END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

2018 Open Enrollment Quick Links


*(OK, six, anyway)

Here's something refreshing: U.S. Senator Angus King (I-ME) giving a floor speech in which he lays out at least a half a dozen different types of deliberate sabotage of the ACA's upcoming 2018 Open Enrollment Period by the Trump Administration to date. Start at 4:30:

On Senate Floor, King Discusses “Sabotage” of the Affordable Care Act
“Why does anyone want to have fewer people with insurance?”

WASHINGTON, D.C. – U.S. Senator Angus King (I-Maine) today spoke on the floor of the U.S. Senate to address threats to the Affordable Care Act’s healthcare marketplace.

“I’m rising today in sadness, but also in some anger because there’s a lot of talk about the Affordable Care Act collapsing,” said Senator King in his speech. “Mr. President, it is not collapsing – it’s being mugged. It’s being stabbed in the back. It’s being sabotaged, deliberately and consciously by the actions of the Administration. And I want to emphasize – this isn’t about ideology, it’s not about politics… this is about people.

Back in July, I had originally estimated the requested rate increases for New Mexico to average roughly 24.2% with partial Trump Administration sabotage or 37.2% with full sabotage (no CSR payments, full mandate enforcement threat). However, figuring out NM's approved rate hikes is proving to be frustrating.

On the one hand, they have a handy database lookup tool right there on the NM Insurance Dept. website, and they even have the actual premium amount listings for every plan from every carrier in every rating area available. Unfortunately, the premium listings don't give a year over year comparison (or an average percent increase), and the database tool seems not to have been fully updated as of this writing, making it kind of useless. I have some info for a couple of the individual carriers but even that's a bit confusing.

To the best of my knowledge, there are only 2 insurance carriers offering ACA-compliant insurance policies in Arizona next year: Blue Cross Blue Shield of AZ and Centene (branded as HealthNet).

Back in early August, BCBSAZ announced that they were asking for a relatively modest 7.2% rate increase next year in the 13 counties (out of 15 total) where they were offering individual plans. They also explicitly stated that if it weren't for their concerns over whether or not the Trump Administration would guarantee reimbursing their CSR expenses, they'd be keeping the 2018 rates flat year over year. Granted, this is after a massive rate increase for 2017, but it was still welcome news, and once again underscored how much damage the Trump sabotage factor is.

UPDATE: The Center on Budget and Policy Priorities has issued their own more detailed analysis which adds substantially to my concerns.

Three days after allowing Children's Health Insurance Program funding to run out for 9 million kids across America, House Republicans are supposedly working on a bill to lock in 5 full years of funding for the program, along with a substantial initial funding infusion to help out Puerto Rico after the devastation of Hurricane Maria:

Republicans on a leading House health-care committee are proposing to send $1 billion in extra Medicaid funding to Puerto Rico as it deals with severe hurricane damage, as part of a five-year plan to fund the federal health insurance program for children.

In a year when every state's 2018 Open Enrollment situation is messy to say the least, Minnesota's is far more so:

  • Last year they were facing massive rate hikes, especially for unsubsidized enrollees (yeah, I know, I know, don't say it), and came very close to having all of their carriers bail
  • In response, they agreed to let most of them put a maximum enrollment cap on a First Come First Serve, with Blue Plus (BCBSMN) agreeing to take the "overflow".
  • However, the unsubsidized individual market enrollees were royally screwed, so the state legislature and governor slapped together a special, one-time 25% premium rebate specifically for them. The money came directly out of other portions of the state general fund, I believe. MNsure, the state exchange, also added an extra 8-day special enrollment period for these folks to jump in and get in on the rebate.

The Maryland Health Connection is now allowing residents to comparison shop for 2018:

View 2018 health insurance plans and prices now!

MarylandHealthConnection.gov has already been loaded with plans and prices for 2018, one month before open enrollment begins. The upcoming open enrollment period will run November 1 - December 15. Health coverage will start on January 1, 2018.

  • How do I get an estimate for 2018 health insurance plans?

You can compare plans and prices through a desktop computer browser or by downloading our mobile app, Enroll MHC, on your iPhone or Android.

Click on “Get Started”- this will take you to the application portal. Next, click “Get an Estimate” on the application site. Finally, enter basic information like your county, age and income to see what coverage and financial help you may qualify for. If you choose to get an estimate, the site will take you through a scenario of what plans and pricing you could receive for 2018. You won’t actually be applying for coverage.

About a month ago, Colorado was among the first states to release their approved 2018 individual market rate hikes. At the time, the average unsubsidized rate increases assuming CSR payments are guaranteed for all of 2018 averaged around 26.7% statewide.

As for CSR payments not being made, however, the press release accompanying the rate tables was more vague; it stated that they would be "up to" 14 points higher, but didn't clarify whether that would apply to every individual plan or only the Silver policies, which is how most other states appear to be handling it. I assumed the "no-CSR" average would be roughly 32.9% if the load is only dumped on Silver plans, but 40.7% if spread across all metal levels.

More recently, Louise Norris (who lives in Colorado herself) gave me the bad news: That "up to 14 points" is being spread across everything:

Your Health Idaho just sent out the following press release:

Preview Health and Dental Plans on Your Health Idaho
Shorter Enrollment Period November 1 - December 15

BOISE, Idaho – Today, Idahoans can get a preview on YourHealthIdaho.org of the 299 health and dental insurance plans being offered on the exchange in 2018, and how much help may be available to them.

“Insurance rates will be higher next year, but tax credits will increase to keep pace. Idahoans are often surprised at how much they can save on their health insurance through the exchange. “By going online now, consumers can check to see if they are eligible for tax credits to lower the cost of premiums,” said Pat Kelly, Your Health Idaho executive director. Consumers can take the savings information to comparison shop for the right plan.

 

Over the years I've repeatedly pointed out the importance of NOT simply "autorenewing" your policy. Yes, it's convenient (you don't have to do anything!), but you could be hit with a nasty pricing shock even if nothing has changed at your end (that is, even if your household size, income, etc has stayed the same). Even if your current policy is still available, due to the way APTC subsidies are calculated, you could see your financial assistance drop substantially or increase substantially from year to year...and there may be a better deal available even if there wasn't last year. ACTIVELY SHOP AROUND.

As David Anderson points out, that advice will be especially important this year, due to the CSR Silver Switcharoo/Gold Gap scenario:

I don't have much to add except the following:

  • Regardless of the shooter's supposed "motivation", this was a terrorist act, plain and simple.
  • Whatever purpose the NRA may have once had, it no longer serves any function other than aiding & abetting terrorism.

The Idaho Insurance Dept. has made things pretty easy for me. While they don't break out the individual market enrollment numbers by insurance carrier, they do provide the statewide, weighted average of those enrollees: 27% approved vs. the 38% average which was requested  requested (assuming no CSR reimbursement payments)

Now that we've passed the 9/27 contract signing deadline for 2018 carrier participation on the ACA exchanges, the state insurance departments are posting their approved final rates pretty quickly. Arkansas has done a fantastic job of clearly laying out not just what the rate changes will be, but is explicitly stating how much of those increases are due to the GOP's refusal to formally appropriate CSR reimbursement payments next year:

Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Arkansas Insurance Department for review and approval before plans can be sold to consumers.  The Department reviews rates to ensure that the plans are priced appropriately.  Under Arkansas Law (Ark. Code Ann. § 23-79-110),  the Commissioner shall disapprove a rate filing if he/she finds that the rate is not actuarially sound, is excessive, is inadequate, or is unfairly discriminatory.  The Department relies on outside actuarial analysis by a member of the American Academy of Actuaries to help determine whether a rate filing is sound.

Louise Norris has been saving me the trouble of digging up/writing up the approved rates in several states...

Insurance Commissioner approves rates insurers filed for 2018; Cost to cover CSRs has been added to silver plan premiums

On September 20, the Tennessee Department of Insurance and Commerce (TDIC) announced that the state had approved the rates that insurers had filed for 2018. However, the announcement indicated that Cigna’s approved average rate increase was 42.1 percent, which was based on the filing Cigna submitted in June 2017. An updated filing, with an average rate increase of 36.5 percent, was submitted in August, and TDIC confirmed by phone on September 21 that the updated filing was approved. The slightly smaller rate increase is due to Cigna’s decision to terminate some existing plans and replace them with new plans).

The following average rate increases were approved for 2018 individual market coverage:

This just in...

New Mexico Health Connections, the nonprofit co-op insurance company formed under the Affordable Care Act, is selling its small group and commercial business to a for-profit company under a restructuring plan that will create a new insurance company that will be able to go after business the struggling nonprofit couldn’t.

...The Washington, D.C.-based Evolent will acquire NMHC’s 22,000 commercial members. NMHC will continue to exist with a few employees and presumably continue to sell individual policies on the New Mexico Health Insurance Exchange. NMHC has 10,000 individual members through the insurance exchange.

...Hickey told ABQ Free Press that the deal will allow the new firm to go after business that NMHC couldn’t, things like Medicare Advantage, federal employees and, eventually, Medicaid. It also gives the new firm capital reserves that NMHC didn’t have, he added.

In August I wrote that the situation in North Dakota was pretty straightforward: Three carriers on the individual exchange (BCBS, Medica and Sanford), requesting average rate hikes of around 24%, 19% and 12% respectively for an average increase of 23% assuming CSR payments are made, or a bit higher (28%) if they aren't.

Yesterday, however, with the final contract signing deadline having passed on the 27th, Louise Norris reports that one of the three carriers, Medica, was forced to drop out of the market at the last moment...not because they wanted to, but because the ND insurance dept. insisted on carriers pricing 2018 premiums on the assumption CSRs will be paid for the full year.

Medica understandably refused to take that risk (the odds of CSRs being guaranteed are virtually nil, and the odds of them being paid each and every month, as they're supposed to, is only so-so), so they dropped out instead.

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