.

via the Maryland Health Connection press release:

158,600 MARYLANDERS ENROLLED THROUGH MARYLAND HEALTH CONNECTION

  • 2020 enrollment total largest in four years

BALTIMORE (DEC. 17, 2019) – A total of 158,600 Marylanders enrolled in private health coverage for 2020 on Maryland Health Connection, the largest enrollment in four years on the state-based health insurance marketplace.

That was 1,637 more enrollees than a year ago when 156,963 enrolled. It was also the largest enrollment on the health insurance marketplace since 2016 when 162,652 enrolled. Enrollments for 2020 coverage grew in 20 of 24 jurisdictions.

The 45-day open enrollment period for the coming plan year began Nov. 1 and ended Sunday. A few hundred additional enrollments will be completed this week for consumers who had begun the process but hadn’t finished by Sunday night.

via the Maryland Health Benefit Exchange:

Maryland Health Connection will hold nearly 20 “Last Chance” events throughout the state during the final week of open enrollment Dec. 7-15 to provide free help enrolling in health coverage. Marylanders can enroll in health and dental coverage until Dec. 15 through Maryland Health Connection, the state’s health insurance marketplace.

At the free “Last Chance” events, certified health insurance navigators will help Marylanders sign up for a health plan and understand their coverage options and financial help available. Assistance also is available in Spanish.

Visit MarylandHealthConnection.gov or the Enroll MHC mobile app to browse plans, compare coverage and costs, and enroll.

The fall open enrollment is for private health and dental plans only. People who have coverage through Medicaid will receive a notice when it’s time to renew; enrollment for Medicaid is all year for eligible Marylanders.

via the Maryland Health Connection:

HEALTH PLAN RATES HAVE DROPPED; OPEN ENROLLMENT BEGINS NOV. 1

  • “START HERE” AT MARYLANDHEALTHCONNECTION.GOV

BALTIMORE (Oct. 30, 2019) - “Start Here” will be the theme for 2020 health care open enrollment season that begins Nov. 1 with Maryland Health Connection.

The “Start Here” campaign will appear on social media, print, online and other venues, including gas station TVs, to emphasize where Marylanders can go to enroll and use the free, expert advisers located throughout Maryland. A TV ad will run to complement the campaign.

Open enrollment begins on MarylandHealthConnection.gov at 5 a.m. on Nov. 1. Dec. 15 is the deadline to sign up for 2020 coverage that begins Jan. 1, 2020.

New this year, Value Plans feature lower deductibles and increased access to primary care, mental health care, and generic drugs before deductibles apply. Value plans are designed to lower consumers’ out-of-pocket costs for the health care services the majority of people use most frequently.

I'm not sure how this slipped by me, but in addition to Covered California already having launched their 2020 Open Enrollment Period yesterday, five other state-based ACA exchanges are already partly open as well. That is, you can shop around, compare prices on next year's health insurance policies and check and see what sort of financial assistance you may be eligible for:

I'm not sure when the other 7 state-based exchanges will launch their 2020 window shopping tools, nor do I know when HealthCare.Gov's window shopping will be open for the other 38 states, although I believe they usually do so about a week ahead of the official November 1st Open Enrollment Period launch date.

Back in May, Maryland was the very first state to publicly release their preliminary 2020 individual and small group market rate change requests. For 2019, thanks to several laws passed by the state legislature and signed by Gov. Hogan, including a robust ACA Section 1332 reinsurance waiver program, instead of increasing by another 30%, premiums dropped by 13.4% this year.

For 2020, the preliminary rates looked pretty good: Average rates were expected to drop by around 3% or so.

Well, today the Maryland Insurance Department announced the approved rates for 2020...and it's even better than 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.

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:

Back in March, I wrote about a clever and absurdly simple (on the surface) bill being passed through the Maryland state legislature which could result in the state lowering their uninsured rate substantially...by as many as 120,000 people:

In early 2018, Maryland state legislators introduced a bill which included a twist on the coverage mandate penalty--those who failed to sign up had another option: They could either pay the penalty or they could choose to have the penalty amount be used to automatically enroll them in the lowest-cost insurance policy available. If they qualified for ACA subsidies, those would even be baked into the equation as well. This was a clever way of softening the blow, while also increasing enrollment and helping out the ACA risk pool.

Every year for 4 years running, I've spent the entire spring/summer/early fall painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

The actual work is difficult due to the ever-changing landscape as carriers jump in and out of the market, their tendency repeatedly revise their requests, and the confusing blizzard of actual filing forms which sometimes make it next to impossible to find the specific data I need.

The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:

Since Congressional Republicans effectively repealed the ACA's individual mandate penalty at the federal level back in December 2017 (by reducing the penalty amount from $695 or 2.5% of income down to $0 or 0.0%), causing premiums on the individual market to shoot up an average of $580 per unsubsidized enrollee nationally, a half-dozen states or so have sprung into action.

Massachusetts, didn't really have to do much, since they never repealed their own state-level pre-ACA mandate penalty; they simply dusted it off and ramped up a statewide outreach/awareness campaign to make sure everyone knew it was still in place. Result: Record-breaking enrollment numbers and the lowest uninsured rate in the nation.

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