20 states went the full #SilverSwitcharoo route (the best option, since it maximizes tax credits for those eligible for them while minimizing the number of unsubsidized enrollees who get hit with the extra CSR load);
16 states went with partial #SilverLoading (the second best option: Subsidized enrollees get bonus assistance, though not as much as in Switch states; more unsubsidized enrollees take the hit, but they aren't hit quite as hard);
6 states went with "Broad Loading", the worst option because everyone gets hit with at least part of the CSR load except for subsidized Silver enrollees;
6 states took a "Mixed" strategy...which is to say, no particular strategy whatsover. The state insurance dept. left it up to each carrier to decide how to handle the CSR issue, and ended up with a hodge podge of the other three
3 states (well, 2 states + DC, anyway) didn't allow CSR costs to be loaded at all. Their carriers have to eat the loss, which makes little sense, but what're ya gonna do?
Louise Norris is an awesome source for all sorts of healthcare policy/insurance data, but she's especially on top of developments in her home state of Colorado, where she and her husband Jay run a small brokerage outlet.
Today Jay and Louise have a couple of interesting tidbits out of The Centennial State (yeah, I had to look up their nickname myself).
That's (sort of) an 88% retention rate through early May. I say "sort of" because this presumably includes some amount of churn (if 100 people drop coverage and 100 off-season enrollees sign up, that'd be a net change of zero). Even so, it's actually slightly better compared to prior years, when the national effectuation number had usually dropped to around 87% by the end of March.
I have mixed feelings about private health insurance companies and, by extension, health insurance brokers.
On the one hand, as a universal coverage advocate who'd prefer that it be pretty much all publicly funded, I see private, profit-based insurance carriers as a middleman which shouldn't be necessary in the first place.
On the other hand, until the day comes where universal coverage via a single Medicare-for-All-like national healthcare system, insurance carriers are necessary, and since they offer a variety of different policies with different networks, coverage features, premiums, deductibles, co-pays and so forth, that means a lot of hand-holding is also necessary.
We released our End of Open Enrollment report this week, our most detailed look at the impact we are having across Colorado. This year, you will see that more of our customers are receiving help through the Advance Premium Tax Credit – 69 percent, compared to 61 percent last year – and the average level of monthly tax credit help climbed to $505 from $369 last year.
Not surprising...the 34% average rate increases (about 6 points of which is due specifically to CSR reimbursement payments being cut off...much lower than most states) meant that a lot more people qualified for tax credits in the first place, and of course the amount of credits went up accordingly...a bit more, actually (37% on average).
As long as I'm snarking on Washington's exchange for getting so excited over what appear to be pretty minor tweaks (to the average Joe, anyway), I might as well also give a shout-out to Connect for Health Colorado as well, which just posted this tidbit:
To Our Valued Stakeholders,
We took an important step forward this week with our board’s decision to move ahead on building a new eligibility system. With our own system, we will be able to provide customers a better application and enrollment experience and at the same gain more control and predictability for IT expenses.
A simplified path for enrolling with financial help can be expected to help us grow enrollment while getting more Coloradans the Advance Premium Tax Credit and Cost Share Reduction benefits that they are eligible to receive. We will continue to support Health First Colorado (Medicaid) enrollments and ensure that customers are routed to the right program, whether they begin at our site or with the PEAK application.
The cumulative enrollment numbers are also important: During the entire off-season (from 2/01/17 - 12/31/17), 41,387 people selected QHPs via Special Enrollment Periods (SEPs), or roughly 124 per day. Of course, technically speaking the last day of SEP enrollment for 2017 should have been 11/15/17 (for coverage starting December 1st), but it looks like a few hundred people slipped in after that.
Colorado's SHOP enrollment, meanwhile, hovered right around the 3,000 person mark all year.
Now that the 2018 Open Enrollment period is officially over in every state +DC, I've started compiling more detailed demographic breakouts of the data on a state-by-state basis. The official CMS report from the Assistant Secretary for Planning & Evaluation (ASPE) report should be released at some point in the next couple of weeks, but until then, I'll have to settle for whatever reports I can patch together from some of the state-based exchanges.
So far I've dug up final (or near final) data for six states: Colorado, Connecticut, Idaho, Maryland, Minnesota and Washington State. Collectively, these states only represent about 890,000 2018 exchange enrollees, or roughly 7.5% of the 11.8 million total, so I have no idea how representative they are nationally, but it's all I have to work with for the moment.
Connect for Health Colorado® Reports Plan Selection Totals for 2018 in Line with Target and Nearly Matching Longer 2017 Enrollment Period
DENVER — More than 165,000 Coloradans selected healthcare coverage for 2018 through the state health insurance Marketplace by the close of Open Enrollment, according to new data released today by Connect for Health Colorado®.
“These are positive results that show us holding steady and in line with our targets for the year,” said Connect for Health Colorado CEO Kevin Patterson. “Despite the uncertainty that created some confusion in the market, we have seen volumes that nearly match last year’s longer Open Enrollment Period. I am happy to see so many families and individuals put this protection for their health and financial well-being in place for the year. We will be reporting our results in coming weeks in our annual End of Open Enrollment Report.”
Connect for Health Colorado® Reports Increase in Healthcare Plan Selections for 2018; Open Enrollment Deadline is Friday
Posted on Tuesday, January 9, 2018
DENVER — More than 158,000 Coloradans selected healthcare coverage for 2018 through the state health insurance Marketplace through January 8, 2018, a rate 2 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®, days ahead of the enrollment deadline.
Connect for Health Colorado® Reports Increase in Healthcare Plan Selections for 2018; Open Enrollment Continues to January 12, 2018
DENVER — More than 149,000 Coloradans selected healthcare coverage for 2018 through the state health insurance Marketplace through the December 17, 2017, a rate 7 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®, mid-way through the Open Enrollment period for 2018 coverage.
“It’s not over, but the first half of this Open Enrollment period has set a solid pace,” said Connect for Health Colorado CEO Kevin Patterson. “We are still enrolling Coloradans who buy their own health insurance through January 12. I encourage everyone who does not have coverage yet to go to our site and see if they qualify for financial help. My message is, ‘Don’t leave money on the table.’ We know that too many Coloradans who qualify for help assume that they don’t.”
A few days ago I noted that based on a rather cryptic press release from Connect for Health Colorado, I deduced that C4HCO had enrolled a minimum of 53,000 people in 2018 ACA exchange policies as of December 7th. Today, however, Louise Norris has clarified that the actual 12/07 tally in CO was 59,590...and that this does not include auto-renewals, as some of the other state-based exchanges have already done:
As I have said, the pace of plan selections continues to run ahead of all previous years but there are plenty of people yet to act to avoid a gap in coverage. Our message remains: Don’t leave money on the table. We know from our own survey that too often Coloradans who are eligible for financial help assume that they make too much to get an Advance Premium Tax Credit.
OK. Last year (OE4) was Colorado's best year so far, with 161,568 QHP selections as of 1/31/17. According to the CMS Public Use File, they hit 42,796 as of 12/03/16 and 59,407 as of 12/10/16. That's an average of 2,373 per day between 12/04 - 12/10, which means they should have reached a minimum of 52,288 QHPs as of 12/07/16.
Connect for Health Colorado® Reports Increase in 2018 Medical Plan Selections
DENVER — More than 43,000 Coloradans selected healthcare coverage for 2018 through the state health insurance Marketplace in November, a rate 29 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®.
“With only two weeks left to enroll for January coverage, I am pleased with the pace of plan selections,” said Connect for Health Colorado CEO Kevin Patterson. “I know people are busy this time of year but I encourage everyone who buys their own health insurance to check to see if they qualify for financial assistance, review the available plans, and complete an enrollment before the last-minute rush. Many will be surprised that they qualify for financial help.”
Given the whole Silver Load/Silver Switcharoo craziness, I was mildly surprised to see that the ratio between Bronze, Silver and Gold have barely changed year over year, and in fact Silver has inched upward by a few points...until I remembered that Colorado is among the few states which went with the "broad load" model, spreading the additional CSR cost across all metal levels both on and off the exchange. This makes the similar metal level spread more understandable, but it also makes the 25% enrollment increase even more surprising, since subsidized enrollees will pay pretty much the same (no more or less) than this year, but unsubsidized enrollees are seeing their rates shoot up no matter where they go. As you can see below, the average premiums for unsubsidized enrollees ("NFA" = "Non-Financial Assistance) is 36.6% higher this year than last.
DENVER — Between Nov.1 and Nov. 15, more than 22,000 Coloradans selected health coverage for 2018 through the state health insurance Marketplace, according to new data released today by Connect for Health Colorado®.
“I am glad to see the number of initial sign-ups during the first two weeks of Open Enrollment,” said Connect for Health Colorado® CEO Kevin Patterson. “There has been some confusion about healthcare coverage this year. I want everyone to know that the financial help to buy health insurance is still available for next year. I urge everybody buying their own health insurance to take a minute on our site, ConnectforhealthCO.com, to check to see if they qualify and then review their options and complete their enrollment before the last-minute rush.”