2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

I realize this may seem a bit late in the game seeing how the 2019 ACA Open Enrollment Period has already started, but I do like to be as complete and thorough as possible, and there were still 9 states missing final/approved premium rate change analyses as of yesterday which I wanted to check off my 2019 Rate Hike Project list.

Fortunately, RateReview.HealthCare.Gov has finally updated their database to include the approved rate changes for every state, which made it easy to take care of most of these.

West Virginia's requested average rate increase was among the highest in the country for 2019--a weighted average of around 14.9%.

However, while state insurance regulators left one of the three carriers offering individual market policies alone, they knocked the other two down substantially: CareSource was lowered from around 13.1% to 9.5%, while Highmark Blue Cross Blue Shield was lowered from an average of 15.9% to 9.0%.

I realize this may seem a bit late in the game seeing how the 2019 ACA Open Enrollment Period has already started, but I do like to be as complete and thorough as possible, and there were still 9 states missing final/approved premium rate change analyses as of yesterday which I wanted to check off my 2019 Rate Hike Project list.

Fortunately, RateReview.HealthCare.Gov has finally updated their database to include the approved rate changes for every state, which made it easy to take care of most of these. In addition, in a few states the insurance department has also posted their own final/approved rate summary.

I realize this may seem a bit late in the game seeing how the 2019 ACA Open Enrollment Period has already started, but I do like to be as complete and thorough as possible, and there were still 9 states missing final/approved premium rate change analyses as of yesterday which I wanted to check off my 2019 Rate Hike Project list.

Fortunately, RateReview.HealthCare.Gov has finally updated their database to include the approved rate changes for every state, which made it easy to take care of most of these. Making things even easier (although not necessarily better from an enrollee perspective), in three states the approved rates are exactly what the requested rates were for every carrier: Alabama, Mississippi and Utah:

In the pile-on among Republican-controlled states to impose work requirements on ACA Medicaid expansion enrollees earlier this year, I somehow missed this one:

Wisconsin waiting to hear about requiring work, drug screening for Medicaid recipients

Wisconsin is still waiting to see if the federal government will let it require childless adults on Medicaid to be screened for drugs and work if they are able.

Gov. Scott Walker’s administration also asked in June to add premiums and co-pays for some adults without dependent children on Medicaid, which the federal government also must authorize.

The changes, which Walker said would help people move from public assistance to the workforce, can’t start until a year after approval by the Centers for Medicare and Medicaid Services, or CMS.

...Under Walker’s proposal, childless adults on Medicaid would have to submit to a drug test or enter drug treatment if drug screening called for it.

The timeline is the same but recent changes mean that Vermonters who take a few minutes to compare plans will find more choices and more financial help than ever before

Open Enrollment is the annual period when new applicants can use the marketplace to sign up for health and dental plans for the coming year. It is also the time that existing members have the option to change plans – an option that many more members than usual will want to consider.

What’s new?

  • Much more financial help - Subsidized members will receive over $1,200 more in premium subsidies in 2019 than they received in 2018. This is because the premiums for Blue Cross Blue Shield of Vermont (BCBSVT) and MVP Health Care (MVP) on-exchange silver plans are increasing significantly. Premiums for silver plans drive federal subsidies—so when the premiums for silver plans increase, subsidies also increase. Premium subsidies can be used on any metal level plan, bronze through platinum (see illustration of what the typical member pays in 2018 vs. 2019).

In other words, Vermont has finally jumped onboard the #SilverSwitcharoo Express!

It’s Time to Start Shopping for Health Insurance

HealthSource RI offers the cheapest insurance in RI, nearly half of customers pay less than $100 per month for coverage

EAST PROVIDENCE, RI (October 29, 2018) – Rhode Islanders: it’s time to put health insurance on your shopping list. Individuals and families looking for coverage starting January 1, 2019 should pick and pay through HealthSource RI by December 23.

“HealthSource RI has the cheapest health insurance in Rhode Island, and I’m proud of the work we’ve done to keep costs as low as possible,” said Governor Raimondo. “I urge Rhode Islanders looking for coverage to explore HealthSource RI’s quality, affordable options.”

And now it’s easier than ever to pick the medical and dental coverage from Rhode Island’s leading insurance companies. Rhode Islanders can visit HealthSource RI’s new and improved English and Spanish websites at HealthSource RI.com, plug in some basic information, and quickly compare their options and estimate their savings. 

Renewing or Changing Coverage Through MNsure

ST. PAUL, Minn.— MNsure is reminding Minnesotans that are currently enrolled in a private health plan through MNsure that they have the option of renewing into the same plan or selecting a new plan during the upcoming open enrollment period beginning November 1. With rates declining across the state from 7 to 27 percent, MNsure recommends that private health plan enrollees use our new comparison tool to find a plan that fits their needs.

Below is a brief guide to assist consumers with coverage options this open enrollment:

Keeping the same plan

Connect for Health Colorado® Customers See Lower Net Premiums, Simplified Application and Market Stabilization

DENVER — Connect for Health Colorado opens for business Thursday, November 1, with rate increases lower than the state has seen in years, a streamlined application process that will save Coloradans time obtaining financial assistance and all seven health insurance companies are returning in 2019, in a sign of a stabilizing marketplace.

More than 130,000 Coloradans got help paying for health insurance in 2018. Renewing customers qualifying for financial help will see their net premium – their cost after the Advance Premium Tax Credit – go down 24% on average in 2019.

This is thanks to the Power of Silver Loading and the Silver Switcharoo (Colorado chose to Broad Load in 2018 but is upgrading this year).

Information for NH Residents on the 2018 Health Insurance Marketplace and Open Enrollment

CONCORD, NH -- Open enrollment in the individual Health Insurance Marketplace will run from November 1 to December 15. In advance of open enrollment on and off the federally facilitated Marketplace, the New Hampshire Insurance Department offers information and resources for the approximately 54,000 state residents who will purchase health insurance in the individual market for 2019 coverage.

"We are encouraging New Hampshire residents who are buying a plan on Healthcare.gov to update their applications and actively compare plan options, “ said New Hampshire Insurance Commissioner John Elias. “Buying insurance is signing a contract. Once you lock in coverage, your rates and cost-sharing amounts will stay the same all year. But if you don’t sign up now, you will not have another chance to enroll until next year – unless you have a qualifying life event.”

Health Insurance Plans:

With the 2019 Open Enrollment Period starts in less than 24 hours, it probably isn't the best timing for this, but with the elections also coming up in just six days, perhaps it is.

Axios just published a new national survey via SurveyMonkey which asks two simple but important questions:

  • Generally speaking, when you hear candidates talking about “Medicare for All,” what do you think they are proposing?
    • A single, government-run health insurance program to cover all Americans
    • An optional government-run program that would compete with private insurance
    • Neither of these
  • And which of the following options for health care would you favor most?
    • A single, government-run health insurance program to cover all Americans
    • An optional government-run program that would compete with private insurance
    • Neither of these

The results are pretty telling:

This is about as minor a rate filing update as I've had, but I'm posting it separately in the interest of completeness.

Insurance carriers in my home state of Michigan originally submitted their requested 2019 ACA individual market rate filings back in June. At the time, the average premium increase being asked for was pretty nominal, around 1.7%, with a smaller-than-average #ACASabotage factor of around 5% due to the ACA's Individual Mandate being repealed and #ShortAssPlans being expanded by the Trump Administration.

Today, just two days before the 2019 Open Enrollment Period actually begins, the Michigan Dept. of Financial Services finally posted the approved 2019 rate filings...and practically nothing ended up changing.

I just realized that while I've written quite a bit about the potential loss of Medicaid coverage for thousands of residents of Michigan, Kentucky and Arkansas over the past few months due to the new work requirement laws in those states, It's been far too long since I've given a shout-out to the four states which are hoping to add Medicaid expansion (or at least continue it, in one case) exactly one week from today.

Bloomberg News has a pretty good overview:

For years, elected leaders in conservative states have resisted expanding Medicaid, the government health program for low-income Americans. Now voters in four of those states will decide the question directly.

I want to stress the unofficial caveat here.

Last year there was an unprecedented amount of uncertainty and chaos surrounding the Affordable Care Act. On the one hand, you had Congressional Republicans desperately attempting to repeal the ACA altogether a good half a dozen times...and coming within a single "thumbs down" of doing so at one point.

At the same time, you had Donald Trump screaming into the wind about doing everything he could to simultaneously cause the ACA exchanges to "blow up" or "implode", depending on the tweet of the day, culminating in him finally pulling the plug on Cost Sharing Reduction reimbursement payments.

There was practically no change whatsoever between the rate changes requested by Louisiana carriers for the 2019 ACA individual market and the rates approved by the state insurance regulators. However, it's still good to be able to lock in the official rates just ahead of the Open Enrollment Period itself, including the individual filing data.

Overall, unsubsidized premiums should drop around 6.5%, which is good news...except that, once again, if it weren't for the ACA's individual mandate being repealed and #ShortAssPlans being expanded by the Trump Administration, I estimate they'd be dropping by another 9.3%, give or take, for a total premium reduction of more like 15.8% on average.

At $649/month full-price on average this year, that means the average unsubsidized enrollee will be paying somewhere around $724 more apiece next year due to those factors.

OK, this is a pretty minor update, but in the interest of completeness I should post it.

In mid-September, the Washington State insurance commissioner posted the approved 2019 average ACA individual market premium changes for carriers statewide, coming in at 13.8% overall.

The only problem is that the report only included the seven on-exchange ACA market carriers. The four carriers which offer off-exchange policies (which are pretty much identical and are part of the same risk pool, but don't qualify for tax credits) weren't included. They make up roughly 23% of Washington State's total individual market.

Today, just a few days before Open Enrollment begins, the WA Insurance Commissioner posted the complete approved rate change information. The overall average has dropped slightly, to 13.6%:

Eleven insurers approved to sell 74 plans in Washington's 2019 individual market
13.57 percent average rate increase approved

October 29, 2018

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