Massachusetts

This just in from the MA Health Connector:

Massachusetts Health Connector to Provide New, Additional Financial Help for Health Insurance Premiums

Extended enrollment to run through July 23 to maximize opportunity for residents to gain access to new premium support

March 23, 2021 – The Massachusetts Health Connector will be able to provide hundreds of thousands of people with new and increased help paying for their health insurance premiums as a result of the recently enacted American Rescue Plan, starting for May coverage.

The new law will make federal premium subsidies, known as Advance Premium Tax Credits, more generous in two ways: It will increase them for many of the Massachusetts residents who already receive them, and it will make federal premium subsidies available to more people who have never qualified before.

Huh...this is interesting. I noted a few weeks back that the Massachusetts Health Connector reported 11% fewer people had enrolled in Qualifying Health Plans (QHPs) for 2021 as of mid-January than they had during the 2020 Open Enrollment Period. At the time, they were running about 6% behind year over year, and attributed the enrollment drop (the first in the MA Health Connector's history since the first Open Enrollment Period back in 2013-2014) primarily to Medicaid enrollment:

Lower membership is primarily the result of decreased new enrollments rather than termination of existing members, likely due to Medicaid protections associated with the federal public health emergency.

This just in via the MA Health Connector...

February 3, 2021 – The Massachusetts Health Connector announced today a further extension of its Open Enrollment through May 23, providing residents impacted by COVID-19 the opportunity to get access to affordable, comprehensive health insurance.

The Health Connector previously announced an extension of Open Enrollment through March 23, two additional months beyond the original Jan. 23 deadline. Open Enrollment started Nov. 1, and the new deadline of May 23 aligns the Massachusetts health insurance exchange with the new open enrollment period for the federal exchange platform, healthcare.gov, which reopens Feb. 15 and remains open through May 15, and will be accompanied by a national marketing and awareness campaign.

This just in via the MA Health Connector...

January 22, 2021 – The Massachusetts Health Connector announced today it is continuing Open Enrollment until March 23, providing additional time for state residents to access affordable, quality health insurance, particularly those hurt by the economic impacts of COVID-19.

With Massachusetts just having become the 3rd state where COVID-19 has killed more than 1 out of 500 residents, this isn't surprising (New York announced an Open Enrollment extension thru the end of March yesterday; New Jersey is still set to end theirs as of January 31st as of this writing Maryland, where COVID has "only" killed 1 out of 900, is extending theirs thru March 15th).

With Open Enrollment ongoing, Massachusetts residents who do not have health insurance have a new opportunity to get coverage through the Health Connector. This includes commercial plans through the ConnectorCare program, which provides help paying monthly premiums, and also offers low co-pays and no deductibles.

Way back on November 30th (a lifetime ago!), my contact at the Massachusetts Health Connector gave me an unofficial mid-period 2021 enrollment report:

Here's where we are at, currently:

  • January effectuations: 275,003
  • Feb. and March effectuations: 5
  • Plan Selections: 9,143
  • Total enrollments: 284,151

As a reminder, "effectuations" have paid the first month premium and are good to go. Plan selections still need payment to start.

As I noted at the time, MA is one of just two states (the other is Rhode Island) which handles premium payments internally, which means they can easily track not just how many people have enrolled but how many have actually made their payments.

Yesterday I requested and received an update six weeks later, and was surprised to see the total number drop slightly:

It's turned into an annual tradition: The official annual ACA Open Enrollment Period (OEP) runs from November 1st - December 15th, but most of the state-based ACA exchanges have later deadlines. hThen, right around the 12/15 point, it begins: One by one, some of the state-based exchanges announce further extensions of their deadlines to #GetCovered for the upcoming year.

In some cases they simply bump out the deadline for coverage starting in January, with the final "hard" deadline for February or March coverage staying where it is. In other cases they were never allowing Open Enrollment start dates past January to begin with, so it's the hard deadline which is being extended.

In any event, here's this year's batch of announcements; note that this list could grow longer over the next week or two:

The Massachusetts Health Connector (MA's ACA exchange) doesn't generally post official enrollment data reports via press releases, but I have a contact there who sends me their latest numbers from time to time during Open Enrollment:

Here's where we are at, currently:

  • January effectuations: 275,003
  • Feb. and March effectuations: 5
  • Plan Selections: 9,143
  • Total enrollments: 284,151

As a reminder, "effectuations" have paid the first month premium and are good to go. Plan selections still need payment to start.

Massachusetts is a bit unique among the ACA exchanges--they, along with Rhode Island, are the only ones which handle premium payments as well as policy enrollments. This means that they don't just track how many people select policies, they also know how many of those who enroll have actually paid their monthly premiums.

Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has ten different carriers participating in the individual market. MA (along with Vermont) has merged their Individual and Small Group risk pools for premium setting purposes, so I'm not bothering breaking out the small group market in this case.

Getting a weighted average is tricky. On the one hand, only one or two of the rate filings included actual enrollment data. On the other hand, the Massachusetts Health Connector puts out monthly enrollment reports which do break out the on-exchange numbers by carrier. This allowed me to run a rough breakout of on-exchange MA enrollment. I don't know whether the off-exchange portion has a similar ratio, but I have to assume it does for the moment.

via the Massachusetts Health Connector:

Are you turning 26 soon and still on your parent’s health insurance policy?  Did you know that you will need to take action or you may no longer have health insurance? Don’t worry, you have options!

Turning 26 triggers a special enrollment period that allows you to enroll in new health insurance coverage a within 60-days of your birthday.

Get coverage from your job

If you have a job that offers insurance, you can enroll in that coverage as turning 26—known as aging out—is considered a qualifying life event and will enable you to enroll in job-based coverage outside of your job’s open enrollment period.

Get covered through your school

If you are a college student, you may be able to enroll in a student health insurance plan through your school. Find out more

Apply for coverage through the Health Connector

Hardly surprising at this point, but still important to note:

Health Connector extends enrollment an additional month to July 23rd for uninsured individuals

On June 22, 2020, the Health Connector announced in an Administrative Bulletin an extension to the special enrollment period in response to the coronavirus (COVID-19) emergency through July 23, 2020 to assist uninsured Massachusetts residents seeking health coverage. (The extended enrollment period was previously set to end June 23.)

If you need to apply for coverage, you can start by creating an application.

If you apply coverage under this special enrollment, the deadlines to complete enrollment are as follows:

Oof! I saw this several weeks ago but somehow forgot to actually post about it until now; it's important to note that the May 25th deadline referred to below was just extended until June 23rd:

Massachusetts Health Connector continues extended enrollment as nearly 45,000 people enroll in new plans, update current coverage

April 28, 2020 – The Massachusetts Health Connector continues to help people who need health insurance after losing coverage or income due to the coronavirus, with a May 23 deadline ahead for June 1 coverage.

Not terribly surprising; via the Massachusetts Health Connector:

On May 21, 2020, the Health Connector announced in an Administrative Bulletin an extension to the extended enrollment period in response to the coronavirus (COVID-19) emergency through June 23, 2020 to assist uninsured Massachusetts residents seeking health coverage. (The extended enrollment period was previously set to end May 25.)

If you need to apply for coverage, you can start by creating an application 

If you apply coverage under this special enrollment, the deadlines to complete enrollment are as follows:

Coverage Start DateEnrollment Deadline

  • Coverage Start Date: June 1st: Enrollment Deadline: May 23rd
  • Coverage Start Date: July 1st: Enrollment Deadline: June 23rd

Please note that if you are eligible to enroll due to normal special enrollment period rules, you can select the one that applies when you complete your application.

via the Massachusetts Health Connector:

Massachusetts Health Connector continues extended enrollment as nearly 45,000 people enroll in new plans, update current coverage

April 28, 2020 – The Massachusetts Health Connector continues to help people who need health insurance after losing coverage or income due to the coronavirus, with a May 23 deadline ahead for June 1 coverage.

In order to help residents who lose their employer-sponsored coverage during the economic crisis created by the coronavirus, the Health Connector has created an extended enrollment period through May 25, so that anyone who needs health insurance can come to the exchange and get into coverage. Additionally, current Health Connector members are encouraged to update their income information if they lost their jobs or working hours have changed, to ensure they are in the plan that provides appropriate financial help paying for their coverage.

The MA Health Connector has extended their COVID-19 SEP out by another month:

Administrative Information Bulletin 03-20
Amendment to Administrative Bulletin 02-20 Guidance Regarding Special Enrollment Periods Due to the Emergence of the Novel Coronavirus SARS-Cov-2, Which Causes the Disease COVID-19
March 30, 2020

via the Massachusetts Health Connector:

Massachusetts Health Connector offers extended enrollment for uninsured individuals to ease coronavirus fears

BOSTON – March 11, 2020 – To ensure everyone who wants access to covered coronavirus services has it, the Massachusetts Health Connector announced today that uninsured residents can apply and get into coverage through a 45-day window running until April 25.

On March 6, the Division of Insurance announced that Massachusetts health insurers are now required to cover the cost of testing and treatment for members who may be affected by the Coronavirus (COVID-19), including not charging co-pays or deductibles for those services. The Health Connector’s decision to open enrollment to anyone without coverage ensures Massachusetts residents concerned about contracting coronavirus can access necessary services without cost barriers.

SUMMARY OF #COVID-19 SPECIAL ENROLLMENT PERIODS:

ALL OTHER STATES: You may qualify for a 60-day Special Enrollment Period (SEP) if you've recently lost (or will soon lose) your employer-based healthcare coverage, or if you've experienced other Qualifying Life Events (QLE) such as getting marrinew yorked/divorced, moving, giving birth/adopting a child, getting out of prison, turning 26 etc. For these SEPs you may have to provide documentation to verify your QLE. Visit HealthCare.Gov or your state's ACA exchange website for details on the process.

Last March I wrote an analysis of H.R.1868, the House Democrats bill that comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or make improvements in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

I just received the final 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):

Here’s where we are:

  • We have 290,105 January enrollments
  • 22,493 February and March enrollments
  • 7,014 plans selected
  • For a total of 319,612

New enrollments currently total 57,044.

I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for January vs. February or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).

Here's what's truly impressive: Massachusetts is the only state to increase their ACA exchange enrollment each and every year for six years running:

via the Massachusetts Health Connector:

On Wednesday, January 15, 2020, the Massachusetts Health Connector embarks on a one-day, multi-city tour that includes stops at six locations along the North and South Shore to remind Massachusetts residents there is still time to get 2020 health coverage before Open Enrollment ends January 23.

On Wednesday, January 15, 2020, the Massachusetts Health Connector holds its “Day of Coverage” featuring activities across the Commonwealth designed to help people #GetCovered with health insurance for the new year.“Day of Coverage” activities will be held in Boston, Hyannis, Lawrence, New Bedford, and Lowell.

Open Enrollment is happening now and runs through January 23, 2020. Massachusetts residents who want to enroll in coverage or switch plans to start February 1, must sign up through the Health Connector by January 23rd.

Residents can sign up for coverage at www.MAhealthconnector.org, over the phone at 1-877-MA-ENROLL (1-877-623-6765), or in person through a local navigator organization.

I just received the following 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):

Here are numbers as of yesterday:

  • We have 290,769 members enrolled in January coverage
  • We have 4,444 members enrolled in February or March coverage
  • We have 5,270 plans selected (1st premium not paid yet)
  • That’s a total of 300,483 people
  • We have 41,477 new enrollments.

I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for January vs. February or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).

via the Massachusetts Health Connector:

Massachusetts Health Connector Open Enrollment Continues through January 23, Offering High-Quality and Affordable Coverage to Residents

BOSTON – December 9, 2019 – Open Enrollment for health insurance through the Massachusetts Health Connector continues through January 23, 2020, providing residents time to find affordable coverage that delivers a wide range of benefits to make it easier and less costly to get health care.

Uninsured residents have until December 23 to apply, pick a plan and make a payment in order to have coverage starting January 1, and they have until January 23 to apply for coverage starting February 1. In contrast, Open Enrollment in other states served through the federal marketplace ends as early as December 15.

I just received the following 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):

It looks like we’ve pretty much wrapped up auto-renewal, how about an update on 2020 enrollment:

As of Nov. 29, we had a total of 286,640 people enrolled in Jan. 1 coverage, 6 with February or March enrollments, and 10,852 who had selected plans and had not yet paid to enroll. So, by the CMS definition, we are at 297,498. That includes about 17,000 new enrollments from people who did not have coverage as of Nov. 4 with the Health Connector.

I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for Januar vs. Feb. or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).

via the Massachusetts Health Connector:

Open Enrollment begins through Massachusetts Health Connector

BOSTON – Nov. 1, 2019 – The Massachusetts Health Connector started Open Enrollment this morning, making affordable coverage available to anyone in Massachusetts without health insurance, including lower-income people who can take advantage of low premiums and co-pays through the ConnectorCare program.

The Health Connector is Massachusetts’ state-based health insurance exchange, and provides health insurance to residents who do not get coverage through their employer. More than 97 percent of Massachusetts residents have health insurance, a result of the state’s 13-year old law which sought to ensure everyone in the Commonwealth has coverage.

Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has ten different carriers participating in the individual market. MA (along with Vermont and the District of Columbia) has merged their Individual and Small Group risk pools for premium setting purposes, so I'm not bothering breaking out the small group market in this case.

Getting a weighted average was a bit tricky. On the one hand, only one or two of the rate filings included actual enrollment data. On the other hand, the Massachusetts Health Connector puts out monthly enrollment reports which do break out the on-exchange numbers by carrier. This allowed me to run a rough breakout of on-exchange MA enrollment. I don't know whether the off-exchange portion has a similar ratio, but I have to assume it does for the moment.

*(Yes, I know, the District of Columbia isn't actually a state, and Vermont's mandate is...well, read on...)

As the 2020 Open Enrollment Period rapidly approaches (it starts November 1st nationwide...except for California, where open enrollment is starting on October 15th), it's time to start getting the word out about some important things to keep in mind this fall.

One of the most critical things to remember for residents of California, the District of Columbia, Massachusetts, New Jersey, Rhode Island and Vermont is that each of these states* has reinstated an individual healthcare coverage mandate law/ordinance to replace the federal ACA mandate penalty which was zeroed out by Congressional Republicans back in December 2017. This means that if you live one one of them, unless you receive an affordability, hardship or other type of acceptable exemption, you'll be charged a financial penalty when you file your state/district taxes for 2020 in spring 2021 if you don't have qualifying healthcare coverage.

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:

Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has ten different carriers participating in the individual market. MA (along with Vermont and the District of Columbia) has merged their Individual and Small Group risk pools for premium setting purposes, so I'm not bothering breaking out the small group market in this case.

Getting a weighted average was a bit tricky. On the one hand, only one or two of the rate filings included actual enrollment data. On the other hand, the Massachusetts Health Connector puts out monthly enrollment reports which do break out the on-exchange numbers by carrier. This allowed me to run a rough breakout of on-exchange MA enrollment. I don't know whether the off-exchange portion has a similar ratio, but I have to assume it does for the moment.

This press release is mostly of interest because it came from the Governor's office, not the MA Health Connector itself:

Baker-Polito Administration Announces Health Connector Completes Successful Open Enrollment with Highest-Ever Membership, Covering 282,000 People with Health Insurance

Governor Baker announced today that the Massachusetts Health Connector completed Open Enrollment with the highest membership in the 13-year history of the state’s health insurance exchange, covering 282,000 people with health insurance.

Heh. "13-year history" took a moment to register...but of course Massachusetts has had a health insurance exchange website since 2006, when "RomneyCare" went into effect.

via Covered California:

New Analysis Finds Leading State-Based Marketplaces Have Performed Well, and Highlights the Impact of the Federal Mandate Penalty Removal

  • The report examines the impact that federal and state actions have had on state-based marketplaces and the federally facilitated marketplace (FFM).
  • Cumulative premium increases in California, Massachusetts and Washington are less than half of the increases seen in FFM states, but 2019 premium increases spiked in California and Washington compared to Massachusetts, which continued its state-based penalty.

WASHINGTON D.C. — A new report highlights the benefits of state-based exchanges, particularly in the areas of controlling premium costs and attracting new enrollment. The report, which was produced by Covered California, the Massachusetts Health Connector and the Washington Health Benefit Exchange, found that premiums in these states were less than half of what consumers saw in the 39 states that relied on the federally facilitated marketplace (FFM) between 2014 and 2019.

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