You may have noticed that I recently set up a GoFundMe account as an alternate method of letting people help keep ACASignups.net going as we enter the 4th Open Enrollment Period.
Until now I've exclusively used PayPal for donations, but decided to add GoFundMe as well to see how that works out.
In addition to my general gratitude, I should also note that anyone who makes a donation is added to the official ACA Signups mailing list. Once a week* I send out a weekly digest including a wrap-up of the past week, along with special bulletins when there's a major ACA-related development.
*(well, nearly every week...occasionally I'm a bit late...)
Since it would take 10x as much time as it does now (which is already a lot) to recreate the tables and graphs every time there's a change, I've been holding off on doing so until I've accounted for several states...which is what I'm doing here.
Yesterday I hobbled together the weighted average rate hikes (either requested or approved) for the ACA-compliant small group markets across 15 states. In 4 of these states, I hadn't yet tallied the weighted average, so I temporarily used the median increase for each. In the case of Pennsylvania, the range was from a 3.8% decrease to a 33% increase, with a midpoint of around 14.6%.
Today, however, I've actually plugged in the enrollment numbers for each sm. group carrier in Pennsylvania based on their 2017 rate request filings, and have come up with a weighted average of just 7.9%:
(sigh) I thought that last Friday was the deadline for carriers to decide whether they were in or out of the exchange for 2017, but between today's news out of Tennessee and now this, apparently that deadline only applies to those who will be participating in the 4th Open Enrollment Period:
IU Health Plans said Monday afternoon it had “restructured its product offerings for 2017” and no longer will be offering individual plans on the exchange. It said the change was necessary “to adapt to new market dynamics” as well as uncertainty created by withdrawals of several other insurers.
Things are looking pretty good for the ACA exchanges in states like Rhode Island, North Dakota and Massachusetts, where they're looking at single-digit rate hikes next year. However, they're looking pretty dire in states like Arizona, Montana and Oklahoma, where the average hikes are likely to be around 50% or higher for many people.
The HHS Dept. is very much aware that they have got to get more millennials enrolled in ACA-compliant individual healthcare policies this season; the exchange risk pool has been hovering at around 28% 18-34 year olds for three years running, when the conventional wisdom among those who know more about such things is that they need that number to be somewhere closer to 40% to stabilize the market.
Now, there's a lot of reasons why more young people aren't signing up, including affordability, which of course is the main reason HHS is trying to get more of them to sign up in the first place, creating a bit of a Catch-22. In addition the very "19-25 year olds allowed to stay on their parents plan" provision of the ACA is itself cannibalizing several million potential ACA exchange enrollees, creating some additional irony, since most of those "sub26ers" are presumably enrolled in the employer policies of their parents. Some of these reasons are completely outside of HHS's control
A few people have asked whether or not the "25% average hikes" I've estimated which have been cited by pretty much every outlet under the sun also apply to job-based coverage.
NO! Absolutely not!
That 25% weighted national average only applies to the roughly 18 million people enrolled in ACA-compliant individual policies...and even then, roughly half of those folks are mostly protected from the hikes thanks to the federal tax credits. So we're really talking about roughly 9 million people who have to pay the full 25% average increases.
When I decided to once again launch my Annual Rate Hike Estimate project this summer, I knew that this year, the rate increases for the individual market were likely to be significantly higher than in years past. Coming as they are in an election year, as a Democrat and ACA supporter, I obviously took no joy in reporting this truth.
However, a) The data is the data; it would be dishonest of me to try and ignore reality; and b) I knew that if I didn't report the rate increases as accurately as possible, Donald Trump and his Republican Party would flat-out lie about them.
Today (Friday, Sept. 23) happens to be the deadline for insurance carriers to sign agreements with the federal government for participating in the exchange this Open Enrollment period (I'm not sure if today's deadline also applies to the state-based exchanges or not; they might be different). Until today, it looked as though there were going to be 3 carriers offering individual policies on the Nebraska exchange:
The figures compared 2016 and 2017 rates for Blue Cross Blue Shield of Nebraska, Aetna Health Inc. and Medica, the three companies that will offer policies to Nebraskans on the exchange when open enrollment starts Nov. 1.
However, as commenter M E noted, it looks like BCBSNE decided to wait until literally the last minute (last hour, anyway) to change their minds:
A couple of days ago, I noted that the latest development in House v. Burwell (the lawsuit brought by former Republican House Speaker John Boehner on behalf of the GOP caucus in the House of Representatives) could, in a worst-case scenario, end up resulting in millions of exchange-based policies being terminated with little notice. Basically, the HHS Dept. has included an "escape hatch" for exchange carriers in the event that the Supreme Court eventually rules in favor of the GOP House when it comes to Cost Sharing Reduction (CSR) financial assistance, although a final ruling wouldn't be likely to happen for at least another year or so.
Today, Michael Cannon of the Cato Institute has posted his own entry about the HvB "escape hatch" development, and while it obviously has an extremely anti-ACA spin, his conclusion is pretty much the same as mine (he assumes all 11 million enrollees would be kicked off their plans, while various state/federal laws could mean a much smaller percentage...but it would be pretty devastating no matter what).
Back in March, Bruce Japsen and Andrew Sprung noted that regardless of the financial woes many carriers are having on the individual market under the ACA, many of those same carriers are raking in big bucks in other divisions...particularly managed Medicare and Medicaid:
A snapshot of health insurers’ Medicaid windfall under the ACA could be seen in the earnings reports of Wellcare Health Plans (WCG) and Centene CNC +0.20% (CNC), which both beat Wall Street’s fourth quarter 2015 earnings expectations. These companies are an important measure of whether health insurers can find financial success providing Medicaid coverage to poor Americans under the health law President Obama signed six years ago even as the other key part of the legislation has growing pains.
Larger plans like Aetna AET +1.51% (AET), Anthem ANTM +1.31% (ANTM) and UnitedHealth Group UNH +1.08% (UNH) are also doing well in the Medicaid business, but their overall profit margins have been somewhat negatively impacted due to the private coverage on the exchanges.