As I noted last week, Your Health Idaho has released their final official OE3 number. I had previously noted that there were only 8 states in which the exchanges appeared to have performed worse on private policy enrollment in 2016 than they did in 2015, and that most of those had special circumstances:

Over the past few months, I've ranted repeatedly about what a stupid, short-sighted, petty move it is of Kentucky Governor Matt Bevin to shut down the kynect ACA exchange, for a variety of reasons...most of which center around the fact that the kynect exchange has been operating smoothly since the moment it launched in October 2013. In other words, there's very little reason to kill kynect, and plenty of reasons to keep it operational.

This does not mean that I'm opposed to moving any state-based exchanges over to Healthcare.Gov. As I said back in June, right after the King v. Burwell decision came out:

If you look at the State-By-State OE3 enrollment breakdown, you'll notice that there are still 4 blank fields all the way down at the bottom, plus a special note regarding California:

If you take a look at the State-by-State chart, you'll notice that in addition to a few clarifications here and there, there are 5 states (well, 4 states +DC) all the way at the bottom labelled "NO DATA YET".

California insists, just like last year, on doing this weird thing where they release the number of new enrollees who have signed up on a fairly regular basis, but the number of renewals by current enrollees is kept a secret all the way into January. I have no idea why they do that, and it's pretty important given that we're likely talking about somewhere between 1.0 - 1.3 million people here.

On the other hand, at least they've posted data on their new additions. DC, Idaho, Kentucky, New York and Vermont haven't even done that much as of this writing.

A few days ago I noted that the Maryland Health Connection has officially launched window shopping for the 2016 open enrollment period (#OE3).

As it happens, at least two other state-based exchanges have done so as well:

COVERED CALIFORNIA: It's pretty obscure for the moment, but if you click the "Shop & Compare Tool" link at the lower left-hand corner of the CoveredCA website, you'll be given the option to shop around for 2016 plans (you can also choose 2015 plans in case you've had a qualifying life change and need coverage for the last 2 months of this year, or even 2014 plans if you still need that information for tax purposes or whatever):


Anonymously Shop and Compare Health and Dental Plans on Your Health Idaho

Presented without comment:


Gov. Shumlin Updates on Vermont Health Connect Progress

MONTPELIER – Gov. Peter Shumlin, representatives from Vermont’s insurance carriers, and officials and staff from Vermont Health Connect (VHC) gathered today to update on the health insurance marketplace’s progress. The Governor announced that the technology upgrade necessary for a smooth open enrollment has been delivered and tested and will be deployed starting this evening; the backlog of change of circumstance cases has been cleared; VHC is now operating at a vastly improved customer service level for change requests; and customers will be able to report many changes online starting Monday. Meeting those milestones is consistent with the schedule laid out by the Governor in March 2015 and in legislation passed later in the spring.


In today's speech at the Howard University College of Medicine, HHS Secretary Sylvia Burwell started ramping things up for the 2016 Open Enrollment Season (which I'm gonna designate #ACA2016 unless someone else comes up with something better) by dropping some data points.

Among these was this one: 

Almost half of the uninsured individuals who are likely eligible for Marketplace plans are between the ages of 18 and 34.

This is really important, because only about 28% of those who enrolled in exchange-based policies this year fall into the 18-34 range, which is a problem from an actuarial/risk pool perspective. Younger people are generally healthier, so the insurance companies prefer to have a higher percentage of them in their risk pools in order to help keep premiums/deductibles from increasing too quickly.

If "almost half" of the 10.5 million uninsured people eligible for the ACA exchanges are in the 18-34 range, that's roughly 5 million young adults who the exchanges need to target.

Vermont was one of the earliest states to report their requested rate hikes back in mid-May. Due to Vermont's small size (both in total population as well as insurance providers...there's only two of them even operating on the individual markets), as well as their unique law requiring that all individual policies be purchased through the ACA exchange, they were also one of the easiest to calculate.

In addition, as far as I can tell, in Vermont, both the individual and small group markets are considered part of the same rate pool, although the market share differences between the two still resulted in slightly different weighted averages: 7.8% for the individual market, 8.1% for the small group market. These were slightly revised to 8.0% and 8.3% just prior to the review/approval process.

Yesterday the state regulators announced the final approved rates for both BCBSVT and MVP...and lo and behold, they've shaved off several points in both the individual and small group markets:

The 2016 rate requests are popping up all over the place's Vermont:

  • Blue Cross Blue Shield of VT is requesting avg. 8.38% increase for 31,147 individual exchange enrollees and 35,903 small business (small group) enrollees.

HOWEVER, it's important to bear in mind that this average a) ranges from 4.7% to 14.3% depending on the type of policy, and they seem to have mixed both individual and small group enrollments together (first time I've seen that so far). Here's the distribution; I'm not sure I understand the 2,964-enrollee difference between the totals:

As you can see, about 1.6% of enrollees would see an increase of 5% or less, while 32% would see a 10-15% increase, with the remaining 66% between 5-10%.

The impending King v. Burwell Supreme Court decision will cast an even larger shadow over the ACA over the next 2 months (the decision is expected to be announced in June), as exchanges in 6 of the 14 states running their own (State-Based Marketplaces, or SBMs) are at risk of either being abandoned, dissolved or otherwise moved over to the federally-run Healthcare.Gov exchange:

The federal government is threatening to take over Hawaii's health insurance exchange within months and has restricted grant money to support operations of the Hawaii Health Connector.

Jeff Kissel, the Connector's executive director, told lawmakers at a briefing Thursday that if the exchange created by the Affordable Care Act does not get state funding soon, the federal government will abolish Hawaii's marketplace and run it directly.