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Virginia was the very first state whose 2018 rate filings I analyzed, way back in early May. At the time, the initial filings amounted to 9 carriers on the individual market with an average rate increase request of around 30%. At the time I hadn't started distinguishing between "with CSR payments" or "without CSR payments", so I don't really know which scenario that 30% reflected; it was probably a mix of both depending on the carrier. 61,000 Aetna enrollees would have to shop around for a new carrier since they had previously announced they were pulling out of the individual market.

Up at the top of the site is a big yellow button leading directly to the ongoing 2018 Rate Hike project. Let's face it, though: It's an awful lot of updates to scroll through. In addition, now that we're past the (extended) rate filing deadline, I've been able to make a lot of updates over the past few days (shoutout to Louise Norris, who did much of the grunt work on these).

As of today (September 6th), I now have average requested 2018 rate changes for the individual market across all 50 states + DC, and have made updates/corrections to several of these.

More importantly, I also now have approved 2018 rate changes for 6 states. They only represent around 9% of the population, though, so I wouldn't focus very much on the "national average" for the approved states yet; that will jump around a lot as more states are added to the mix, and likely won't start to settle in until at least half the states are included.

Having said that, here's what things look like as of today:

(sigh) Colorado's state insurance division just released their approved 2018 rate increases (busy day!), and the situation appears to be similar to Maine: The average requested rates which I thought already assumed no CSR reimbursements appear to have assumed CSRs would be paid after all:

Division of Insurance approves health insurance premiums for 2018
Commissioner: Measures to stablize market for 2018 must happen by Sept. 30

DENVER (Sept. 6, 2017) – The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), has approved the individual and small group health insurance plans for 2018. Average premium changes within each market - individual and small group - as well as the average change for each insurance company are listed below.

The state of Maine's insurance regulatory agency has announced the approved 2018 individual market rate hikes for the three carriers operating in the state. Louise Norris beat me to the punch:

Regulators in Maine published rate proposals for the three Maine exchange insurers in June, and finalized the rates in early September. Insurers proposed two sets of rates: one that assumes cost-sharing reduction (CSR) funding will continue, and another that assumes the federal government will not fund CSRs in 2018.

The Maine Bureau of Insurance initially rejected all three insurers’ rate proposals on August 10, and asked them to submit new rates. The revised rate filings were then approved on September 1. These average approved rate increases all assume that CSR funding will continue in 2018:

Vermont was one of the first states I analyzed back in the late spring; obvoiusly a lot has changed since then, so I updated/revised my analysis of their requested rate hikes for 2018 a couple of weeks ago, with requested average increases of 11.9% if CSR payments are made or 21.6% if they aren't.

Yesterday, Louise Norris gave me a heads up that the Vermont regulators have issued their approved rate increases for the two carriers operating on the individual and small group markets in the tiny state. This makes Vermont the 4th state to announce their approved rates for next year, joining Oregon, Maryland and New York.

Nevada is the final state to post their requested rate hikes for 2018 (or at least they're the last one I tracked down, anyway). I've now done at least a rough analysis of all 50 states + DC, and while some of the data is a bit outdated (remember, I started doing this back in late April/early May), most of it should still be fairly close to the present situation...at least in terms of requested rate hikes.

In Nevada, after much concern that a bunch of rural counties wouldn't have any exchange carriers at all, Centene stepped in to cover them. They aren't listed in the table below, but since I believe they're new to the state, that shouldn't matter in terms of rate increases since there's no base rates to compare against anyway.

Both Politico and Axios have picked up my story about the $60 million in ACA Open Enrollment Navigator/Outreach grants being cancelled at literally the last minute:

Politico:

Did CMS execute a last-minute reversal on navigator program? That's what independent blogger Charles Gaba is reporting, posting what appear to be internal CMS documents that show the agency was poised to essentially renew last year's funding for this year's ACA open enrollment.

One document posted by Gaba indicates that Randy Pate — tapped by the Trump administration to run Medicare's Center for Consumer Information and Insurance Oversight — signed off on $60 million in program funding on Aug. 24. More. However, CMS ultimately funded the program at less than $37 million for the upcoming enrollment, a 41 percent cut from last year.

Utah has also finally released their requested 2018 individual market rate increases. There are six carriers offering individual policies next year, but only 2 of them are participating on the ACA exchange (and the 4 off-exchange carriers hold less than 4% of the total market combined). In fact, two of the off-exchange-only carriers are barely participating at all: BridgeSpan has only 8 enrollees, while "National Foundation" (a "phantom carrier" which also goes by "Freedom Life" in other states) once again supposedly only has a single "enrollee". Molina has a few hundred off-exchange enrollees, but the bulk of their 70,000-person membership are in exchange-based policies, and they're dropping off the exchange next year, so those 70K will have to choose from one of the two remaining exchange carriers: SelectHealth and the University of Utah.

Until recently, my 2018 Rate Hike project was still missing 4 states: Kansas, Missouri, Nevada and Utah. Last week Missouri finally posted their requested rate increases for next year. Today it looks like Kansas has done the same...at least partly.

As I noted back in June, there are 3 carrers on the KS individual market this year: Medica, Blue Cross Blue Shield of Kansas Solutions and Blue Cross Blue Shield of Kansas City. Any confusion between the BCBS names was made moot, however, as BCBS of KC announced they were dropping out of the indy market anyway.

That leaves Medica and BCBSKS, both of whom filed plans to stay on the market...but only Medica appears to have actually submitted rate requests, for a mere 7,600 enrollees:

ACA Signups isn't normally known for "big scoop" stories. Yes, I'm often the first one to openly post analysis and/or debunking of information/data/claims which have already been made public, but I'm not usually the first one to actually make the underlying data itself public in the first place.

This is an exception to that rule.

I've recently acquired documentation related to last weeks' shock announcement by the Trump Administration's Centers for Medicare & Medicaid that they're slashing the advertising/marketing budget for HealthCare.Gov for the upcoming 2018 Open Enrollment Period by 90%...as well as cutting the in-person outreach program budget by nearly 40%.

I've confirmed the veracity of these documents, and the claims related to them seem to be on the level.

According to my source, these are signed orders instructing the grant awarding officer to distribute $60,000,000 in grants with an effective date and time of August 31st, first thing in the morning.

Thanks to Zach Tracer for the heads up!

My 2018 Rate Hike project petered out a few weeks back with the requested rate increases posted for 46 out of 50 states (along with DC). Unfortunately, the last 4 states (Kansas, Missouri, Nevada and Utah) decided to keep their cards close to their chest, delaying any public viewing of even the requested rate increases for awhile longer.

Lori Lodes used to be Communications Director for the Centers for Medicare & Medicaid until last year under President Obama. As such, a big part of her job was administering ACA outreach efforts.

This evening, upon learning of the Trump administration's announcement that they're slashing advertising budget by 90% and outreach/navigation assistance funding by 39%, she was...not pleased. She took to Twitter to get a few things off her chest.

Instead of embedding a bunch of full Tweets, I'm pasting in the actual text of her thread to give the full picture:

Time to put on my "I used to run outreach for Obamacare" hat and talk about the Admin's decision to gut outreach and education.

***note*** This thread is long and barely touches on just how bad the impact of the Admin's decision will be.

First, it's the job of the government - in regs and everything - to educate people about signing up for health care.

Second, slashing navigator funding in a 3 yr cycle from $67m (2016) and $63m (2017) to $33m (2018) will mean that fewer people get covered.

via Sarah Kliff of Vox.com:

Trump is slashing Obamacare’s advertising budget by 90 percent

The White House will also cut the in-person outreach program by $23 million.

The Trump administration plans to deeply cut Obamacare outreach and advertising, officials announced Thursday.

Trump will reduce Obamacare advertising spending 90 percent, from the $100 million that Obama administration spent last year to $10 million this year. It will also cut the budget for the in-person enrollment program by 39 percent.

Administration officials cited “diminishing returns” from outreach activities. In a phone call with reporters, they said that most Americans already know about the Affordable Care Act.

As a reminder, here's what happened back in January, when Trump pulled the plug on advertising for HealthCare.Gov in the final, critical week of the 2017 Open Enrollment Period:

via Robert Pear, New York Times:

A Trump administration official said Wednesday that the administration wanted to stabilize health insurance markets, but refused to say if the government would promote enrollment this fall under the Affordable Care Act or pay for the activities of counselors who help people sign up for coverage.

The official also declined to say whether the administration would continue paying subsidies to insurance companies to compensate them for reducing deductibles and other out-of-pocket costs for low-income people. Without the subsidies, insurers say, they would sharply increase premiums.

The administration, the official suggested, will do the minimum necessary to comply with the law, which Mr. Trump has called “an absolute disaster” and threatened to let collapse.

When I last checked in on Maryland's individual market rate hikes for next year, the picture was pretty grim: Overall requested increases of around 46%...and that assumed that CSR reimbursements are made in 2018. If you assume CSRs aren't paid, it looked even worse: A whopping 57% average increase statewide for unsubsidized enrollees. Ouch.

Today, the Maryland Insurance Dept. issued their approved rate changes for the individual and small group markets...and while they did knock the rate increased down significantly, there's still not much to be cheery about. It also includes a couple of handy additional data points:

The Maryland Insurance Administration Approves Non-Medigap Premium Rates for 2018 Small Group and Individual Markets

Open Enrollment Begins Nov. 1 in the Individual Market; Consumers Encouraged to Shop Rates

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