2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Washington State

This Just In via the Washington HealthPlanFinder:

Washington Healthplanfinder Urges Customers to Act Fast for Jan. 1 Coverage

The Washington Health Benefit Exchange (Exchange) today is warning customers without 2020 coverage that Sunday, Dec. 15 at 11:59 p.m. is the deadline to sign up for health and dental plans through Washington Healthplanfinder that begin on Jan. 1.

Since the open enrollment period began, more than 187,000 Washingtonians have already selected 2020 Qualified Health Plans (QHP) using Washington Healthplanfinder, including around 15,000 residents who signed up for health coverage over the past week. With traffic to wahealthplanfinder.org expected to continue rising, customers needing 2020 coverage are directed to submit an application and lock in their plan selection immediately to avoid any potential delays.

Back in late October, a few days before the launch of the 2020 Open Enrollment Period, I issued a warning to ACA exchange enrollees who may have been benefiting from the "Silver Loading" premium pricing strategy for in 2018 and/or 2019 that the enhanced subsidies they've been taking advantage of for two years are likely going to be reversed for 2020:

What happens next year if the benchmark Silver plan drops by 4%...but the Bronze, Gold, and the OTHER Silver plans stay flat?

via the Washington Healthplanfinder:

Washington Healthplanfinder Ready for Start of 2020 Open Enrollment

  • More health plans, new health insurance carriers, and lower premiums available in most counties

Washington Health Benefit Exchange (Exchange) announced today the start of the 2020 open enrollment period that will feature more plan options and the potential for lower premiums for the majority of customers.

Now through December 15, Washingtonians seeking health insurance plans for themselves and their families can visit Washington Healthplanfinder to review and enroll in coverage. This year customers will find a total of 66 qualified health plans (QHP) from nine insurance providers – a 65 percent increase in QHPs from the 40 plans available last year. And, for the first time ever, a bronze plan offering will be available in every county in the state.

Back in early June, the Washington State Insurance Commissioner announced that preliminary rate filings for the ACA individual market in 2020 were averaging just 1.0% higher than this year. My own analysis brought the weighted average in at 1.4%, but whatever. The Small Group market requests also came in at an average increase of 6.7%.

A couple of days ago, the WA Insurance Dept. posted a press release with the final/approved rates for 2020, and they've managed to knock average premiums on the Individual market down by about 4 more points:

Kreidler approves record low average rate decrease of -3.27% for Exchange plans

Eight health insurers approved to sell in next year's Exchange marketplace

MLR rebate payments for 2018 are being sent out to enrollees even as I type this. The data for 2018 MLR rebates won't be officially posted for another month or so, but I've managed to acquire it early, and after a lot of number-crunching the data, I've recompiled it into an easy-to-read format.

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:

This Just In via the Washington State Insurance Commissioner's office...

Thirteen health insurers request record-low increase of less than 1%; Two new insurers join individual market in 2020

June 3, 2019

OLYMPIA, Wash. – Thirteen health insurers filed a record-low average proposed rate increase of 0.96% for the 2020 individual health insurance market. Also, two new insurers — PacificSource Health Plans and Providence Health Plan — are joining Washington’s market next year.

All 39 counties will have at least one insurer selling inside the Exchange, Washington Healthplanfinder.

via the Washington HealthPlanFinder (aka the Washington Health Benefit Exchange):

The Washington Health Benefit Exchange today released its Spring Health Coverage Enrollment Report detailing the more than 1.6 million customers – one in four Washingtonians – who used Washington Healthplanfinder to access their 2019 health insurance coverage.

Nearly 200,000 customers used the state’s online marketplace to purchase a Qualified Health Plan (QHP) for coverage this year, adding to the more than 1.4 million residents who connected with free or low-cost health insurance through Washington Apple Health. In several rural counties (Adams, Grant, Okanogan, Pacific and Yakima), nearly half of the population relied on Washington Healthplanfinder to enroll in a 2019 health insurance plan.

via the Washington Insurance Commissioner's Office:

OLYMPIA, Wash. – Gov. Jay Inslee today signed Insurance Commissioner Mike Kreidler’s request legislation to end surprise medical billing, enacting arguably the strongest law in the country to protect consumers from this unfair practice.

The new law protects consumers from getting a surprise bill when they get either emergency services at an out-of-network emergency room or medical treatment at an in-network hospital or facility but are seen by an out-of-network provider.

I haven't written about "Healthcare Sharing Ministries" as much as I should have. This is from my only substantive blog post about them 3 years ago:

A health care sharing ministry is an organization that facilitates sharing of health care costs between individual members who have common ethical or religious beliefs in the United States. A health care sharing ministry does not use actuaries, does not accept risk or make guarantees, and does not purchase reinsurance polices on behalf of its members.

Members of health care sharing ministries are exempt from the individual responsibility requirements of the Patient Protection and Affordable Care Act, often referred to as Obamacare. This means members of health care sharing ministries are not required to have insurance as outlined in the individual mandate.

A couple of weeks ago I wrote an extensive piece laying out what seemed, at first glance, to be a bona fide state-level Public Option bill quietly working its way through the Washington State legislature:

Democrats in Olympia push through governor’s 'green' agenda and public healthcare coverage bills

...Another key item on the governor’s agenda is the so-called “public option” socialized health care coverage measure, SB 5526. This bill would create subsidized state-funded public health plans managed by regulated insurance companies. It would require the State Insurance Commissioner and the Health Care Authority to set up the socialized plans by 2021.

,,,These plans would be available through the state’s health care exchange to all residents, but the state would pay subsidies to individuals with incomes of up to five times the poverty level. Premiums would be limited to no more than ten percent of adjusted gross income, and payments to doctors and other health care providers would be restricted to Medicare-level limits.

I don't know if I'm just asleep at the wheel when it comes to healthcare happenings in Washington State lately, but this one caught me by surprise as well:

Today I signed a bill that protects Affordable Care Act health care insurance practices in WA state. This bill assures Washingtonians that regardless of what happens in D.C., we’re protecting your access to care here here at home. #waleg #ACAhttps://t.co/e3g35Fch68

— Governor Jay Inslee (@GovInslee) April 17, 2019

From the official press release:

Back in January, 2nd-term Washington Governor and Democratic Presidential candidate Jay Inslee jumped fully onboard the Public Option train:

Inslee proposes ‘public option’ health-insurance plan for Washington

The proposal, which Inslee said is the first step toward universal health care, is geared in part to help stabilize the exchange, which has wrestled with double-digit premium increases and attempts by Republicans in Congress and President Donald Trump to dismantle the Affordable Care Act.

...The proposal would have the state Health Care Authority contract with at least one health-insurance carrier to offer qualified health coverage on the Washington Health Benefit Exchange, according to a summary of the proposal.

This Just In from the Washington State Insurance Commissioner's office...

Kreidler's bill to protect consumers from surprise billing passes Senate
April 10, 2019

OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler’s proposal to end the harmful practice of surprise medical billing passed the Senate today on a vote of 47 to 0. It now goes back to the House of Representatives for a concurrence vote before heading to the governor’s desk.

Second Substitute House Bill 1065 (www.leg.wa.gov) prevents consumers from getting a surprise bill when they seek either emergency treatment at an out-of-network emergency room or medical services at an in-network hospital or facility but are treated by an out-of-network provider.

The Washington Health Benefit Exchange today announced that more than 200,000 people purchased their 2019 health insurance coverage through Washington Healthplanfinder, the state’s online health insurance marketplace, during the most recent open enrollment period held Nov. 1 through Dec. 15 of last year.

Even with the four percent decrease in total number of enrollments reported from February of 2018, the Exchange saw more than 90 percent of those who selected a 2019 health plan during the open enrollment period make their initial premium payment.

A 4% drop may sound bad, but total QHP selections during OE6 were actually down 8.3% year over year (from 243K to 223K), so this is actually an improvement in that sense. 90.5% of those who selected policies are still effectuated as of February this year vs. 86.4% as of February in 2018.

Something is definitely in the water this week, and I believe it's called "Democrats hitting their stride on healthcare reform":

And now, this:

Gov. Jay Inslee and Democratic lawmakers Tuesday announced proposed legislation for a new “public option” health-care plan under Washington’s health-insurance exchange.

The proposal, which Inslee said is the first step toward universal health care, is geared in part to help stabilize the exchange, which has wrestled with double-digit premium increases and attempts by Republicans in Congress and President Donald Trump to dismantle the Affordable Care Act.

“We are proposing to the state Legislature that we have a public option that is available throughout the state of Washington so that we can increase the ability to move forward on the road to universal health care in the state of Washington,” said the governor, who is considering a run for president in 2020.

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