Wisconsin

Gold Bars

NOTE: This is an updated version of a post from a couple of months ago. Since then, there's been a MASSIVELY important development: The passage of the American Rescue Plan, which includes a dramatic upgrade in ACA subsidies for not only the millions of people already receiving them, but for millions more who didn't previously qualify for financial assistance.

Much has been written by myself and others (especially the Kaiser Family Foundation) about the fact that millions of uninsured Americans are eligible for ZERO PREMIUM Bronze ACA healthcare policies.

I say "Zero Premium" instead of "Free" because there's still deductibles and co-pays involved, although all ACA plans also include a long list of free preventative services from physicals and blood screenings to mammograms and immunizations with no deductible or co-pay involved.

Much has been written by myself and others (especially the Kaiser Family Foundation) about the fact that millions of uninsured Americans are eligible for ZERO PREMIUM Bronze ACA healthcare policies.

I say "Zero Premium" instead of "Free" because there's still deductibles and co-pays involved, although all ACA plans also include a long list of free preventative services from physicals and blood screenings to mammograms and immunizations with no deductible or co-pay involved.

If you have a fairly healthy year, you really could go the entire year without paying a dime in healthcare costs while still taking advantage of many of these free services, and also having the peace of mind that in a worst-case scenario, at least you wouldn't go bankrupt. Not perfect, but a lot better than going bare especially since you wouldn't pay a dime in premiums.

I don't know if this is an industry trend, a state regulator trend or new policies being implemented by CMS, but it seems that either more health insurance carriers have been redacting their Actuarial Memos and/or not uploading their URRT files to the publicly-accessible SERFF database or the state insurance departments, SERFF database and/or CMS's Rate Review database aren't posting as many of them publicly.

Case in point, Wisconsin: I have the average requested 2021 premium rate filings for every carrier on the individual and small group markets...but the actuarial memos are all redacted and none of the URRTs are available at all, making it impossible for me to run a weighted average since I don't know how many enrollees each carrier has. Also, for the second year running, Compcare Health Services doesn't appear in CMS's Rate Review database at all for reasons unknown.

A few weeks ago, I posted a detailed analysis of how the COVID-19 virus has been spreading throughout Wisconsin. I noted that while the outbreak originally spread quickly in the more urban/blue-leaning areas, that has gradually changed over time, with the virus spreading to the rest of the state--including rural, conservative-leaning areas--at a faster rate while it slowed down in the urban areas.

It's time to check in to see whether that trend has continued...and sure enough, it has. Here's what this trend looks like visually:

For weeks now, I've been tracking the daily COVID-19 numbers at the county level in several states; particularly Michigan, Wisconsin and Pennsylvania. While the pandemic hit the more densely-populated areas first (which tend to lean Democratic), the trendlines in Michigan and Wisconsin have been clearly moving towards the more rural, Republican-leaning counties increasing their share of the cases and corresponding deaths as time has passed.

Pennsylvania has been different--after a less dramatic shift from blue to red counties in late March, PA seems to have levelled off, with new cases holding pretty steady between the two.

It's been another week, so I figured I should post and update...and it's more of the same in all three cases. First up, Michigan:

Yesterday I had a lengthy post in which I noted that the claims by certain Republicans/"MAGA" types that the COVID-19 pandemic was limited to "blue" areas and "big cities" (wink, wink) is quickly unraveling...at least here in Michigan.

Today, I've run the numbers and put together similar Red/Blue and Urban/Rural breakouts for another extremely closely-watched swing state: Wisconsin.

For Michigan, I was able to separate out the City of Detroit itself from the rest of Wayne County. I also included the wider "Metro Detroit Area", which consists of both Oakland and Macomb County along with the part of Wayne County outside of Detroit.

I'm a lot less familiar with Wisconsin, and they don't break out Milwaukee separately anyway, so I went with Milwaukee County, Dane County (which includes the 2nd largest city in the state, Madison), and the Rest of Wisconsin. Here's what the breakout of COVID-19 cases has looked like over time. Once again, it's really only relevant after the state reached 100 cases:

Louisiana's 2020 Presidential primary was scheduled for April 4th, but the other day Democratic Governor John Bel Edwards and Republican Secretary of State Kyle Ardoin agreed to reschedule it for June 20th...which is actually later than the last previously-scheduled primary in the U.S. Virgin Islands on June 6th:

The presidential primary elections in Louisiana slated for April will be delayed by two months, the latest in a series of dramatic steps government leaders have taken to slow the spread of the new coronavirus.

Secretary of State Kyle Ardoin, Republican, and Gov. John Bel Edwards, a Democrat, both said Friday they would use a provision of state law that allows them to move any election in an emergency situation to delay the primary.

The presidential primary elections, initially scheduled for April 4th, will now be held June 20th. Ardoin said in a press conference he does not know of any other states that have moved elections because of the new coronavirus, or COVID-19.

I posted Wisconsin's preliminary 2020 rate filings in early August. Yesterday the state insurance department posted this press release, which includes the final, approved rate changes. As far as I can tell, nothing has changed (the final statewide weighted average is a 3.2% average premium reduction over last year, thanks primarily to them implementing a fairly robust ACA Section 1332 reinsurance waiver:

​Gov. Evers Announces More Health Insurance Options for Wisconsinites in 2020 Ahead of Open Enrollment

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:

I feel kind of stupid posting this in the aftermath of not one, but two massacres in El Paso, TX and Dayton, OH (at least one of which was a clear case of white nationalist terrorism inspired and encouraged by Donald Trump), but I was bout 80% done with this last night and this is part of my job, so here it is.

Wisconsin Governor Tony Evers posted the following press release:

Gov. Tony Evers today announced that 2020 rates on Wisconsin’s individual health insurance market will be 3.2 percent lower on a weighted average compared to 2019 rates. This encouraging news further demonstrates that the individual market is stabilizing and Wisconsin residents are able to access more affordable coverage options.

The rate decrease also highlights the positive impact of that the Wisconsin Healthcare Stability Plan (WIHSP), or the state’s reinsurance program, is having on the individual market. WIHSP was fully funded in the recently signed 2019-2021 state biennial budget. Without the WIHSP, rates in the individual market were expected to increase by 9 percent in 2020.

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