Confirmed Exchange QHPs: 12,909,955 as of 8/28/15
Estimated: 13.45M (10.22M via HCgov) as of 8/31/15

Estimated ACA-Enabled Policy Enrollment: 32.2M
(10.4M Paid/Effectuated Exchange QHPs, 7.0M OFF-Exchange QHPs, 200K SHOP, 14.6M Medicaid/CHIP)

I spent most of July and August simply overwriting/updating the original version of this entry, but now that the approved 2016 premium rates are starting to pop up all over (the deadline for approval of exchange policy rates was a few days ago), I figured it was time to start fresh.

OK, so what I've done here is to take the overall weighted average 2016 rate increases for the ACA-compliant individual health insurance market for each state (requested in some states, approved in others) and plug those into a spreadsheet. Then, I've further weighted each state's average increase by that state's percentage of the national total, using 3 different criteria: Total Individual Market (as of 2014); ACA Exchange Enrollment Size (as of March 2015); and Total State Population Size (as of 2014). Again, the bold-faced/green states are ones where the 2016 rates have been approved; the rest are still requested only and could change dramatically in some cases.

The CMS Dept. has quietly released their latest monthly Medicaid/CHIP enrollment report through the end of June...which happens to line up almost perfectly with what I was expecting:

  • Nearly 72 million individuals were enrolled in Medicaid and CHIP in June 2015. This enrollment count is point-in-time (on the last day of the month) and includes all enrollees in the Medicaid and CHIP programs who are receiving a comprehensive benefit package.
  • 292,112 additional people were enrolled in June 2015 as compared to May 2015 in the 51 states that reported comparable May and April 2015 data.
  • Looking at the additional enrollment since October 2013 when the initial Marketplace open enrollment period began, among the 49 states reporting both May 2015 enrollment data and data from July-September of 2013, nearly 13.1 million additional individuals are enrolled in Medicaid and CHIP as of June 2015, almost a 22.7 percent increase over the average monthly enrollment for July through September of 2013. (Connecticut and Maine are not included in this count.)

This is a huge story which I should have been following, but a) I was on vacation the past couple of weeks, b) I can't cover everything healthcare-related, and c) it's really not directly related to the Affordable Care Act. Fortunately, the Arkansas Times' David Ramsey has been all over it, so I'll let him lay it out for you:

...all three members of the household were among almost 36,000 Arkansans who were kicked off of their health coverage on July 31. Insurance for another 13,000 people across the state will terminate at the end of this month. The cancellations are the result of a statewide sweep of Medicaid performed by the Arkansas Department of Human Services in an attempt to weed out those beneficiaries whose incomes are too high.

Last week I estimated the overall weighted average rate increases for the Arkansas individual market at "between 4-5%", with a rough estimate of around 4.6%.

Today, Arkansas Times reporter David Ramsey has provided the exact market share numbers for Arkansas. When I plug these in, the weighted average comes in a bit higher, at 4.98%:

HOWEVER, according to Ramsey, the Arkansas Insurance Division says that the actual weighted average is only 4.4% overall.

There could be any number of reasons for the discrepancy; it's possible that there's a few additional minor off-exchange carriers who I've missed, or there could be rounding errors/etc. In any event, these are all just estimates anyway, so I'll go with AID's official 4.4% figure.

Nevada's insurance dept. rate filing website has an extremely user-friendly, interactive website which lets you drill down and find exactly what you're looking for: Individual or Small Group policies, HMO or PPO, Under Review or Reviewed. From what I can tell, there are 12 companies offering individual policies in 2016 (a 13th, the Nevada Health COOP, just announced that they've gone belly-up and are being dissolved, meaning a minimum of 16,000 Nevadans will have to switch to a differnet insurance carrier).

The requested rates were approved for 8 of the companies, but were reduced significantly for Aetna (from 21-24% down to 15%). Here's what it looks like in the end:

The Small Group market is faring somewhat better, with just a 5.3% overall weighted average increase:

The Washington Health Benefit Exchange and Healthplanfinder, the state’s marketplace and website where people can buy individual and subsidized health insurance under health reform, have gone through some big changes lately.

Most important to consumers, Healthplanfinder is no longer the portal through which customers pay their insurance premiums.

On Tuesday, the organization announced that starting Sept. 24, Qualified Health Plan and Qualified Dental Plan customers will be required to pay their monthly premiums directly to their insurance companies, and the site will no longer accept those payments after Sept. 23.

The change mirrors a stop-gap measure put in place last year after problems plagued the site’s payment mechanism.

OK, I'm a little late on this one due to being on vacation last week, but the Kaiser Family Foundation released their latest national healthcare tracking poll:

Consistent with findings over the past few months, the American public remains divided in their opinion of the health care law; 44 percent say they have a favorable view and 41 percent say they have an unfavorable view. Opinion of the law continues to diverge along party lines, with most Democrats reporting a favorable view of the law (76 percent) and most Republicans reporting an unfavorable view of the law (71 percent). Among independents, 46 percent say they have an unfavorable view, while 39 percent report a favorable view.

When I last checked in on Rhode Island's 2016 rate increase status, the three companies operating in the state (BCBSRI, Neighborhood and UnitedHealthcare) had requested hikes of 7%, 8.6% and 11% respectively. There was no off-exchange enrollment data, but the exchange-based market share breakdown was roughly 48.5% / 48.5% / 3%. This meant a requested average hike of around 7.9%.

A week or so ago, the approved rate hikes were released for Neighborhood and UHC, along with total enrollments (on+off exchange) for BCBS:

Still unresolved is how much Blue Cross and Blue Shield of Rhode Island may raise rates for its individual plans, which cover about 25,000 people. The nonprofit insurer initially requested an 18-percent increase, but no decision has yet been made because, by law, its rate hike requests are reviewed in a separate process that reserves a key role for the state's attorney general.

After yesterday's ugly news about Alaska's private policy rate hikes, this is welcome relief:

Judge says Alaska Medicaid expansion can go ahead Tuesday

An Anchorage trial court judge Friday said that Alaska Gov. Bill Walker’s administration can expand the Medicaid health care program starting next week, dismissing a request by the state Legislature to temporarily block enrollment while attorneys fully argue lawmakers’ legal challenge.

In a 45-minute opinion delivered from the bench, Pfiffner rejected a series of arguments by the Legislature that starting expanded Medicaid enrollment Tuesday was so problematic that it should be put on hold while the Legislature’s lawsuit proceeds.

The actual lawsuit will still proceed, but this is still great news for up to 40,000 Alaskans.

Not such great news in Nevada, however:

Nevada Health Co-Op to close, leaving thousands to find new insurance

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