OK, this one caught me by surprise. I'm not sure how I missed it last fall, but back in October of last year, around the same time CMS Administrator released her proposal to turn the ACA's 1332 Waiver rules into a complete joke, Trump's IRS, Labor and HHS Dept. got together and came up with this proposal for opening up the rules on Health Reimbursement Arrangements for employer-based healthcare coverage:

Last year individual market carriers here in my home state of Michigan only raised premiums 1.7% on average in 2019, with Oscar Insurance Co. being a new addition to the market. For 2020, they're reducing average premiums by about 2.0%. Oscar made very little headway in their debut year, only enrolling 649 people statewide.

On the surface, it looks like Michigan's total ACA-compliant individual market has plummeted by a whopping 18% (281K vs. 344K last year). However, this can be misleading because the enrollment numbers listed each year only include the number of enrollees actually impacted by the rate changes. For instance, if a carrier pulls out of half the state, then a chunk of their current total enrollment won't be listed since enrollees in that half aren't seeing their current premiums change...they'll be losing coverage altogether and will have to switch to a different carrier.

A couple of weeks ago I noted that Louisiana Governor John Bel Edwards, a Democratic governor in a pretty red state, was trying to take whatever measures he could to provide ACA protections at the state level in case the insane federal "Texas Fold'em" lawsuit against the ACA ends up tearing down the entire law:

On Tuesday, May 21, Governor John Bel Edwards issued an executive order launching the Protecting Health Coverage in Louisiana Task Force after efforts to have protections offered to Louisianans with preexisting conditions repealed.

 

There's another Congressional healthcare hearing going on right now as well, this time in the House Energy & Commerce Committee; this one is on Surprise Billing:

HEARING ON “NO MORE SURPRISES: PROTECTING PATIENTS FROM SURPRISE MEDICAL BILLS”

The Subcommittee on Health of the Committee on Energy and Commerce will hold a legislative hearing on Wednesday, June 12, 2019, at 10 a.m. in the John D. Dingell Room, 2123 of the Rayburn House Office Building.  The hearing is entitled, “No More Surprises: Protecting Patients from Surprise Medical Bills.”  

Key Documents

The New Mexico Office of the Superintendent of Insurance website just posted the preliminary 2020 insurance rate filings. Here's the full list, which includes a mish-mash of Individual Market, Large Group and Small Group Market policies, with a Pediatric Dental standalone plan thrown in as well.

It's worth noting that the NM carriers are being very careful to separate out on & off-exchange policies into separate listings even though they're all part of the same risk pool, and they're even separating out off-exchange "Mirrored" policies, which refers to CSR Silver Switching; this is a very good thing.

I've cleaned up the listings and plugged in the weighted average rate increases in the table below this one:

 

via Delaware Business Now:

Legislation calls for reinsurance program to aid people with extremely high health insurance premiums

Lawmakers have introduced legislation this week that would create a reinsurance program to help lower the cost of premiums for Delawareans who do not get insurance through their employers.

House Bill 176, which has no Republican co-sponsors, would stabilize the individual health insurance market and help Delawareans struggling with extremely highhealthcare costs to get relief, a release from House Democrats stated.

Last week I noted that Pennsylvania is joining Nevada, New Mexico, New Jersey and (apparently) Oregon in moving away from the federal ACA exchange mothership known as HealthCare.Gov:

Pennsylvania moves to take over health insurance exchange

Pennsylvania is moving to take over the online health insurance exchange that’s been operated by the federal government since 2014, saying it can cut health insurance costs for the hundreds of thousands who buy the individual Affordable Care Act policies.

...The bill is backed by Gov. Tom Wolf, a Democrat, and his administration says it would make two important changes to reduce premiums for the 400,000 people who purchase health insurance through the Healthcare.gov online marketplace.

A week or so ago I reported that New Jersey is moving forward with fourteen bills related to protecting, repairing and improving the ACA at the state level...including several related to the state's transitioning to their own full state-based ACA exchange.

Today, Lilo Stainton of the New Jersey Spotlight reports that while things are proceeding smoothly for the most part, at least one of the bills is causing a few concerns:

Earlier today I noted that RateReview.HealthCare.Gov, which is a public-facing searchable database for annual health insurance policy premium rate changes, has gone through some updates on the ACA-Compliant side.

I also noted that the other section of the database, which tracks non-ACA compliant rate changes for "Transitional Plans" and "Student Plans", may have had some updates as well, but it's hard to say since I've poked around there so rarely. This morning I decided to rectify that by searching through the entire Transitional/Student plan database and compiling the results. Unlike the ACA side, there's no way of filtering it out by year, so the following table includes every rate change filing entry listed...and the results surprised me:

Warning: There's perhaps 100 people on the planet who'll have any interest in this post. Fortunately, most of those 100 people read this site regularly.

Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease. There are hundreds of insurance carriers nationally, with dozens of forms apiece, some of which follow no hard formatting guidelines, and most of which are revised at least once over the course of the spring, summer and fall before being locked in for the upcoming open enrollment period. It's a pretty imposing task.

Regular readers know that I occasionally write freelance blog posts for healthinsurance.org.

In my latest post, I revisited a project which I originally took a crack at last year: Attempting to track every action or legislation introduced, voted on, passed, signed and implemented by every state to protect, repair and/or improve the Affordable Care Act.

At the time I was trying to list the actual legislation and every change in status from start to finish (including bills which died in committee, faile in one house or the other, were vetoed, etc). I quickly discovered that it was next to impossible to keep up with all of that.

This time I took a simpler approach--I only list bills or executive orders which have either been fully approved/implemented or which are pending/in progress. I do plan on going back to updating the spreadsheet, however.

As I noted the other day, some of my blog posts don't have any insight to add, they're purely for aggregating data points. This is one of those posts.

Here's the Connect for Health Colorado May enrollment dashboard report. It doesn't provide much detail, and it's kind of fuzzy/hard to read, but I do like the way it shows both QHP selections (that is, how many people selected exchange policies) as well as effectuated enrollments from month to month.

Remember, around 10% of those who select plans never end up actually paying the first month's premium, and are thus never actually enrolled...and there's some amount of churn after that as people drop their coverage mid-year and new people enroll via Special Enrollment Periods. Then the whole process starts over again the following January.

As a result, you see a gradual divergence between QHP selections increasing and effectuated enrollments decreasing throughout the year...only to reset in January of the next year.

Over the past year or so I've written numerous entries about Michigan Republicans pushing through an ineffective, inefficient, cruel and pointless work requirement addition to Michigan's implementation of Medicaid expansion under the Affordable Care Act, culminating in this one:

New work requirements for people in Michigan's Medicaid expansion group could cause as many as 183,000 people to lose their coverage.

Anywhere between 9 and 27 percent of the approximately 680,000 people enrolled in the Michigan Healthy Plan - or 61,000 to 183,000 recipients - could be kicked of the rolls.

That's up to three times what was estimated by the House Fiscal Agency when the work requirement bill was passed last year. The work requirements are scheduled to take effect on January 1, 2020.

Sometimes I don't have anything particularly useful to add to a data point. New Hampshire is one of the very few states which don't operate their own ACA exchange which does keep track of (and, more importantly, report) ACA exchange enrollment on a regular basis, via a monthly report.

New Hampshire enrolled 44,581 people in individual market QHPs during open enrollment this year, so the 40,728 enrolled as of May shows an impressive 91% retention rate.

Their SHOP enrollment is around ~1,300 people working for ~230 small businesses.

Pages