Vermont

And here...we...go...

Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:

This morning, George Conway (yes, that George Conway) asked a reasonable question on Twitter:

Has anyone estimated how many American lives would have been saved if the entire country had gotten vaccinated at the rates at which people in, say Vermont or Portugal, or at which registered Democrats, have gotten vaccinated?

This is a serious question.

— George Conway (@gtconway3d) February 3, 2022

Several people asked me to chime in.

Now, according to the CDC, Vermont had around 250 total COVID-19 deaths reported as of June 30th, 2021, and is now up to more than double that (516), which means they've had around 266 deaths out of 643,000 residents since 6/30/21, or 41.4 per 100K.

Vermont

Vermont's 2022 rate filings are pretty straightforward: They only have two carriers in the state offering either individual or small group plans to begin with, and the insurance department clearly states not only the requested and approved rate changes, but the exact number of enrollees each carrier has.

There's one major change this year, however: After many years of having their individual & small group risk pools merged, Vermont has decided to unmerge the two (I believe Massachusetts is the only other state which has a combined indy/small group risk pool). The press releases for rate filings in each explains the rationale:

GREEN MOUNTAIN CARE BOARD REDUCES RATE REQUESTS FOR INDIVIDUAL AND FAMILY PLANS FOR 2022

Vermont

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, but Vermont isn't among them.

Vermont is one of only two states (the other is Massachusetts) where everyone enrolled in Medicaid via ACA expansion was already previously eligible before the law passed via state programs or federal waivers. However, those programs (and funding) have presumably long since been discontinued, so if the ACA is struck down, those enrollees would be in the same boat as those enabled specifically due to the ACA unless funding was immediately restored.

Vermont

 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 Vermont:

NOTE: The CDC lists ~91,000 Vermont residents (3.5% of the total fully vaccinated) whose county of residence is unknown.

Vermont Health Connect

Huh. Vermont's ACA exchange website, Vermont Health Connect, has looked pretty much the same for at least the past 5-6 years, but a month or so ago they quietly overhauled the layout & design interface of the site. I have no idea if they actually updated the back-end, however.

In any event, the VT Health Connect's COVID-19 Special Enrollment Period was originally supposed to end last Friday (May 14th), but they appear to have done something else without much fanfare as well:

Vermont Health Connect

I just received confirmation from Vermont Health Connect that they're joining nearly every other state in offering an official COVID-19 Special Enrollment Period...with a few caveats:

Special Enrollment Period for Uninsured Vermonters Opens February 16, 2021

Waterbury, VT— In alignment with the Federal initiative, the State of Vermont is re-opening a special enrollment period on February 16, 2021 to offer Vermonters who do not currently have health insurance an opportunity to enroll in a qualified health plan and receive premium and cost-sharing assistance, if eligible. Intended to facilitate access to health insurance, the special enrollment period is being implemented in partnership with qualified health plan issuers, Blue Cross and Blue Shield of Vermont, MVP Health Care, and Northeast Delta Dental. To enroll, Vermonters should call the Customer Support Center at 1-855-899- 9600 Monday through Friday, 8:00AM – 4:30PM.

Way back in May (a lifetime ago), Vermont was among the first states to publicly post their preliminary 2021 rate filings for their combined individual & small group market. At the time, the carriers were requesting an average 6.8% rate increase, and noted that they had no clue how much to tack on to cover themselves for the COVID-19 factor...or to even reduce rates because of it.

This week, the Vermont insurance regulatory board issued their final decisions about both BCBS of Vermont and MVP Health Plan, and cut down on each of their requested increases by several points (h/t Louise Norris for the links):

On March 20th, the Vermont Health Connect ACA exchange joined other state-based exchanges in launching a formal COVID-19 Special Enrollment Period.

On April 15th, just ahead of the original SEP deadline, they bumped it out by a month:

Due to the COVID-19 emergency, Vermont Health Connect has opened a Special Enrollment Period until May 15, 2020. During this time, any uninsured Vermonter can sign up for a Qualified Health Plan through Vermont Health Connect. Qualified families can also get financial help paying for coverage.. Please call us at 1-855-899-9600 to learn more.

Then, with the May deadline approaching, I took a look and sure enough, they've bumped it out another month:

Annnnnd we're off! In the middle of a deadly global pandemic which has already killed more than 85,000 Americans and completely disrupted the entire U.S. healthcare system, private insurance carriers still have to go about preparing their annual premium rate change filings for 2021. This is a long, complicated process which begins a good nine months before the new plans and prices are actually enrolled in.

The task of setting 2020 premiums was the first time since the ACA went into effect which was relatively calm for insurance carrier actuaries. Unlike setting rates for 2014 or 2015, they weren't dealing with a complete overhaul of the entire insurance industry. Unlike 2016-2017, they weren't dealing with the prospect of ACA premiums being crippled for 3/4 of the country (via King v. Burwell) or the fallout of the Risk Corridor Massacre. Unlike 2018, they weren't dealing with how to deal with CSR rembursements being cut off or the entire ACA being repealed by Congress. Unlike 2019, they didn't have the unknown impact of the individual mandate being repealed to consider.

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