Ohio

It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

The Ohio Insurance Department does this weird thing where they list all of the carriers offering policies on the individual market and list the weighted average year over year premium change...but they don't list the actual rate increases for each carrier. Fortunately, federal Rate Review site includes the rate changes, and the SERFF database for Ohio includes the actual enrollment numbers for all of the individual market carriers.

As a result, I've been able to put together a weighted average requested rate increase for the individual market, which comes in at +3.9%.

For the small group market, I have to go with an unweighted average of +12.0%. It's also worth noting that it looks like one of Aetna's divisions is pulling out of the OH small group market, as are two fof the 4 (!) UnitedHealthcare divisions and possibly AultCare, although I'm not sure about that one.

The Ohio Insurance Department does this weird thing where they list all of the carriers offering policies on the individual market and list the weighted average year over year premium change...but they don't list the actual rate increases for each carrier. Fortunately, federal Rate Review site includes the rate changes, and the SERFF database for Ohio includes the actual enrollment numbers for all of the individual market carriers except one.

As a result, I've been able to put together a weighted average requested rate increase for the individual market (I estimated the one missing enrollment number based on the overall Ohio indy market total); it comes in at 7.6%.

For the small group market, I have to go with an unweighted average of +10.8%. It's also worth noting that, once again, Humana appears to be bailing on the entire small group market nationally from what I can tell.

UPDATE 10/31/23: The Ohio Insurance Dept. has posted a summary of the weighted average rate increase for the individual market as being slightly higher than the preliminary requests (+7.8% vs. 7.6%):

Premiums for 2024 are projected to increase compared to 2023 - though individual companies' rates will vary from the average.

Weighted average annual premiums for the individual market for 2024 are projected to be $7,010.20. In 2023 weighted average annual premiums were $6,500.65. - an increase of 7.84%.

The final/approved rates are also now posted at the federal Rate Review website...and they've barely changed at all. Yet the official weighted average is slightly higher than I had estimated earlier.

The same is true of the small group market...only 2 carriers (Medical Mutual and Paramount) had their requested changes modified, and even then it was only by a hair apiece.

Over on Twitter, political commentator Krystal Ball made an interesting claim:

A provision in Obamacare allows residents in areas deemed a public health disaster to be covered by Medicare for life. At the very least, East Palestine residents deserve this universal coverage after being exposed to a known carcinogen. https://t.co/ooPYmJ4Y8b

— Krystal Ball (@krystalball) February 21, 2023

What she's referring to is an obscure & fascinating nugget buried in the Patient Protection & Affordable Care Act: Section 10323, which states:

SEC. 10323. MEDICARE COVERAGE FOR INDIVIDUALS EXPOSED TO ENVIRONMENTAL HEALTH HAZARDS.

(a) In General.--Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is amended by inserting after section 1881 the following new section:

``SEC. 1881A. <<NOTE: 42 USC 1395rr-1.>> MEDICARE COVERAGE FOR INDIVIDUALS EXPOSED TO ENVIRONMENTAL HEALTH HAZARDS.

via the Centers for Medicare & Medicaid Services:

• An estimated additional 34,000 people are now eligible for essential care for a full year after pregnancy, thanks to the American Rescue Plan and the Biden-Harris Administration’s efforts to strengthen maternal health coverage.

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy in Hawaii, Maryland, and Ohio. As a result, up to an additional 34,000 people annually – including 2,000 in Hawaii; 11,000 in Maryland; and 21,000 in Ohio – will now be eligible for Medicaid or Title XXI-funded Medicaid expansion CHIP coverage for a full year after pregnancy. With today’s approval, in combination with previously approved state extensions, an estimated 318,000 Americans annually in 21 states and D.C. are eligible for 12 months of postpartum coverage. If all states adopted this option, as many as 720,000 people across the United States annually would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.

The Ohio Insurance Department does this weird thing where they list all of the carriers offering policies on the individual market and list the weighted average year over year premium change...but they don't list the actual rate increases for each carrier.

For the small group market I don't think they even do that; I have to rely on the federal Rate Review site, which almost never provides enrollment data.

Fortunately, for the indy market at least, all of the requested rate filings are available via the SERFF database, along with enrollment figures for 9 of the 10 carriers in the market. For the tenth (AuitCare), I used an estimate based on last years' hard number. Unfortunately, I still don't know the approved rates for any of them, but it looks like the state regulators chopped them down somwhat, since the weighted average comes in at 4.8% vs. the requested 8.4% statewide.

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.

For Ohio, I'm relying on raw data from the Ohio Dept. of Medicaid for January 2021 and later.

 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 Ohio:

• 2020 Presidential Election results via OH Secretary of State's office (thru Wikipedia)

• Vaccination data via Centers for Disease Control database

NOTE: The CDC lists ~111,000 Ohio residents (2.4% of the total fully vaccinated) whose county of residence is unknown.

Hmmm...on the one hand, this summary of the 2021 ACA individual market rate filings from the Ohio Insurance Dept. would appear to be pretty straightforward:

The sections below include a summary of Ohio’s individual market for 2021.  The data is based on product filings the Ohio Department of Insurance is currently reviewing.

Ohio’s Health Insurance Market 2021

For 2020, the department approved 10 companies to sell on the exchange. Based on the plan information the department approved, most counties had at least three insurers.  29 counties had two insurers, and just one county had only one insurer.

For 2021, the department approved those same 10 companies to sell on the exchange.  Based on those filings, all counties will have at least two insurers and all but 10 counties will have three or more insurers. 

Companies Who Have Filed to Sell in 2021

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.