2018 MIDTERM ELECTION

Time: D H M S

Delaware

Calculating the average requested rate hike in Delaware is easier than most states. This year they officially have 5 carriers participating in the individual market (3 on exchange, 2 off)...but one of those is "Freedom Life" which is a phantom carrier; another is Golden Rule which only has about 120 enrollees; and two of the others are divisions of Aetna, which is dropping out of Delaware's indy market next year altogether. That leaves just Highmark BCBS, unless Golden Rule has surprised me by enrolling a significant number of people off-exchange this year.

Today the Delaware Dept. of Insurance issued this press release:

Highmark Requests 2018 Health Insurance Rate Increase of 33.6%

Date Posted: Wednesday, June 14th, 2017

Hardly surprising given they made good on their "Give us our merger or we're out of here!" threat last year, followed by further drop-outs from both Iowa and Virginia announced for next year over the past few weeks, but the final Aetna shoe has just dropped:

.@Aetna will not offer on- or off-exchange individual plans in DE or NE for 2018, and at this time has completely exited the exchanges.

— T.J. Crawford (@TJatAetna) May 10, 2017

T.J. Crawford is apparently Aetna's head of media relations, so yeah, that seems pretty definitive.

A bit more courtesy of Peter Sullivan of The Hill:

In Delaware, assuming 30,000 people enroll in private exchange policies by the end of January, I estimate around 20,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 10,000 enrolled in the ACA Medicaid expansion program (PPT), for a total of 30,000 residents kicked to the curb.

As for the individual market, my standard methodology applies:

My original estimate for the average unsubsidized rate hikes for Delaware's individual market back in June was 30.6%. Today the DE Dept. of Insurance issued their final approved rates, including the small group market:

Insurance Commissioner Karen Weldin Stewart today released Delaware’s Qualified Health Plan average rates for Plan Year 2017.

The Commissioner recommended approval of a 32.5 % average rate increase in the individual market for Highmark Blue Cross Blue Shield of Delaware. The approved average rate increase for the small group market for Highmark’s plans is 2.74%.

Aetna Life Insurance Company received an average of 22.8 % increase in the individual market and Aetna Health Insurance Company received an average increase of 23.6 %. In the small group market, Aetna Life received an average increase of 15.2 % and Aetna Health received an average increase of 19.7 %.

Delaware is a small state, and only has a total of 4 carriers offering individual polcies (2 on exchange, 2 off). One of those, however, is once again "Freedom Life" which, once again, is asking for precisely a 17.37% rate hike on their almost-certain-to-be-nonexistent enrollees. So...never mind them. That leaves Aetna (split into HMOs and PPOs) and Highmark BCBS offering policies on the exchange, and Golden Rule off the exchange.

Unfortunately, I can't find Golden Rule's actual current enrollment number, but as you can see below, it really doesn't matter:

As you can see, no matter how many enrollees Golden Rule has, their 30.3% average hike request is very close to the 30.6% average of the other carriers. The very most it could do is nudge the weighted average down by a tenth of a point or two, so let's call it 30.5%. 

There's an old saying: Figures lie and liars figure. Statistics and percentages are a funny thing; as politicians of every stripe know, you can often twist them to mean whatever you like, especially when you don't provide proper (or sometimes any) context whatsoever. Case in point: Yesterday's embarrassingly dishonest "chart" presented by Representative Jason Chaffetz at the Planned Parenthood witchhunt committee hearing.

For a less inflamatory example of this, consider the headline of this entry:

Delaware: *Approved* 2016 rate hikes reduced by 11.4%!!

At first glance, of course, it looks like I'm saying that after going through the regulatory approval process, the individual health insurance premium rates in Delaware are being reduced by 11.4% next year! Hooray!

Delaware's 2016 rate hike analysis is about as simple and straightforward as it gets: Two companies (Aetna and Highmark BCBS) for both the individual and small group market, both on- and off-exchange, period...and their website includes the actual affected enrollee tallies for each, giving weighted totals:

Ugh. Nearly 25% requested for the individual market, just under 10% for the small group market. Of course these are requests only, so they might be slashed somewhat by regulators yet.

THIS JUST IN...

CMS today conditionally approved Delaware and Pennsylvania to operate State-based Marketplaces (SBMs)" #kingvburwell @charles_gaba

— Dan Mangan (@_DanMangan) June 15, 2015

Obama administration has approved Pennsylvania and Delaware’s blueprints to become state-based ACA exchanges next year.

— Dylan Scott (@dylanlscott) June 15, 2015

It appears that at while most of the 34 states on the federal exchange have spent the past 5 months wandering around aimlessly, at least two of them did pay attention last November when the Supreme Court, to the astonishment of anyone with an ounce of sanity, agreed to take up the King v. Burwell case.

Tom Wolf, the newly-elected (Democratic) Governor of Pennsylvania, announced back in March that yes, he would absolutely push to "establish" a state ACA exchange in the event of a King plaintiff win, and earlier this week he made good on this by formally submitting an application to the HHS Dept.:

Pennsylvania became the first state Tuesday to publicly put in motion a back-up plan to protect its federal health insurance subsidies in the event the Supreme Court dismantles a key part of President Obama’s health care law.

OK, this is the 2nd most obscure data update I've received so far this fall (the first was Hawaii's "more than 40" on the first day):

State officials say they don't yet know how enrollment is going this year in Delaware's health insurance exchange.

The Delaware Health Care Commission received an update Thursday on the second year of implementation of the Affordable Care Act.

But state health and social services officials say won't be able report any enrollment numbers until they get them from the federal government. They say they hope to see the first monthly federal report around later this month.

I did receive these oddly-worded tidbits via Twitter:

More than 23,612 Delawareans have enrolled in a #ACA plan since October 2013 #netDE

— Jen Rini (@JenRini) December 4, 2014

No 2015 data yet, but at least this has an update to the ACA Medicaid expansion figure for Delaware, tiny though it might be:

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage through Delaware’s expanded Medicaid program, which continues year-round. More than 9,000 individuals have received coverage under the Medicaid expansion in the past year.

Hmmm....like Hawaii, this enrollment update is a) tiny (small state) and b) confusing, since it means that either not a single additional person has enrolled in Delaware since April 30th (which I highly doubt), or it means that the number of people dropping out has precisely matched the number added since then (which I also highly doubt), or it means that the reporter got their numbers and dates mixed up by mashing up the 4/30 QHP total with the 8/31 Medicaid total:

As of Aug. 31, a total of 22,340 Delawareans have enrolled in coverage since Oct. 1, 2013, which Rita Landgraf, secretary of Delaware Health and Social Services, said came as a pleasant surprise to the commission.

...Of the enrollees in the health-care marketplace over the past 11 months, 7,943 individuals enrolled as part of the Medicaid expansion, an 8 percent increase from the month of July.

As deaconblues notes, if you subtract the 7,943 Medicaid additions from the 22,340 total above, you get...14,397...the exact same number that was reported as of May 1st.

Last October, at the height of the botched HC.gov rollout, I repeatedly commented over at Daily Kos:

 I still don't know why they didn't roll it out one state per day; if they'd gone alphabetically, they would have had a solid week to work the kinks out with a (relatively) low volume before hitting a big state:

  • Alabama, Alaska, Arizona and Arkansas are all relatively low-population.
  • California, Colorado, Connecticut and Delaware* are all state-run exchanges.
  • That means they wouldn't have hit Florida on the federal site until tomorrow.

I know that the system still would have had serious software issues, but at least they wouldn't have to deal with the massive overload of traffic at the same time that they were trying to fix the issues.

*(Obviously I was mistaken at the time about Delaware running their own exchange, but it's still a low-population state so my point was still valid...and of course the District of Columbia does run their own exchange).

Well, obviously it was too late for that at the time, and they've since scrambled to get their act together on the individual exchange side.

Remember, the HHS report from yesterday only runs through 4/19...there's still 11 days worth of data missing from most states...

DOVER, Del. (AP) — Final enrollment numbers released by state officials Thursday show that 14,397 Delawareans signed up for health insurance coverage under the federal Affordable Care Act in the first year of open enrollment.

....Health and Social Services Secretary Rita Landgraf told the state Health Care Commission that 4,217 other Delawareans were found eligible for coverage under expanded Medicaid rules the state adopted as part of an effort to reduce the number of uninsured residents.

The numbers are small, but the percentages are impressive: Delaware's 3/31 tally is in:

DOVER – Delaware ended its first enrollment period for the nation's new Obamacare health plans with 11,335 people enrolled – about 3,000 more than federal goals for the state.

Another 3,411 people gained coverage through the state's expanded Medicaid coverage, which extended eligibility to 138 percent of the federal poverty level.

Pages