Missouri

When UnitedHealthcare announced last month that they were making good on their threat last fall to pull out of the individual market in over two dozen states next year, it caused shockwaves across the health insurance industry. It is an important development, as around 800,000 people will be impacted.

When Humana announced last week that they plan on pulling out of the individual market in at least 5 states next year, it was interesting and a bit of a bummer, but not nearly as earthshattering, because only about 25,000 people will have to shop around and find a new carrier.

Today, it is my duty to announce that Celtic insurance has also decided to pull out of the entire individual insurance market (both on and off-exchange) across at least 6 states, including:

When I was crunching the numbers to come up with my rough estimate of the weighted average rate increase requests for Florida yesterday, I had a revelation: While Healthcare.Gov's Rate Review database, frustratingly, only includes rate requests higher than 10% (thus ignoring dozens of requests of under 10%, or even rate reductions in some cases), it does still at least provide guidance as to what the maximum average could possibly be.

For instance, let's say that there's a state with 4 insurance carriers, each of which has exactly 10,000 enrollees. Two of them are asking for a 20% and 15% increase respectively. Since those are both above 10%, they'll both show up on the Rate Review site:

Part of the key to the successful enrollment of over 8 million* people last year and around 12 million* this year in the various ACA exchange policies has been the army of so-called "navigators" or "assisters" who, along with private health insurance brokers, helped educate millions of people about how the exchanges work, what their best options were and how to go through the procedure.

Unfortunately, some states (those run by administrations of a certain crimson hue, shall we say) decided, in their effort to obstruct Obamacare at every possible opportunity, to be utter jackasses by ginning up absurd regulations/restrictions about who "qualified" to be an ACA navigator.

The poster child for this ass-jackery was Ralph Hudgens, the Insurance Commissioner of Georgia, who actually bragged about his efforts:

Last October, at the height of the botched HC.gov rollout, I repeatedly commented over at Daily Kos:

 I still don't know why they didn't roll it out one state per day; if they'd gone alphabetically, they would have had a solid week to work the kinks out with a (relatively) low volume before hitting a big state:

  • Alabama, Alaska, Arizona and Arkansas are all relatively low-population.
  • California, Colorado, Connecticut and Delaware* are all state-run exchanges.
  • That means they wouldn't have hit Florida on the federal site until tomorrow.

I know that the system still would have had serious software issues, but at least they wouldn't have to deal with the massive overload of traffic at the same time that they were trying to fix the issues.

*(Obviously I was mistaken at the time about Delaware running their own exchange, but it's still a low-population state so my point was still valid...and of course the District of Columbia does run their own exchange).

Well, obviously it was too late for that at the time, and they've since scrambled to get their act together on the individual exchange side.

UPDATE: On the down side, I was off by 4% this time around.

On the up side, I UNDERESTIMATED:

Actual Feb. enrollments: 942,833, for a total of 4,242,325 thru 3/01/14.

Sarah Kliff at Vox just announced that the February HHS report is expected to be released today at around 4:00pm. A few items in anticipation of that:

  • As I've noted several times, I'm projecting the report to total around 902,000 exchange-based private QHP enrollments for the month of February (technically 2/02 - 3/01)
  • If accurate, this would bring the cumulative total of exchange-based private QHP enrollments to 4.202 million (from 10/1/13 - 3/01/14)
  • From the data I have, the average daily enrollment rate in February was almost identical to that of January, which had about 1.146 million QHP enrollments. HOWEVER, the January report included five weeks of data (12/28 - 2/01), while the February report will only include four weeks (2/02 - 3/01). Therefore, even at the same daily average, it'll be about 20% lower no matter what.
  • Don't be surprised if Peter Lee of CoveredCA decides to steal some thunder by announcing that California has enrolled 1,000,000 QHPs all by itself either today or tomorrow. However, that would include the past 10 days, while the HHS number will only run thru 3/01.
  • If you want to get REALLY specific, call it 902,800 and 4,202,292.
  • I've been dead-on target 6 times in a row without hyping up my projections beforehand. This time I am hyping myself up beforehand, so I'll probably be way off...but as long as I've UNDERestimated the tally, I'll be perfectly fine with that...
  • The report will be released in about 5 minutes, but my kid gets home from school in about 10, so it'll be a good 20 minutes before I can really post anything. Feel free to follow Sarah Kliff of Vox in the meantime!

I believe this is my first Missouri-specific QHP update: Their private enrollments went up from 54,147 as of February 1st to "about 68,000" by February 20, an increase of 13,853. Like the average of the other 17 states I have post-2/1 data for, Missouri's February enrollment rate appears to be very close to what it was in January, so I'm still confident of my appx. 902,000 February HHS report projection.

As of Feb. 20, about 68,000 Missouri residents had enrolled in private health plans through the online insurance marketplace, most of whom received federal subsidies to help offset the cost of premiums, said Ryan Barker, vice president for health policy at the Missouri Foundation for Health, a nonprofit group that's promoting the insurance marketplace.

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