Massachusetts: APPROVED 2019 #ACA rate hikes: "less than 5.0%" (NO 2018 #ACASabotage impact for obvious reasons)

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

This Just In...

Ready for Open Enrollment, Health Connector sets 2019 plans with lower premium increases, selects community organizations to provide in-person support to residents

Boston – September 13, 2018 – The Massachusetts Health Connector Board of Directors today approved 57 Qualified Health Plans from nine carriers for individuals and families, with new plan designs that create better value for members and premium increases that average under 5 percent from 2018.

Unfortunately, the press release doesn't specify what "under 5%" means, nor does it break that out by carrier/market share. I've put in a request for those details and will update this as soon as I hear back from them. They sent me the following chart, but this only includes enrollees earning between 300-400% of the Federal Poverty Level, which means the marketshare across the entire individual market is likely somewhat different. I'm assuming the 4.4% overall average applies to the entire market but could be wrong about that as well:

My previous estimate for Massachusetts based on the requested rate hikes was 4.1%, so the odds are that the approved average increase will end up being slightly higher than I thought, but not by enough to move the needle more than a smidge.

Also during today’s meeting, the Health Connector announced 16 community groups from around Massachusetts have been selected as Navigators organizations. Their staff use their experience and knowledge to help people get covered and stay covered, both during Open Enrollment and throughout the year.

Finalizing the carriers and plans, and selecting Navigator organizations, are part of the process of preparing for Open Enrollment. 2019 Open Enrollment starts Nov. 1 and runs through Jan. 23, 2019, and is the time when anyone without health insurance can sign up for coverage, and people with existing coverage can make changes for the New Year.

“Through expanded plan offerings and an overall commitment to making health insurance more affordable, we are confident our members will have an Open Enrollment shopping experience that provides valuable options,” said Louis Gutierrez, the Executive Director of the Massachusetts Health Connector. “One of the reasons Massachusetts remains the national leader in health care access, with 97 percent of our residents covered, is because of the great work our Navigator organizations do reaching out to their communities and sitting down directly with their clients and ensuring they have strong health insurance.”

Since initiating state-based health care reform in 2006 and implementing the Affordable Care Act, Massachusetts has been a national leader in creating opportunities for residents to gain access to affordable coverage, with the highest insured rate in the nation at 97 percent, the lowest 2018 average Exchange premiums in the country according to the Centers for Medicare and Medicaid Services, and being the healthiest state in the nation according to the United Health Federation and American Public Health Association.

Yes, that's right: As shocking as it may seem to those who assume that everything is wicked expensive in "Taxachusetts", it turns out that Massachusetts' $383/month average unsubsidized monthly premium is the lowest in the country (the 2nd lowest is a tie between Rhode Island and the District of Columbia...both of which are a) part of New England and b) solidly Democratic. Imagine that.)

Even more amazing: Massachusetts will continue to have the lowest average unsubsidized ACA market premiums in the country next year even with some states lowering their rates. If 4.4% is accurate, average MA premiums will increase to $400/month even; even at 5.0% they'd only average $402/month, well below Rhode Island's $451/month average.

Moving forward into 2019 Open Enrollment, the plans approved today include a new category of plans, called “Low Gold” in the Health Connector’s metallic tier ordering of plans. The new plans generally offer richer benefits than Silver plans, but in some cases may have lower premiums.

The Health Connector also will make changes to its ConnectorCare plan structure to improve program stability and make more plans affordable for members. In almost every part of the state ConnectorCare members will have at least two options at the lowest cost in each Plan Type.

Small business owners will experience the same premium changes as the individual market. In November 2017, the new Health Connector for Business platform launched, providing small businesses a new way to compare and shop for health insurance, while also providing options for employees to pick their own plans.

For members or new applicants, Navigator organizations offer in-person assistance, with a total of 94 people from the organization providing help in 15 languages. During 2019 Open Enrollment, Navigators will play an important role in the Health Connector’s #StayCovered campaign, reminding Massachusetts residents that the state’s individual mandate remains in place, even as federal penalties for not having coverage disappear in 2019. Navigators help more than 100,000 people a year get or keep health insurance.

Additionally, the Health Connector is also contracting with Health Care For All for a new Marketplace Awareness Program, a statewide initiative designed to increase awareness around ongoing state-based policy such as the Massachusetts individual mandate, which requires resident have coverage that meets state standards or face a financial penalty.

Yes, that's right: Massachusetts doesn't have to worry about Congressional Republicans repealing the ACA's individual mandate penalty...because they still have their own mandate penalty...the one which the ACA's penalty was based on in the first place.

Massachusetts never repealed their own penalty, they just sort of mothballed it once the ACA's went into effect...and now that the ACA penalty has been repealed, they're simply dusting theirs off and firing it back up again starting in 2019.

In addition, I believe that Massachusetts' precursor to the ACA, "Romneycare", pretty much made "short-term" and "association" plans moot at the state level, so none of the Trump/GOP sabotage efforts this year should have any negative impact on the risk pool...and therefore, on 2019 premium rates.

Navigators for 2019 and 2020 Open Enrollment

  • Boston Public Health Commission, $136,279
    • Seven individuals will serve as Navigators, providing assistance in the following languages: English, Spanish, Cape Verdean Creole, Haitian Creole, French, and Portuguese.
  • Cambridge Economic Opportunity Commission, $89,775
    • Six individuals will serve as Navigators, providing assistance in the following languages: English, Spanish, Haitian Creole, French, Amharic, and Portuguese.
  • Caring Health Center (Springfield), $182,942
    • Six individuals will serve as Navigators, providing assistance in English, Spanish, and Arabic.
  • Community Health Center of Franklin County (Greenfield), $47,822
    • Two individuals will serve as Navigators, providing assistance in English.
  • Community Action Committee of Cape Cod & Islands (Hyannis), $106,969
    • Four individuals will serve as Navigators, providing assistance in English, Spanish, and Portuguese.
  • Ecu-Health Care (North Adams), $50,000
    • Three individuals will serve as Navigators, providing assistance in English.
  • Edward M. Kennedy Community Health Center (Framingham and Worcester), $120,000
    • This is a new Navigator organization, with 15 individuals serving as Navigators and providing assistance in English, Spanish, and Portuguese.
  • Family Health Center of Worcester, $182,000
    • Ten individuals will serve as Navigators, providing assistance in the following languages: English, Albanian, Greek, Spanish, Portuguese, Berber, Arabic, French, German, Italian, Sango, and Kaba.
  • Fishing Partnership Support Services (North Shore, South Shore, Cape Cod and SouthCoast), $100,000
    • Seven individuals will serve as Navigators, providing assistance in English, Portuguese, and Italian.
  • Greater Lawrence Community Action Council, $131,905
    • Four individuals will serve as Navigators, providing assistance in English and Spanish.
  • HealthFirst Family Care Center (Fall River), $100,000
    • This is a new Navigator organization, with two individuals serving as Navigators and providing assistance in English, Portuguese, Spanish, and Cape Verdean Creole.
  • Hilltown Community Health Center (Huntington), $45,779
    • Two individuals will serve as Navigators, providing assistance in English.
  • Joint Committee for Children’s Health Care in Everett, $123,000
    • Eleven individuals will serve as Navigators, providing assistance in English, Portuguese, Italian, Spanish, Haitian Creole, and French.
  • Manet Community Health Center (Quincy), $97,650
    • Six individuals will serve as Navigators, providing assistance in the following languages: English, Arabic, Vietnamese, Haitian Creole, Portuguese, French, and Italian.
  • PACE (People Acting in Community Endeavors, New Bedford), $97,513
    • Four individuals will serve as Navigators, providing assistance in English, Spanish, Portuguese, and Creole.
  • Vineyard Health Care Access, $45,004
    • Five individuals will serve as Navigators, providing assistance in English, Spanish, and Portuguese.