Unfortunately, while the SERFF database shows 2019 listings for most of the 11 carriers which offer ACA policies in Texas this year, it only actually has the filings posted for 3 of them so far: CHRISTUS, Sendero and FirstCare Health Plans (aka SHA, LLC). Even then, those three carriers hold a pretty small share of the market, totalling just 65,000 enrollees. That means I only have actual 2019 rate data for about 5% of the ACA market available so far.
Now that it appears that the full list of states and counties eligible for hurricane (or windstorm, in the case of Maine) Special Enrollment Periods (SEP) has settled down, Huffington Post reporter Jonathan Cohn asked an interesting question:
How if at all do you allow for the extensions in FL, TX, etc.? Or, to put another way, how many post-Dec 15 signups through https://t.co/bhGNSognZK do you expect?
The closest parallel to this particular situation I can think of was the #ACATaxTime SEP back in spring 2015. In that case, it was the first year that the ACA's (defunct as of this morning) Individual Mandate was being enforced, and a lot of people either never got the message about being required to #GetCovered or at least pretended that they didn't.
I've saved Texas for last because, frankly, I haven't been able to make heads or tails out of their actual average rate increases for next year (and unlike smaller states which might not move the needle on the national average anyway, Texas has one of the largest populations in the country, so a substantial error here can also impact the national numbers significantly).
Back in early August, I pieced together a rough average of the requested rate increases for the Lone Star State of around 20% if CSR payments are made or 32.5% if they aren't:
CMS Announces Special Enrollment Periods for Americans Impacted by Recent Hurricanes Agency provides special open enrollment periods for 2017 Medicare and Exchange coverage
As a result of Hurricanes Harvey, Irma, and Maria, the Centers for Medicare & Medicaid Services (CMS) will make available special enrollment periods for all Medicare beneficiaries and certain individuals seeking health plans offered through the Federal Health Insurance Exchange. This important step gives these individuals and families who have been impacted by the hurricanes the opportunity to change their Medicare health and prescription drug plans and gain access to health coverage on the Exchange immediately if eligible for a special enrollment period.
Health and Human Services Secretary Tom Price, MD, declared a public health emergency in Texas on Saturday as Hurricane Harvey was pounding the state's coast.
Harvey made landfall late Friday night with winds topping 130 mph. Forecasts called for the storm to hover over the state for 5 days or more, possibly drenching some areas with as much as 50 inches of rain. Hundreds of thousands were without power and the National Weather Service said parts of Texas could be "uninhabitable for weeks or months."
"Many Medicare beneficiaries have been evacuated to neighboring communities where receiving hospitals and nursing homes may have no health care records, information on current health status or even verification of the person's status as a Medicare beneficiary. Due to the emergency declaration and other actions taken by HHS, CMS is able to waive certain documentation requirements to help ensure facilities can deliver care," an HHS statement read.
Whew! OK, Texas was a bear for obvious reasons...13 different carriers (well, 12 really...Centene is new to their market). Several more are dropping out (Aetna, Allegian, Cigna, Humana, Memorial Hermann and Prominence), but suposedly theyonly have around 64,000 enrollees in TX combined. Texas's total individual market is actually closer to 1.6 million, so I'm obvoiusly missing a big chunk of enrollees below (and before my regular commenters say it: Yes, I'm sure the off-exchange TX indy market has shrunk this year, but I find it hard to believe it's shrunk by over 60% already).
Anyway, I've managed to plug in one hard request percent for each carrier--the FULL Trump Tax for 3 of them, the NO/PARTIAL Trump Tax for most. In Vista's case, they're off-exchange only so the CSR issue isn't a factor anyway. Unfortunately, I can't seem to find the enrollment number for Community Health Choice, so I don't know what their share of the market is, which could make a big difference if they have high enrollment. I've plugged in a flat 100,000 enrollees for the moment, but will change that if I'm able to track the actual number down.
Well, Republican U.S. Senator John Cornyn, the Majority Senate Whip (and therefore one of the biggest shots in the Senate) shot off quite a promise about the concerns regarding up to 32 million people potentially losing their healthcare coverage in the event the ACA is repealed:
One of the top concerns is what will happen to individuals who became eligible for Medicaid with its expansion under Obamacare. The Senate's No. 2 Republican, however, promised that no one who got coverage under Medicaid expansion will lose it.
When Conrnyn was asked if he was concerned about people who've benefited from Medicaid expansion losing coverage, he said it was a shared concern.
(sigh) OK, after doing this for Michigan earlier today, I said that I wasn't gonna do this for every state, and I'm not...but the irony is that the 19 non-expansion states are actually easier to compile this data for than the expansion states...because you can't rip away healthcare from someone you never provided it to in the first place. Anyway, someone requested that I do a county-level estimate of how many people would likely lose their healthcare coverage in Texas under a full repeal of the Affordable Care Act, so here it is.
However, I also noted that I'd make sure to fill in the approved rates for the remaining 10 states as they came in, for completeness sake...and today, thanks to the HHS Dept. cutting the ribbon on 2017 Window Shopping at HealthCare.Gov, I've also been able to fill in the blanks for five of the remaining states all in one shot (the other five remain elusive).