Connecticut

Just 3 days ago, I wrote about the changing 2016 rate increase request situation in Connecticut, where Arielle Levin Becker reported that 2 of the state insurance providers were lowering their requested rates ahead of the public regulatory hearings...even though the CT exchange, Access Health CT, is increasing their rates a bit to cover expenses. As a result, the overall weighted average increases being requested dropped a half a point, from 7.7% down to 7.2%, which is pretty darned good, all things considered.

Well, it looks like I should have waited a couple of days, because this morning Ms. Becker, of the CT Mirror, has posted another update...and the news is even better:

The four companies selling individual health plans through Connecticut’s health insurance exchange have revised their proposals to raise rates in 2016, seeking lower increases than initially proposed.

Nearly 2 months ago, I posted about Connecticut's insurance policy rate change requests from the 9 companies which plan on offering individual healthcare policies either on or off the ACA exchange, Access Health CT. The takeaway at the time was that, when weighted for the relative market share of each company, it looked like a statewide average requested rate increase of 7.7%, which isn't bad at all given the massive hikes being tossed around in some other states:

None of these have actually been approved yet, mind you...and in fact, just today it was announced that the CT Insurance Dept. will be holding public hearings to discuss the rate requests by three of the companies above: Anthem, ConnectiCare and Golden Rule.

Even before that happens, however, there's been some shifting: The first two companies, Anthem and ConnectiCare, have put in revisions to their earlier requests:

In 2014, the overall average premium payment rate for those who selected a Qualified Health Plan (QHP) from the various ACA exchanges ended up being around 88% nationally. This varied from state to state and company to company, but in the end it was roughly 88%.

In 2014, the overall average net monthly attrition rate ended up being roughly 3% per month (by net, I mean after taking into account both new people enrolling during the off-season and existing enrollees dropping their coverage). Based on this, here's what the 2014 exchange enrollment looked like (click image for full-size version):

Last year, Connecticut was a perfect example of how the initial requested insurance policy rate changes from the companies involved in a given state can end up changing dramatically after the approval process (and in CT's case, change even more when the actual Open Enrollment period actually arrives). The original requested average increas in CT was 12.8%, but the approved changes ended up only being around 4.5%...and in the end they were far lower: Less than a 1% overall weighted average increase!

With that in mind, here's the story on 2016 requested changes in CT:

Four major health care providers that offer plans on Connecticut's health insurance marketplace have filed for rate increases for the upcoming open enrollment period that begins Nov. 1, 2015.

...The following increases have been proposed: 2 percent for ConnectiCare, 6.7 percent for Anthem, 12.4 percent for United Healthcare and 13.96 percent for Healthy CT.

The CEO of Access Health CT, Connecticut's ACA exchange, just issued a press release:

Hartford, Conn. (May 5, 2015) – Access Health CT (AHCT) today announced that they enrolled 1,429 Connecticut residents during the Special Open Enrollment Period which began April 1, 2015 and ended April 30, 2015. The special enrollment period was open to individuals who did not have health care coverage in 2014 and were subject to a penalty on their 2014 federal taxes.

It's important to bear in mind that this number specifically does not include "normal" off-season QHP enrollees via marriage, birth, job loss and so forth.

1,429 over 30 days = about 48 per day. My final estimate of 3,000/day nationally would scale down to just 28/day for Connecticut specifically based on their Open Enrollment Period percentage, so this is actually pretty good.

Last week, Access Health CT released a rough enrollment update (103K QHPs), but that only ran through 2/13...it didn't include the final 2 days of the official open enrollment period.

Today, as promised, at their board meeting, they gave the full, official update which includes the final weekend:

.@AccessHealthCT making #CT healthier.2nd open enrollment exceeded expectations. 204,358 signed up for healthcare. pic.twitter.com/QMgSlTQEzn

— Lt. Gov. Nancy Wyman (@LGWyman) February 23, 2015

OK, that includes both QHPs and Medicaid/CHIP enrollment...

CT is a national leader. Total enrollment through @AccessHealthCT 552,603. Workforce, economy, families are stronger pic.twitter.com/bfpIk4p1uR

— Lt. Gov. Nancy Wyman (@LGWyman) February 23, 2015

This is a "mini" update, as it doesn't include the final weekend, but it still means that CT nudged over their internal 100K target without those last 2 crucial days:

As of 2/13, there were 103,007 QHP Enrollees and 433,429 medicaid customers. #AHCTBoDMeeting

— Access Health CT (@AccessHealthCT) February 19, 2015

The Medicaid number is a bit misleading; I'm almost certain  that 433K figure refers to everyone in Medicaid state-wide, not just via ACA expansion. The state only has 3.6 million people total; I find it difficult to believe that 12% of the population falls into the expansion range specifically.

They also threw in the SHOP tally:

Dental plans & the SHOP program continues to show solid gains. Over 1,100 SHOP members enrolled. #AHCTBoDMeeting

Just a few hours ago, Access Health CT issued what seemed to be a fairly solid, hard-line statement about midnight tonight being their open enrollment deadline.

Apparently the moves made by HC.gov, CO, NY, CA, MA, WA & MD (just moments earlier) got to Connecticut...

(sorry, couldn't resist)

Connecticut's official 2015 QHP target is an even 100K. They were 99% of the way there as of last night, with no technical problems to speak of gumming up the works:

As of Jan. 30, 95,700 people had signed up for private insurance through Access Health, including about 66,700 repeat customers from 2014. (On Monday, officials said more than 99,000 people had signed up for private insurance plans through the exchange.) By comparison, last year, slightly more than 80,000 people bought insurance through the exchange (though a few thousand dropped out as the year went on).

My own target for CT is 114K. To reach that, they'll have to enroll just 2,100/day for the final week, or less than twice the rate they've averaged so far. This shouldn't be a problem; nationally, I'm expecting QHP enrollments to average around 286K/day all this week, which is around 2.33x more than the average to date, and Connecticut has one of the most solid operations of any state.

This isn't a formal press release, but according to NBC Connecticut, Access Health CT has enrolled "more than 96,000" people into Qualified Health Plans (QHPs). The article ran yesterday, so presumably the number is current as of February 2nd at the latest:

Connecticut residents signing up for health insurance through Access Health CT must enroll by Feb. 15 or face a potential tax penalty from the federal government.

"We're on track to hit our [enrollment] goals," said Access Health CT's acting CEO, Jim Wadleigh.

The state's health care marketplace aims to sign up 100,000 private citizens during the current enrollment period. With less than two weeks left, more than 96,000 residents have signed up for qualifying health plans.

About 30,000 of them are new sign-ups, Wadleigh said, adding that all avenues for enrollment have been successful.

The Access Health CT board of directors is holding a meeting this morning and promises to liveblog the latest developments, including updated enrollment numbers.

Connecticut hasn't updated their numbers since 12/15, when they announced 66K renewals and 19.4K new enrollees, so this should be somewhat interesting.

  • Remember that today (Jan. 15th) is the deadline for February 1st coverage

ENROLLMENT:

  • As of last Friday, "around" 90,000 customers (20% higher than last year)
  • 1,500 - 2,000/day...on track to hit/exceed (combined)
  • last year: 100 - 120K total (includes Medicaid)
  • midnight tonight: should have over 500K in system (includes Medicaid)
  • dental: 1K any day now

OPERATIONS:

  • IRS form 1095 (tax credit form)
  • education/outreach/etc. programs already in gear
  • some people already asking questions, etc. re taxes

SHOP:

No formal press release yet, but CT is the 2nd state (after Kentucky) to announce how many 2014 enrollees were automatically renewed (as opposed to manually renewing):

66,000 of our customers were auto enrolled in our system and continue to have health coverage for 2015. #OEUpdate

— Access Health CT (@AccessHealthCT) December 17, 2014

We added roughly 20,000 new QHP customers & 46,000 new Medicaid customers over the last month. #OE2015Update

— Access Health CT (@AccessHealthCT) December 17, 2014

The most recent update I have from Connecticut was 13,000 new enrollees, but that was only through last Friday, before the big weekend push. That means they added another 7K over the weekend; not bad!

As you can see from the graphic I posted yesterday (and had to revise several times throughout the day), the official enrollment deadline for private policies starting on January 1st, 2015 has now passed for all 37 states operating via HealthCare.Gov, as well as residents of DC, Hawaii and Kentucky. It's certainly possible that any or all of these will announce some sort of "special circumstances" allowance for those who didn't make the midnight cut-off (10pm in Alaska), but I'm assuming those would be done strictly on a case-by-case basis.

OK, so what about the remaining 11 states?

Well, 4 of them (MD, MA, RI & WA) had later deadlines for January coverage all along: Maryland on 12/18 (Thursday) and the other 3 on 12/23 (next Tuesday).

New York and Idaho bumped their deadlines out from yesterday until 12/20 (Saturday), although Idaho had previously claimed that their deadline was 12/23, but are now claiming that it was originally 12/15. I still don't understand what happened there, but so be it: 12/20 it is for ID.

I wasn't really expecting any data drops today, but I've already received surprise updates from California and Massachusetts, and now I can add Connecticut, DC and Hawaii all in one shot (via separate entries):

Connecticut: Last year the state's uninsured rate dropped by about half – from nearly 8 percent to 4 percent. Likely for this reason Kevin Counihan, the CEO of Access Health CT, was scooped up by the federal government to help fix Healthcare.gov. Latest figures for this year come from Dec. 12, which showed 39,000 new Medicaid enrollees and 13,000 new private health plans, according to an email from a state official. Late Monday, Access Health CT announced that it was allowing a grace period until Dec. 19 for enrollment that would begin January 2015. Consumers who had started an application before Monday could have four additional days to fill out their information.

That's 13K new enrollees only; again, it's safe to assume at least a 1:1 ratio between new & renewed enrollees, so I'm calling it at least 26K total for CT so far.

THIS JUST IN...

For Immediate Release

STATEMENT FROM ACCESS HEALTH CT ACTING CEO JIM WADLEIGH ON TONIGHT’S OPEN ENROLLMENT DEADLINE FOR HEALTH CARE COVERAGE BEGINNING JANUARY 1, 2015

Hartford, Conn. (December 15, 2014) – In advance of tonight’s midnight deadline for coverage beginning January 1, Access Health CT (AHCT) Acting CEO Jim Wadleigh has released the following statement:

“The deadline to sign up for quality, affordable health care coverage that begins on January 1, 2015 is tonight at midnight. If customers have an application started and select a plan before midnight tonight, they can still get coverage beginning January 1, as long as they complete the application and get us all the relevant information by midnight this Friday, December 19.

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