On another note, I also want to use this as an opportunity to point out that maintaining quality health insurance coverage needs to be a priority year in and year out. Jenks notes that "Pregnancies are often unplanned, making limited enrollment periods impractical for many women." But can't that be said of any medical condition? In fact, I would say pregnancy is one aspect of healthcare that's probably much more likely to actually be planned. While about half of pregnancies are planned, I doubt the same could be said for cancers, heart attacks, or car accidents.
In other words, while not all pregnancies are planned, overall it's a lot less "random" than most other expensive healthcare incidents.
Now that the 2018 Open Enrollment period is officially over in every state +DC, I've started compiling more detailed demographic breakouts of the data on a state-by-state basis. The official CMS report from the Assistant Secretary for Planning & Evaluation (ASPE) report should be released at some point in the next couple of weeks, but until then, I'll have to settle for whatever reports I can patch together from some of the state-based exchanges.
So far I've dug up final (or near final) data for six states: Colorado, Connecticut, Idaho, Maryland, Minnesota and Washington State. Collectively, these states only represent about 890,000 2018 exchange enrollees, or roughly 7.5% of the 11.8 million total, so I have no idea how representative they are nationally, but it's all I have to work with for the moment.
At this point, the only significant top-line 2018 Open Enrollment numbers missing are the final 10 days out of California (which could add perhaps 40,000 to the total) and a solid month of enrollment from the District of Columbia (23 days, actually, but they extended their deadline by 5 extra days, which may or may not be included in the final, official report from CMS). DC's tally through 1/08 was 21,352 QHP selections. Their all-time high was around 22,700 set in 2016, so I can't imagine that they added more than perhaps 2,000 more since 1/08. In other words, about 99.5% of the 2018 OEP QHP selections have likely been accounted for.
That means it's time to move on to...breaking down the demographic data! Woo-hoo! Parrrr-tyyyy!!
The big, official CMS report from the Assistant Secretary for Planning and Evaluation (ASPE) presumably won't be released for a couple of weeks, but some of the state-based exchanges are faster about posting their demographics. First up: Connecticut!
LT. GOV. WYMAN: DEMAND FOR HEALTH INSURANCE ROSE, 2018 OPEN ENROLLMENT STRONGER THAN PREVIOUS YEARS
(HARTFORD, Conn.) – Lt. Governor Nancy Wyman and Access Health CT (AHCT) CEO Jim Wadleigh today provided the results of the Connecticut healthcare exchange’s fifth open enrollment period, which ran from November 1 to December 22, 2017. During this open enrollment cycle, 114,134 residents signed up for private health insurance coverage, reflecting a 2.3 percent increase compared to enrollment figures last year.
Open enrollment on the state’s health care exchange, Access Health Connecticut, ends Friday at midnight.
Connecticut residents had one week longer to sign up for an insurance plan than customers of the federal site, healthcare.gov.
As of Thursday morning, some 106,000 people had signed up for health care plans through Access Health CT.
Exchange CEO Jim Wadleigh called this the most challenging open enrollment period in the five years it’s been up and running, citing uncertainty over the future of the health care law, mixed messages from the Trump administration, and the shortest enrollment period ever, at just seven weeks.
This means they added 1,613 more people in the past week, but the pool of current enrollees dropped by 1,675, which means that at least a small number have actively cancelled their policies altogether. Looked at another way, the number of new enrollees has increased by 3,211 (from 11,749 to 14,960), which means that, again, a couple thousand current enrollees who either actively (or were passively) auto-renewed have since gone back into the system and changed their mind and cancelled their 2018 plans. This is normal, especially for the states which "front-load" auto-renewals before the December deadline passes.
They've also done something interesting: They're listing the 11,055 current enrollees who haven't actively re-enrolled as of yet. If every one of them did so (they won't), that would bring the grand total up to 101.4K.
That same day in Connecticut [Wednesday, Nov. 1st], 1,596 residents enrolled in qualified health plans on the state exchange while another 2,293 people either completed Medicaid applications or determined that they were eligible for that program. Access Health CT CEO Jim Wadleigh said in a statement that the state’s call center and website experienced a 15 percent increase in volume compared to opening day last year.
Not much to add here; last year the first enrollment number I had for Connecticut didn't show up until halfway through November (about 16,000 selections in 15 days), but that doesn't give me much to compare with for the first day only. Still, the 15% traffic increase is a good thing.
I ran an updated analysis of the requested average rate hikes for Connecticut last month. At the time, the only two carriers operating on the CT exchange next year (Anthem and ConnectiCare) were still noncommittal about actually committing to doing so. Statewide, it looked like the carriers were asking for rate increases averaging around 23.8% if CSR payments were guaranteed or 33.5% if they weren't.
As reported by Louise Norris today, the Connecticut insurance dept. reported that both carriers have now committed to sticking around next year, and the approved average rate increases now assume that CSR payments won't be made after all. In the end, the statewide average looks like roughly 28.4% (Norris pegs it at 29.3%, but that's because she generally only includes individual market carriers participating on the ACA exchanges, while I also include carriers and plans offered off-exchange as well).
As noted in the Virginia and Maryland updates, I've started going through the earlier state rate filings and revising them to include:
Updated/revised carrier rate filings;
Additional market withdrawls and/or expansions;
Corrections to CSR factor impact, etc.
The original versions of each state writeup includes screen shots of the actual filing documents and explainers behind specific requests; I don't have time for that with most of the updates, so I'm bundling several states together. Here's Connecticut, Oregon and Vermont's revisions:
UPDATE: As I've been warning for months, several carriers have now openly stated that perhaps 40% of their requested rate hike is due specifically to concerns about the Trump administration & the GOP's ongoing sowing of confusion and outright sabotage of the ACA and the individual market.
Unlike most states, Connecticut did all the legwork for me, making it incredibly easy to plug the numbers into a spreadsheet for weighted average (requested, unsubsidized) rate hikes for both the individual and small group markets: