The main reason for this was the implementation of a so-called "reinsurance" program which was originally passed by the (then Democratically-controlled) state legislature:
The most significant thing to impact Virginia carriers 2023 filings was the state's Section 1332 Reinsurance Waiver. I wrote about this way back in 2018 when the state was originally considering applying for one, but it didn't actually go into effect until January 2023:
Back in 2019, long before the American Rescue Plan passed, I embarked on an ambitious project. I wanted to see what the real-world effects would be of passing a piece of legislation which would eliminate the Affordable Care Act's so-called "Subsidy Cliff" while also strengthening the subsidy formula for those who qualified. Call it "ACA 2.0" for short, if you will (that's what I do, anyway).
This legislation has been around in near-identical form under one official title or another for years, usually bundled within a larger healthcare package. In 2018 it was called the "Undo Sabotage & Expand Affordability of Health Insurance Act of 2018" (or "USEAHIA" which is about as awkward a title as I can imagine.
MICHIGAN: Another One (Mostly) Bites The Dust; 12th CO-OP Drops Off Exchange, May Go Belly-Up
It appears that East Lansing-based Consumers Mutual Insurance of Michigan could wind down operations this year as it is not participating in the state health insurance exchange for 2016.
But officials of Consumers Mutual today are discussing several options that could determine its future status with the state Department of Insurance and Financial Services, said David Eich, marketing and public relations officer with Consumers Mutual.
Consumers Mutual CEO Dennis Litos said: "We are reviewing our situation (financial condition) with DIFS and should conclude on a future direction this week.”
While Eich said he could not disclose the options, he said one is “winding down” the company, which has 28,000 members, including about 6,000 on the exchange.
Virginia has an extremely robust, competitive individual & small group insurance market...and in 2023 it's getting even more competitive, with what appear to be two new carriers joining the individual market (Aetna Health Inc. and Anthem EPO), although Anthem is only offering off-exchange policies (why??) while Bright Health Insurance appears to be dropping out of the individual market (which is a common theme for Bright this year...)
Virginia used to be one of the first states to release their preliminary rate filings for the upcoming year, but for the past year or two it's been among the later ones. I don't know how much of this is due to COVID-related issues or if it's just an internal policy change for some other reason. Regardless, as a result, VA also happens to be the first state to release their annual rate filings since the Inflation Reduction Act (which includes a 3-year extension of the enhanced ACA subsidies) passed both the U.S. House and Senate.
As I noted in a bunch of posts yesterday, several states have launched "Tax Time Special Enrollment Periods" (Maryland launched theirs a couple years ago; Colorado, Massachusetts & Pennsylvania are bringing their programs online right now). New Mexico is also moving their own version through the legislative process.
Well, it turns out (thanks to Louise Norris for the heads up) that Virginia also passed their own version of this bill last year...although in their case it's being phased in over a two year time period:
Virginia has an extremely robust, competitive individual & small group insurance market...and in 2022 it's getting even more competitive, with three new carriers joining the individual market: Aetna, Bright and Innovation Health Plan.
Beyond that, I don't see any shocking or dramatic developments for 2022; average unsubsidized individual market premiums are dropping by 2.9% statewide, while average small group premiums are increasing by 3.6% overall.
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.
UPDATE: As I figured, the original data was massivly wrong. Just as one simple example, Virginia's own data set puts Danville's vaccination rate at around 35.5% vs. the 0.1% according to the CDC data.
The following states have ≤80% completeness reporting vaccinations by county, which may result in underestimates of vaccination data for counties and CBSAs: VT (74%), CO (73%), WV (54%), VA (51%), GA (50%), HI (0%), AS (0%), TX (0%), PW (0%), FM (0%), MH (0%), MP (0%)
I'm not doing the U.S. territories anyway, and I gathered the data for Hawaii and Texas straight from the state health departments. Sounds like I'll have to do the same for Virginia if possible. I'll also have to go back and re-do Colorado, Georgia and Vermont, though there was at least some clear pattern in those states (Vermont has few enough counties that it'd be hard to see one anyway). I haven't gotten to West Virginia yet.
I'll leave this post up for the moment but will take it down this evening until I've corrected the data.
UPDATE 6/02/21 9:11pm: OK, I'm using the data from the COVID Act Now project instead, which appears to be pulling their data directly from the Virginia Health Dept's website. Oddly, they don't list any numbers for Manassas City and Manassas Park, so I've pulled it directly from the VA COVID Vaccine Tracker myself.
I've swapped out both the graphs and the county/city table with the corrected versions below.
There still doesn't appear to be much of a partisan lean correlation in Virginia--it's more apparent in the "bubble view" which sizes the dots by population--but at least the numbers are accurate and make sense now, which is the main point.
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.
NOTE: The CDC lists ~1.895 million Virginia residents (9.6% of the total fully vaccinated)whose county of residence is unknown. In addition, there are 9 counties which don't list any vaccination data at all. Both of these could skew the trendline significantly.
Even with those factors accounted for, the Virginia graphs below are still massively out of whack with almost every other state. I don't mean because the trendline tilts slightly upwards towards the right side--New Jersey does that as well--I mean because there's massive ranges in vaccination rates across the board regardless of partisan lean, relative county population, etc. Even New Jersey still seems to form some sort of coherent pattern.
I don't know if this is a data error or what. Will update if I find out more.
