This just in via the Massachusetts Health Connector (by email):
253,253 January effectuations
6,247 February and March effectuations
4,643 plan selections
264,143 total enrollments/plan selections
The above includes 22,729 new enrollments, which includes people who never had Health Connector coverage in the past, or who did, dropped exchange at some point, and have come back for 2022.
This is up around 2,000 since December 25th, but is still down over 10% from last year, making Massachusetts one of only 5 state exchanges to see QHP enrollment drop year over year (to be fair, there's still a few days left for MA as well as Kentucky, DC and New York. The fifth is Hawaii. Having said that, enrollments in the other four states only runs through anywhere from December 15th - December 25th, whereas MA's total is current through yesterday.
As I noted last night, thanks to the federal Rate Review website finally being updated to include the final, approved 2022 rates for both the individual and small group markets in all 50 states (+DC), I've been able to fill in the missing data for my annual ACA Rate Change Project.
As I note there, the overall weighted average looks like it'll be roughly +3.5% nationally.
Normally I write up a separate entry for both the preliminary and approved rate changes in each individual state, but it seems like overkill to create 14 separate entries at once. Besides, in many of these states there's been few if any changes between the preliminary and approved rate changes.
Nov. 1, 2021 – Open Enrollment for 2022 health insurance begins today at the Massachusetts Health Connector, with more opportunities for enrollees to find financial assistance with their monthly premiums.
Open Enrollment runs through Jan. 23, 2022, with a deadline to apply, pick a plan, and make a first premium payment by Dec. 23, for coverage to begin Jan. 1, 2022. Open Enrollment is the time when individuals without health insurance can find coverage through the Health Connector without a qualifying reason.
“Access to affordable health care for individuals and families in Massachusetts is vital,” said Marylou Sudders, Secretary of Health and Human Services and Chair of the Health Connector’s Board of Directors. “Massachusetts has the highest insured rate in the nation, and Open Enrollment offers individuals the opportunity to apply and choose a coverage plan that meets their needs and provides security for their health and wellbeing.”
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 9 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 for Massachusetts is trickier than in most states, for a couple of reasons. The good news is there's an August 2021 enrollment report which breaks out exactly how many MA residents are enrolled in each carrier's policies. However, the numbers are actually broken into 4 different categories: Small Group (which, again, is merged with the individual market in MA); "ConnectorCare" individual market policies; subsidized Qualified Health Plans and unsubsidized QHPs.
Last week I noted that MNsure, Minnesota's state-based ACA exchange, announced that while the general, open-ended 2021 Special Enrollment Period had ended back in mid-July, they're still letting any Minnesotan who received unemployment benefits at any point in 2021 the opportunity to enroll in ACA healthcare coverage & take advantage of the American Rescue Plan's Unemployment Benefit.
The key point is that Minnesotans can still do so even if they received UI benefits prior to the July 15th SEP deadline. This means that if you were on unemployment back in, say, January or February, and you still need healthcare coverage for the remainder of 2021, you can still visit MNsure.org and get coverage for the last 4 months of this year for $0 in premiums and with mostly nominal deductibles/co-pays (assuming you aren't eligible for employer-based coverage, Medicaid, etc. instead).
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.
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.
Note: The CDC lists ~413,000 Massachusetts residents (12.3% of the total fully vaccinated) whose county of residence is unknown.
For Massachusetts, it's important to note several things: First, every county in the state voted for Joe Biden by a wide margin (Bristol is the closest thing the state has to a "swing district").
Second, there's very little variance in vaccination rates between them as of today...with two weird exceptions: Barnstable and Dukes/Nantucket...in which, according to the CDC, only 4% and 2% of residents have been vaccinated to date, which makes zero sense whatsoever.
I know that Dukes & Nantucket are often merged for purposes of county-level data, and have a far lower combined population than the rest of the state, so I assume there's some unusual "county classification" going on there, or that the residents are reported as residing elsewhere or something. I don't know what the deal is with Barnstable, however.
Combine this with the unusually high "unknown" vaccination rate (no other state I've seen so far has had more than half as many in that category) and I'm not sure what to make of Massachusetts.
Massachusetts Health Connector and member carriers agree to carry over out-of-pocket costs for mid-year moves to access new lower premiums on-exchange
Agreement allows carrier members to access to lower Health Connector premiums as a result of the American Rescue Plan without resetting deductibles in 2021
May 20, 2021 – All nine health insurance carriers who participate in the Massachusetts Health Connector have agreed to let their off-exchange members move from an off-exchange plan to an exchange-based plan mid-year without losing spent out-of-pocket costs in 2021. This flexibility can help Massachusetts residents access new lower-cost plans through the 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.
