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. Unfortunately, Rhode Island is among the few states where I haven't been able to get ahold of post-2020 data yet, even estimates.
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.
Utah's preliminary (and possibly final?) 2021 individual and small group market rate filings are listed below. Unless there's a change in the final/approved rates, individual marekt plan premiums will drop slightly by around 1.2% on average next year, while small group plans will increase by around 4.3%.
One by one, the dozen or so states which had either already implemented work requirement programs for Medicaid expansion enrollees or which were planning on doing so have either "delayed" or dropped those requirements entirely, either by force due to a federal judge ruling against them, or "voluntarily" due to them seeing the writing on the wall and realizing that a federal judge was going to rule against them in the near future.
Every state except one, that is: Utah.
Utah passed ACA Medicaid expansion solidly back in 2018...and they passed a "clean" version, which was supposed to mean anyone earning up to 138% of the Federal Poverty Line would be eligible, and the program wouldn't have any barriers or hurdles like work requirements and so forth.
A brief recap of ACA Medicaid expansion in the great state of Utah:
November 2018: Utah voters pass Proposition 3, a "clean" Medicaid expansion ballot initiative, by a solid margin, 53-47. "Clean" expansion means just that: The program would be expanded to every legally documented Utah resident earning up to 138% of the Federal Poverty level, without requiring additional barriers like work requirements, etc.
February 2019: The Utah state legislature, blatantly defying the clear will of the people, votes to effectively ignore Prop 3 by replacing it with Senate Bill 96, which would only partially expand Medicaid to those earning just 100% FPL (around 50,000 fewer low-income residents) while also tacking on work requirements to boot.
Adding insult to injury, while you might think this would at least save the state a few bucks (under ACA Medicaid expansion, the federal government pays 90% of the bill for the expanded population while the state has to pay the other 10%), this would actually cost the state around $50 million more, because the partial expansion, if approved by the federal government, would mean the state would instead pay the 32% portion they already pay for other Medicaid populations. The state put in a separate waiver request asking for the feds to agree to the 90% match rate anyway.
Yes, that's right: Not only did they lop 50,000 people out of the loop entirely, the other 90 - 100K enrollees will also be subject to...wait for it...work requirements. Well...sort of; keep reading.
First, it looks like they'll have to apply to at least 48 employers as well. So...what, if they get hired by the first one they still have to apply with 47 more?
Note that it says "and" before the fourth item, not "or"...which means all of them will have to register online, complete a training assessment, apply to at least 48 companies and complete an online training course.
...Oh by the way, one more thing: The minimum wage in Utah is $7.25/hour.
Utah's final weighted average rate increase is a bit tricky. On the one hand, I have the hard enrollment numbers for three of the five carriers offering ACA-compliant individual market policies. On the other hand, I have no idea what the numbers are for the other two...both of which happen to have the lowest average rate drops in the state (BridgeSpan and Molina).
The weighted average of the other three carriers is a 2.3% reduction. Assuming the other two have, say, 20,000 enrollees apiece, that would knock it down another 1.5 points or so, but until I have a better idea of how many enrollees those carriers have I'll stick with the -2.3% figure.
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.
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:
(sigh) The good news is that none of the five carrier rate filings for Utah's individual market have been redacted. Hooray! The bad news is taht only one of the five (Molina) included their current enrollment total on the filing at all. Boo!
As a result, I'm only able to run a "mostly" unweighted average...that is, it's an unweighted average of the other four carriers, plus a slight additional tweak based on the tiny number (448 people) enrolled in Molina policies. Utah's total individual market should be around 240,000 people, so that's barely a rounding error. My best guess is that unsubsidized enrollees are looking at roughly a 5.9% average premium drop next year.
For the state's small group market, the unweighted average increase is 2.7%.