OE7

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.

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:

I was surprised to realize that I haven't written a word about Wisconsin since before the midterm election last fall, when Democrat Tony Evers defeated Republican incumbent Scott Walker. Since then, the state has actually gone through a lot of turmoil regarding healthcare policy (and every other policy as well, of course). The GOP still controls both the state House and Senate, so during the lame duck session they tried to pull a whole mess of crap legislation to strip Evers of his authority before he even took office...as well as that of incoming Democratic state Attorney General, Josh Kaul, to prevent him from withdrawing from the plaintiff's side in the #TexasFoldEm lawsuit, among other things.

Lawsuits were filed, and a judicial tug of war has since ensued, and the last I heard, the state Supreme Court (which leans conservative by one vote) held a hearing over the mess. I'm not sure if they've issued their final ruling yet. 

This Just In via the Washington State Insurance Commissioner's office...

Thirteen health insurers request record-low increase of less than 1%; Two new insurers join individual market in 2020

June 3, 2019

OLYMPIA, Wash. – Thirteen health insurers filed a record-low average proposed rate increase of 0.96% for the 2020 individual health insurance market. Also, two new insurers — PacificSource Health Plans and Providence Health Plan — are joining Washington’s market next year.

All 39 counties will have at least one insurer selling inside the Exchange, Washington Healthplanfinder.

Thanks to Dan Goldberg for the heads up; this Just In via the New York Dept. of Financial Services:

2020 INDIVIDUAL AND SMALL GROUP REQUESTED RATE ACTIONS

5/31/2019 - Health insurers in New York have submitted their requested rates for 2020, as set forth in the charts below. These are the rates proposed by health insurers, and have not been approved by DFS.

* Indicates the Company offers products on the NY State of Health Marketplace.

The NY DFS website also includes handy links to the actual enrollment numbers for every carrier on both the Individual and Small Group market, allowing me to break out the numbers further:

So far, only 4 states have released their preliminary 2020 ACA-compliant individual market premium rate filings: Maryland, Virginia, Vermont and Oregon.

So what's the deal with the other 46 states (+DC)? Well, here's a handy 2020 Submission Deadline table from SERFF (the System for Electronic Rates & Forms Filing, a database maintained by the National Association of Insurance Commissioners).

However, it's a bit overly cumbersome: It stretches out over 5 full pages, and includes columns for Standalone Dental Plans as well as a bunch of info regarding the Small Group Market. I used to try tracking Small Group rates as well, but that got to be too difficult to keep up with, and I haven't really done much analysis of standalone dental plans at all. Let's face it: About 90% of the drama, controversy and confusion regarding ACA premiums is all about the individual market.

via Covered California:

Covered California Announces Grants to Community-Based Organizations Across California in Preparation for 2020 and Beyond

  • Community-based organizations and clinics will receive a total of $6.3 million in grant funding to help people enroll in quality health care coverage.
  • The 105 organizations reflect California’s diversity and will target populations that are hard to reach, uninsured and eligible for financial help through Covered California.
  • Approximately 89 percent of Californians live within a 15-minute drive of these community-based organizations.

Covered California announced Friday that it intends to partner with 105 community-based organizations to educate consumers about their health care options, offer in-person enrollment and renewal assistance and provide ongoing support on how to get the best value from their health plan. The Navigator grants announced are part of Covered California’s ongoing commitment to support robust marketing and outreach, including working with trusted organizations throughout the state to help hard-to-reach people understand this new era of health care.

Yesterday, the Dept. of Health & Human Services finally released the 2020 Notice of Benefit and Payment Parmeters, otherwise known as the NBPP, several months later than they were supposed to. There's a LOT of proposed changes to digest, and I'll write more about others soon, but I want to focus on one of the bigger ones here: Auto-renewals:

Currently, enrollees in plans offered through a Federally-facilitated Exchange or a State-based Exchange using the Federal platform can take action to re-enroll in their current plan, can take action to select a new plan, or can take no action and be re-enrolled in their current plan. Since the program’s inception, these Exchanges have maintained an automatic reenrollment process which generally continues enrollment for current enrollees who do not notify the Exchange of eligibility changes or take action to actively select the same or different plan.

via Amy Lotven of Inside Health Policy two days ago:

Issuers Urge CMS To Offer Guidance On 2020 Exchange Policy As Rule Stalled

Two associations representing health plans tell CMS that with the annual exchange rule stalled at the White House Office of Management and Budget (OMB) due to the government shutdown, the agency should immediately issue informal guidance that the plans need to understand regulatory and operational changes for the 2020 plan year. Issuers will likely be asked to submit applications in May, and it is critical to get guidance as soon as possible for adequate preparation, the Association for Community Affiliated Plans (ACAP) and the Alliance for Community Health Plans (ACHP) say in a Jan. 15 letter.

CMS typically released the draft Notice of Benefit and Payment Parameters (NBPP) in the early fall and it was generally finalized prior to the new year, although last year the final version was delayed until spring, which also frustrated plans. This year, the proposed rule didn’t land at the OMB for review until Nov. 28.

Last night I made a big fuss about New Jersey Governor Phil Murphy signing a restoration of the ACA's individual mandate penalty into law.

It turns out that the Governor of Vermont also signed the ACA mandate restoration bill I wrote about back in March into law a few days ago as well...but it's not as noteworthy, for several reasons. As Louise Norris reports over at healthinsurance.org:

Vermont governor signs legislation to implement an individual mandate starting in 2020; working group will sort out enforcement details

 

On October 1st, 2013, the first Open Enrollment Period (OE1) under the Affordable Care Act kicked off to much hoopla. As everyone knows, the largest of the ACA exchange websites, HealthCare.Gov, infamously melted down at launch due to a multitude of hardware and software problems ranging from insufficient server capacity to poor workflow design to buggy coding and much, much more. However, as Steven Brill detailed in the March 10, 2014 issue of Time magazine, by early December, the worst of the problems had been resolved, and by the time the second Open Enrollment Period came along a year later, HealthCare.Gov had been completely overhauled, with additional improvements and enhancements every year since.

The difference has been dramatic: On October 1, 2013, only six people (not six thousand or six hundred...six) were able to actually make it all the way through the HC.gov interface and enroll in a healthcare policy. On December 15, 2016, six hundred and seventy thousand enrolled.