Tennessee

Tennessee

Tennessee's proposed 2022 rate filings are pretty straightforward...no new entrants or drop-outs among the carriers in either the individual or small group markets, and the SERFF filings actually include the enrollment totals for all of them in both markets (a rarity these days!).

The weighted average premium increase for unsubsidized enrollees is 4.4% for indy market enrollees and 8.9% on the small group market.

UPDATE 10/26/21: Well, it looks like all of the requested rates have been approved by the TN regulators without any changes on either market.

COVID-19

 

I'm presenting snippets of these stories without much comment because...really, there's not much more for me to add:

Via Brett Kelman of the Nashville Tennessean, two days ago:

Tennessee fires top vaccine official as COVID-19 shows signs of new spread

The Tennessee state government on Monday fired its top vaccination official, becoming the latest of about two dozen states to lose years of institutional knowledge about vaccines in the midst of the coronavirus pandemic.

The termination comes as the virus shows new signs of spread in Tennessee, and the more-transmissible delta variant surfaces in greater numbers.

Dr. Michelle Fiscus, the medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health, said she was fired on Monday afternoon and provided a copy of her termination letter. It provides no explanation for her termination.

Tennessee

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 most states I've been able to get more recent enrollment data from state websites and other sources. For Tennessee, I'm using estimates based on raw data from the Tennessee Division of TennCare for January 2021 and beyond.

Tennessee is one of 12 states which still hasn't expanded Medicaid eligibility under the ACA (13 if you include Missouri, whose voters expanded the program last year...but which the state legislature refuses to fund).

Tennessee

 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.

Here's Tennessee:

NOTE: The CDC lists ~49,000 Tennessee residents (2.3% of the total fully vaccinated) whose county of residence is unknown.

Gummy Penis

March 2, 2021:

The ACA's language didn't account for the possibility that some states might not expand Medicaid, which is why the lower-end range of exchange plan subsidy eligibility starts off at 100% FPL...

Unfortunately, those earning less than 100% FPL are still stuck without any viable options besides either "going bare" and praying they don't get sick or injured or possibly buying a junk plan of some sort. According to the Kaiser Family Foundation, there's around 2.2 million Americans still caught in the "Medicaid Gap", where they don't qualify for Medicaid but don't earn enough to be eligible for subsidized ACA exchange policies (Kaiser estimates another 1.8 million uninsured adults in these states in the 100 - 138% "overlap" cateogory, plus around 356,000 who are eligible for Medicaid but still haven't enrolled for one reason or another).

Tennessee has also posted their preliminary 2021 rate filings for both the individual and small group markets. Aside from being one of the few states where a significant number of carriers are including any COVID-19 pandemic factor at all (in both markets), Tennessee has several new entrants and one significant withdrawl (I think).

On the individual market, UnitedHealthcare is newly entering, while Cigna is expanding their coverage areas as noted here. Cigna is also newly entering Tennessee's small group market, as is Bright Health Insurance.

Overall, Tennessee carriers are asking for a 10.3% increase on the indy market (the second highest so far after New York's 11.7% average), mostly driven by Blue Cross Blue Shield, which holds a whopping 83% of the market. On the small group market, the average increase is 5.5%.

COVID-19 accounts for 1.7 points of the increase on average in the indy market and 2.6 points in the small group market. This, again, is the highest statewide average COVID impact I've seen after New York state so far.

via Becker's Hospital Review:

Cigna extended its individual healthcare exchange products for the 2020 plan year, the insurer said Sept. 18.

For 2020, individuals can purchase individual health plans in 19 markets across 10 states. The expansions will take place in counties in Kansas, South Florida, Utah, Tennessee and Virginia. The other states include Arizona, Colorado, Illinois and North Carolina.

The plans will be available for purchase on the individual marketplace during the 2020 open enrollment period, which begins Nov. 1. Plans will take effect Jan. 1.

via Bruce Japsen of Forbes:

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:

Last month I reported on Tennessee's preliminary 2020 premium rate filings. At the time, the weighted average rate change for ACA Individual Market policies was a 1.1% reduction over this year.

Today, the Tennessee Insurance Dept. officially approved the rate changes exactly as is, without making any changes one way or the other:

TDCI Approves Carriers’ 2020 Rates on the Federally Facilitated Marketplace
More Choices, Rate Decrease Highlight Rating Filing Season

The Tennessee Department of Commerce and Insurance (TDCI) announces the approval of insurance rates requested by the five carriers offering coverage on the Federally Facilitated Marketplace (FFM) in 2020.

via Brett Kelman of The Tennessean:

A new set of proposals provide some of the strongest evidence yet that Obamacare -- once on the verge of collapse in Tennessee -- has stabilized.

The state’s largest insurance company, BlueCross BlueShield of Tennessee, plans to reenter the Affordable Care Act marketplace in Nashville, Memphis and surrounding counties next year, providing another option for residents on Obamacare. Additionally, two other insurance companies that already offer Obamacare in these cities, Cigna and Oscar Health, are planning to significantly reduce the cost of their coverage plans.

Although the proposals are not final, it appears Tennesseans will have more options and competitive prices in the coming year, said Kevin Walters, a spokesman for the Department of Commerce and Insurance.

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