Pennsylvania

They haven't issued a press release, but the December board meeting PDF for Pennsylvania's new ACA exchange, Pennie, breaks out their first Open Enrollment Period numbers in detail, and they're doing pretty well so far:

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:

There's no formal press release, but Pennie, Pennsylvania's brand-new state-based ACA exchange just noted via their official Twitter account that they're extending the enrollment deadline for coverage starting January 1st by one week:

IMPORTANT ANNOUNCEMENT! We have extended the deadline! You now have until Tuesday, December 22 to select health coverage that begins New Year’s Day.

— Pennie (@PennieOfficial) December 15, 2020

via Pennie, PA's new ACA exchange:

Governor Wolf Declares Dec. 10 Get Covered 2021 Pennsylvania Day in Support of the National Initiative, Get Covered 2021

  • Pennie stressed the December 15 plan selection deadline and the connection between health coverage and COVID-19 safety

Harrisburg, PA – December 10, 2020 – Today, Pennsylvania leadership announced a statewide partnership with Get Covered 2021 and re-emphasized the vital role that health coverage plays in the overall health and well-being of all Pennsylvanians. Improving access to affordable, quality health coverage is a priority for Pennie, Pennsylvania’s new state-based health insurance marketplace.

Get Covered 2021 is a national initiative promoting COVID-19 safety precautions and the importance of having health coverage. Pennie, in partnership with Pennsylvania leadership, along with 15 other states and Washington D.C., hundreds of health associations, sports figures, and celebrities have joined together to help spread the word to “mask up and get covered.”

via Pennie, PA's new ACA exchange:

December 15 is the Deadline for Individuals to Enroll in Health Insurance Coverage for January 

  • Pennie urges all Pennsylvanians seeking 2021 coverage to enroll this Open Enrollment 

Harrisburg, PA – December 7, 2020 –  Pennie, the state’s new health insurance marketplace is approaching its first enrollment deadline. December 15th is the last day for individuals and families to purchase health coverage starting January 2021. Current and potential customers are encouraged to select a plan by December 15 to ensure continuous coverage.

Pennie allows customers to compare and shop for medical and dental insurance from participating insurers, who are required to offer qualified, comprehensive plans. Pennie is also the only source for financial assistance to help lower the cost of coverage and care and nearly 9 out of 10 of customers qualify for financial assistance

As I've noted several times before, two more states have split off from the federal ACA health insurance exchange (HealthCare.Gov) this year. New Jersey and Pennsylvania have joined twelve other states (and DC) in operating their own full ACA enrollment platform.

In the case of Pennsylvania, they decided to call theirs "Pennie" (Pennsylvania Insurance Exchange), and judging by their first enrollment report, it looks like it's off to a great start:

Open Enrollment Early Highlights

Back in early August, the Pennsylvania Insurance Dept. issued the preliminary rate filings for PA's individual and small group market carriers. At the time, the weighted average rate change being requested on the individual market came to a 2.6% reduction in unsubsidized premiums, while the average small group plan was set to increase by 2.3%.

Last week, the PA DOI issued their final decisions for the long list of carriers on each market, and the changes were...minimal, really. In fact, there was no change at all made to most requested rate filings--only two of the 17 indy market carriers saw a change (reductions for each), and only four of the 21 small group carriers did...and even then, the changes aren't terribly dramatic, just a few percentage points in most cases.

Here's the press release:

Insurance Department Announces Lower ACA Individual Plan Health Insurance Rates, Attributes Them To New State-Based Exchange And Reinsurance Program

Pennsylvania launches new state-based health insurance marketplace, Pennie

  • Pennie replaces Healthcare.Gov and will improve access to coverage and increase affordability

Harrisburg, PA – September 22, 2020 – Today, Pennsylvania announced, Pennie, the new state-based health insurance marketplace for 2021 coverage. Pennie is available to all Pennsylvanians and aims to improve the accessibility and affordability of individual market health coverage. It is also the only place that connects Pennsylvanians to financial assistance to reduce the cost of coverage and care.

Pennie was created by Act 42 of 2019, passed unanimously by both chambers of the General Assembly and signed into law by Governor Tom Wolf on July 2, 2019.

Yesterday the Pennsylvania Insurance Dept. posted the preliminary 2021 rate filings for the individual and small group markets. On the surface, it appears that Pennsylvania has an absurdly competitive market, with 17 carriers listed on the indy market and 21 small group carriers...but when you look closer, many of these are simply branches of the same main company.

For instance, fully five of the individual market carriers are variants of "Highmark"...which is actually Pennsylvania's rebranding of Blue Cross Blue Shield. Two are branches of Geisinger and another two are both UPMC. The same is true in the small group market.

And don't even get me started about "Capital Advantage Assurance Company" and "Capital Advantage Insurance Company". Sheesh.

In any event, the overall rate filings average out to rougly a 2.6% premium decrease on the individual market and a 2.3% increase for small group plans, when weighted by carrier market share.

Between the COVID-19 pandemic and just getting generally swamped, I haven't gotten around to writing about Pennsylvania's state-based ACA exchange, due to launch this fall, since way back in December:

PA’s A Step Closer To Starting A State-Based Health Insurance Exchange

Pennsylvania’s new, state-run health ​insurance exchange is getting rolling ahead of its launch in 2021.

The commonwealth has chosen a California-based company, GetInsured to run it.

...Zachary Sherman, who heads the newly-created Pennsylvania Health Insurance Exchange Authority, said the contract with GetInsured will cost around $25 million annually, plus startup expenses that’ll be spread over several years.

“That’s compared to what we currently pay for Healthcare.gov, which is in the $90 to $95 million range,” he said.

Sherman said the administration chose GetInsured because it has already contracted with other states, like Nevada and Minnesota.

He said the new exchange is expected to save people between five and ten percent every year on premiums.

Over the past few days, I've collected and analyzed the daily COVID-19 cases at the county level in Michigan and Wisconsin to see what patterns are emerging as time goes by. I've tried to do this via two criteria: Population density (urban vs. rural) and politically (red vs. blue). The latter, of course, shouldn't even be a thing, but of course it is; pretty much every policy decision being made by the Trump Administration is based on tribal politics, so it'd be naive not to look at the data in that light.

So far, I've found clear and obvious trends in both midwest states, which happen to be two of the three most closely-watched swing states this year: While the urban centers (Detroit/Metro Detroit in Michigan; Milwaukee/Madison in Wisconsin) started out with much higher rates of infection than the rest of the state, over the past few weeks this has shifted dramatically, and appears set to continue to do so.

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 haven't written anything about Pennsylvania's surprisingly bipartisan decision to break off of the federal ACA exchange at HealthCare.Gov onto their own state-based exchange since June:

After some last-minute drama in one state and a surprising lack of drama in another, both New Jersey and Pennsylvania have officially passed bills allowing them to each establish their own ACA exchanges and enrollment platforms, splitting off from the federal exchange and HealthCare.Gov:

Pennsylvania:

Pennsylvania is poised to roll out its own online health insurance exchange to take the place of the one run by the federal government for the state's residents since 2014, saying it can save money for hundreds of thousands of policy-buyers.

Back in July, the Pennsylvania Insurance Dept. posted the preliminary/requested 2020 average premium rate changes for the individual and small group markets. The ACA-compliant individual market average increase was around 4.6%; for small businesses, the average was 9.6%.

Today they finally posted the approved rate changes for each...and the indy market average has dropped to a 3.8% increase, while the small group market has gone up just a hair to 9.7%.

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