Nevada

In early August, the Nevada Dept. of Insurance posted the state's preliminary 2020 individual market rate changes. The data was a bit incomplete and confusing, but the bottom line is that average unsubsidized 2020 premiums were only expected to increase about 1.0%.

Today they posted the final/approved rate changes, and unlike most states, the overall weighted average will be slightly higher than the original numbers...although only by a hair:

Nevada Division of Insurance reveals approved 2020 Health Insurance Rates

Carson City, NV – The Division of Insurance (‘Division”) has posted the approved 2020 health insurance rates for all plans in the Individual Health Insurance Market at healthrates.doi.nv.gov and encourages consumers to review this information before the Open Enrollment Period begins.

HealthCare.gov incorrectly sent out open enrollment notices

LAS VEGAS (KLAS) — In a statement issued by Nevada Health Link, the organization announced that it had become aware that the Federal Health Insurance Marketplace, known as HealthCare.gov had incorrectly sent notices to Nevada consumers regarding the upcoming open enrollment period.

The incorrect notices were sent to Nevada consumers via mail, email and through notices on the HealthCare.gov portal.

"These notices from the Marketplace were sent in error. Nevadans who received these notices from the Marketplace should be aware that NevadaHealthLink.com is the only place to get enrolled in a qualified health plan during the next open enrollment period beginning on November 1, 2019," said Heather Korbulic, Executive Director for the Silver State Health Insurance Exchange.

Nevada consumers are asked to reach out to the Nevada Health Link consumer assistance center for further questions by calling 1-800-547-2927.

Not much to add here.

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:

Way back in October 2013, the very first official ACA Open Enrollment Period began...and was an immediate disaster for not just the federal exchange website (HealthCare.Gov), but also for about half of the states which were operating their own whole-widget ACA exchange websites.

That first year, there were 15 states doing so: California, Colorado, Connecticut, the District of Columbia (not actually a state, I know), Hawaii, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New York, Oregon, Rhode Island, Vermont and Washington State. There were oddball problems at launch with most of them, but HI, MD, MA, MN, NV, OR and VT had serious issues.

This Just In from the Nevada Insurance Dept...

Proposed rate change averages for health insurance are available to the public for review

Consumers who shop for health insurance in the individual market, can now view new rate information for Plan Year 2020 on the Nevada Division of Insurance website.

Based on the rate submissions the Division has received for 2020 plans, there are three insurance companies that submitted proposed rates for plans on the Silver State Health Insurance Exchange (Exchange): Health Plan of Nevada, SilverSummit, and HMO Colorado, with up to 26 individual health plans to choose from. The proposed average increase is 0.5% for those health insurance plans sold On-Exchange through Nevada Health Link.

About three weeks ago I noted that the Nevada state Senate had passed a bill which locks in many of the ACA's patient protections at the state level, just in case the idiotic #TexasFoldEm lawsuit prevails and the ACA is repealed after all.

Yesterday, the Nevada state House followed through as well:

Nevada stands to become the fifth state to fully incorporate the federal Affordable Care Act’s protections for patients with pre-existing conditions into state law after unanimous passage of a bill Tuesday in the state Senate.

"Fully incorporate" isn't quite accurate; as I noted with the Senate version, it looks like the three most important ones are covered (Guaranteed Issue, Community Rating and the ACA's 10 Essential Health Benefits), along with a pre-ACA law letting young adults stay on their parents plan until age 24 (but only if they're unmarried and enrolled in school).

There seems to be something in the air this week...or perhaps it just takes roughly 3 months from the time a new legislative session starts for the first legislation to work its way through the process. Whatever the reason, Washington, Connecticut and now Nevada have all made major moves towards codifying ACA patient protections at the state level in the even the ACA itself is repealed:

The Nevada Senate has passed a bill that would enact state-level health care protections for people with pre-existing conditions.

State Sen. Julia Ratti says the legislation aims to bring about protections that are already in place under the Affordable Care Act. The Democrat told lawmakers last month that people are worried about their health care access.

She says Nevada should make sure these protections are in place at the state level if the federal provisions are rolled back.

State senators approved the measure on Monday in a unanimous vote.

The measure stipulates that insurers cannot deny a person health care coverage due to a pre-existing condition.

As I noted a few weeks ago, I haven't written a whole lot about the idiotic (but terrifyingly so) TexasFoldEm lawsuit in awhile. Part of this is because I was out of the country over the holidays; part is because there hasn't been a whole lot of movement on the case since right-wing federal Judge Reed O'Connor ruled that the ACA was unconstitutional using a legal argument so thin it hula hoops with a Cheerio.

Anyway, when I last checked in, a coalition of Attorneys General from 16 states (plus the District of Columbia) had formally filed to appeal Judge O'Connor's ruling, and the U.S. House of Representatives had also formally voted to intervene on behalf of defending the ACA from the lawsuit, which was filed last year by a coalition of 18 Republican Attorneys General, plus two Republican Governors.

I ran the numbers for Nevada's preliminary 2019 ACA individual market rate changes back in July. At the time, the average requested rate increase was around 2.3% statewide.

With the 2019 Open Enrollment Period coming up fast, I checked on the approved rate changes and found that state regulators had cut down on the rates quite a bit...although mostly for carriers which only offer off-exchange plans and only have small numbers of enrollees anyway.

For instance, HMO Colorado (dba HMO Nevada) originally requested a 20.9% increase; this was reduced to 9.5%...but they only have 200 people enrolled anyway, so it's not even a rounding error. Rocky Mountain was cut from 34.4% to 18.5%...but only has 300 enrollees, and so on.

The three carriers which hold the vast bulk of the market had far less dramatic changes, although Silver Summit was cut from a 5.2% increase to a 1.1% decrease for 2019.

Breaking out of Nevada...

The cost of plans through Nevada’s health insurance exchange are anticipated to only increase by an average of 1.9 percent next year in what the state’s insurance commissioner said is the lowest proposed rate increase from insurance companies since the Affordable Care Act went into effect in 2014.

The announcement, made by the Division of Insurance late Tuesday morning, comes amid ongoing uncertainty about the impact that Congress’s repeal of the Affordable Care Act’s individual mandate and federal rule changes for two types of non-ACA-compliant health plans will have on the individual market as a whole. Insurance Commissioner Barbara Richardson cautioned that the proposed rates are subject to change based on any action by the federal government and said the division is working “diligently” to review the proposed rates from insurance companies.

That 1.9% figure is slightly misleading, though, because...

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