Washington State

2018 MIDTERM ELECTION

Time: D H M S

As noted before, I'm really trying to move onto the actual enrollment part of the 2017 open enrollment period, but I can't resist doing some more final cleanup of my Rate Hike project:

  • SOUTH CAROLINA: This is one of the 5 states which I still didn't have approved rate changes for. Today the RateReview.HC.gov site finally added in the final numbers for SC, so here's what it looks like:

Aetna was a bit tricky--the total enrollee number is actually 41,988. They dropped out of the ACA exchange but are sticking around the off-exchange market, so I had to figure out how many of those 42K are on vs. off-exchange. The answer is in this article which notes:

More than 220,000 South Carolinians rely on the federal health care law for insurance. This year, only 8,000 of them are covered by Aetna plans.

A week or so ago, the Washington Insurance Commissioner announced that the weighted average rate hike for 46 plans certified by the state insurance dept. regulators is 13.1%. However, there was a major caveat: There were another 52 plans which still had to be certified by the board. Without knowing the average rate hike for the other half of the plans, there's no way of knowing what the final approved average increase will be.

In addition, I also don't know what the relative market share of any of the plans (certified vs. uncertified) is, so there's no way of weighting the average across the full market. For all I know, 90% of enrollees might be among the first 46 (in which case any variances mong the other 52 plans would barely move the needle). Alternately, 90% could be among the missing 52 plans, or anywhere in between.

WIth that in mind, here's a press release from the WA exchange yesterday:

The Washington Insurance Commissioner just issued the following press release. On the surface, it looks straightforward: 13.5% avg. requested, 13.1% approved. However, it's more complicated than that, because that 13.1% figure only applies to fewer than half of the plans (46 out of 98). The other 52 are still being reviewed:

OLYMPIA, Wash. – The Office of the Insurance Commissioner (OIC) has approved 46 individual health plans from seven insurers who will offer them in the Exchange, Wahealthplanfinder (www.wahealthplanfinder.org), for sale in 2017. The Washington Health Benefit Exchange Board is scheduled to certify the approved insurers and their plans at its board meeting later today.  

Regence Blueshield also filed 21 plans for sale in the Exchange and Bridgespan filed 31 plans. Both companies’ filings and rates are still under review. They must be approved by the OIC before they can be considered for certification by the Exchange.

Now that the official ASPE Q1 2016 Effectuated Enrollment report is out, I can compare various state exchange reports against that to see how they're doing. In Washington State, 158,245 people were reported as being enrolled in active, effectuated exchange policies as of 3/31/16.

The WA HealthplanFinder has issued their July dashboard report, and their off-season retention numbers look pretty good: 168,958 people had paid their monthly premiums as of June...a 6.8% increase over the March figure. Even if this is off slightly due to methodology differences, it's still a good thing to see exchange enrollment up from earlier in the year, since overall enrollment is down at least 12.6% since the end of open enrollment due to non-payments, legal issues and so on.

Just yesterday I posted the Washington Healthplanfinder's latest monthly report, which showed either 177,613, 170,267 or 167,827 people currently enrolled in exchange QHPs statewide, depending on whether you go by the number who have "selected plans", the number that the carriers have reported as being paid up or the number who the exchange has recorded as having paid.

The first number has been pretty confusing to me over the past few months, because the actual number of people who selected QHPs during the 2016 open enrollment period was reported as just over 200,000 by both the exchange itself as well as in the official national ASPE report, so I wasn't quite sure whether to report the net effectuated enrollment drop since then as being almost none at all or around 15%. I finally went with the 15% figure because dividing into the 177K number just didn't make sense by any other measure.

Last month I noted that the Washington Healthplanfinder was reporting currently effectuated QHP enrollment at 170,527 as of the end of March, a 15.0% drop from the official number of QHP selections during the 2016 Open Enrollment Period. I also noted that due to some confusion about how the numbers are reported by the exchange, it could also be argued that WA has seen just a 6.6% net drop, depending on how you look at it.

However, since 200,691 is the official number included in the ASPE report, I'm finally letting that one go...and actually, that's OK, because a 15% drop by 3/31 is fairly close to what I would expect anyway (a bit higher than the 13% national drop from last year, but not out of line).

Anyway, the WA exchange just released their May report (with data through the end of April), and it's actually pretty good--there's only been a very slight net drop since March, for an overall drop of just 15.2% from the 200K figure:

A few days ago, I noted that Premera Blue Cross was asking for a 19.6% average rate hike for ACA-compliant individual policies in Washington State, while also pulling out of several WA counties entirely.

Today, the Washington Insurance Commissioner issued a press release with the full, weighted average rate hike requests for the individual market (including both on and off-exchange carriers):

13 health insurers file 154 plans for 2017 - 13.5 average requested rate change • May 16, 2016

OLYMPIA, Wash.– Thirteen health insurers have filed 154 individual health plans for 2017 both inside and outside of the Exchange, Washington Healthplanfinder. The average requested rate change based on enrollment is 13.5 percent.

This year, Washington State has a total of 16 carriers offering policies on the individual market: 13 via the ACA exchange, plus another 3 selling off-exchange only (one of them, Regence Blue Shield, seems to be selling both on and off exchange, but I might be misunderstanding something there):

2016 insurers with plans approved to be certified by the Exchange, Wahealthplanfinder:

  • Bridgespan Health Company
  • Columbia United Providers
  • Coordinated Care Corporation
  • Community Health Plan of Washington
  • Group Health Cooperative
  • Health Alliance Northwest Health Plan, Inc.
  • Kaiser Foundation Health Plan of the Northwest
  • LifeWise Health Plan of Washington
  • Moda Health Plan, Inc.
  • Molina Healthcare of Washington, Inc.
  • Premera Blue Cross
  • Regence BlueShield
  • United Healthcare of Washington, Inc.

Off-exchange only (?):

Last month I noted that the Washington HealthplanFinder enrollment report was simultaneously clearcut and confusing at the same time:

According to the ASPE report, as of 1/31/16, 200,691 people had selected QHPs via the WA exchange. This is completely consistent with the exchange's own final report of "more than 200,000".

However, according to their March monthly enrollment dashboard report, the Washington HealthplanFinder only had 176,914 people having "Selected a Plan" as of February...and of those, only 156,493 were reported by the carriers as having paid.

That payment rate is a quite reasonable 88.5%, which is slightly lower than my general 90% rule of thumb estiamate nationally but not out of line at all. However, what's the deal with that 177K topline figure? Where did the remaining 23,777 people go?

Well, the WA exchange just released their April report (which includes data through March) and while the numbers are better, the original mystery remains.

There's definitely some weirdness going on with some of the exchange enrollment reports.

Last night I noted that there's roughly a 17.3K gap between the number of people reported to have selected QHPs during the 2016 Open Enrollment Period according to the official ASPE report (213,883) and the number reported by the exchange itself (196,554).

Based on that discrepancy, the MA Health Connector has increased their enrollment by either a nominal 0.6% or an impressive 9.5%, depending on what you use as the starting number.

Well, this morning I've found a similar report for the Washington exchange, and this one makes even less sense to me because it not only contradicts the ASPE report, it seems to contradict the WA exchange itself.

Coming on top of yesterday's announcement that their state exchange broke the 200,000 QHP enrollment mark this year, Washington State Insurance Commissioner Mike Kreidler has released a new report laying out the uninsured rate for the entire state population:

OLYMPIA, Wash. – The number of people without health insurance in Washington state has dropped from 14.5 percent in 2012 to an estimated 7.3 percent or 522,000 people in 2015, according to a new report issued today by Insurance Commissioner Mike Kreidler.

Nearly every county in Washington saw a drop in the uninsured

The report highlights the positive impact of the federal Affordable Care Act in Washington with county-by-county data on the uninsured and the law’s effect on many segments of the population.

The Washington State ACA exchange has been very good about providing enrollment updates over the final couple of weeks of open enrollment, although the numbers have been included as part of general press releases rather than detailed demographic breakdowns.

They hit 190,000 as of January 29th, and it looks like they managed to rack up over 10,000 more in just the final two days, which is pretty impressive.

OLYMPIA, Wash. — The Washington Health Benefit Exchange today announced that more than 200,000 Washingtonians selected a Qualified Health Plan through Washington Healthplanfinder by the close of open enrollment on Jan. 31. The number of plans selected is nearly 25 percent higher than those selected in open enrollment last year, with approximately 39,000 more customers signed up for coverage this year than in 2015.

I may have seriously lowered my final projection earlier today, but Washington State is still cranking along. Just a few days ago they reported having enrolled 180,000 people in private policies (thru 1/21). Today they report:

Through the first 12 weeks of open enrollment, more than 188,000 residents have selected a Qualified Health Plan for coverage in 2016. Those sign-ups represent a 30 percent increase in plans selected over the first 12 weeks of open enrollment last year.

I presume "the first 12 weeks" means as of 1/23, which would mean another 8,000 people in just 2 days, which is excellent if true (WA was one of 3 states to have a later February coverage deadline...of 1/23).

In any event, this brings WA up to 188,000 people, or 89.5% of my 210K target for the state.

That leaves just 1 week to enroll at least 22,000 people, or 3,142 per day, which actually seems doable after all.

The last official enrollment report from Washington State was 173,947 QHP selections as of January 2nd.

While this isn't an official update, yesterday they posted this blog entry, pushing today's deadline for February coverage (again, the final deadline for coverage starting in March is still January 31st, like every other state):

Washington Healthplanfinder has seen a continued increase in sign-ups as residents coming into the final days of open enrollment. An additional 11,000 customers have selected new or renewed health plans since the start of the new year, bringing the total number of sign-ups to 180,000 since open enrollment began on Nov. 1. 

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