START OF 2018 OPEN ENROLLMENT PERIOD

Time: D H M S

Kansas

I was a bit confused by the initial rate hike request for individual market carriers in Kansas, but it seems I was overthinking it. There will be three carriers offering indy market plans this year: Medica, Blue Cross Blue Shield of Kansas and Ambetter (aka Centene, but operating under the name "Sunflower State" here, which is just annoying).

Ambetter ("Sunflower State") is new to the state, so there's no "rate hikes" to speak of. My confusion was regarding BCBSKS, which is already on the KS exchange but didn't appear to submit any actual "rate change" request last time I checked. Louise Norris has cleared up this mystery:

Until recently, my 2018 Rate Hike project was still missing 4 states: Kansas, Missouri, Nevada and Utah. Last week Missouri finally posted their requested rate increases for next year. Today it looks like Kansas has done the same...at least partly.

As I noted back in June, there are 3 carrers on the KS individual market this year: Medica, Blue Cross Blue Shield of Kansas Solutions and Blue Cross Blue Shield of Kansas City. Any confusion between the BCBS names was made moot, however, as BCBS of KC announced they were dropping out of the indy market anyway.

That leaves Medica and BCBSKS, both of whom filed plans to stay on the market...but only Medica appears to have actually submitted rate requests, for a mere 7,600 enrollees:

Between updating the "Who could lose coverage" graphics, prepping for my town hall thing last night and updating the 2018 Rate Hike project, I've gotten way behind on my "Who's saying 'screw rate hikes, I'm just gonna bail completely next year' updates. Let's take care of that now, OK? The first three updates are courtesy of Louise Norris writing for healthinsurance.org; the fourth is vai Kimberly Leonard for the Washington Examiner:

IDAHO: BridgeSpan is out, 4 carriers staying put:

Insurers in Idaho had to submit forms for 2018 plans by May 15, but they have until June 2 to file rates. Mountain Health CO-OP, SelectHealth, PacificSource and Blue Cross of Idaho all filed forms to continue to offer Your Health Idaho plans in 2018.

As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.

My standard methodology applies:

I originally looked at the requested rate hikes in Kansas back in June; at the time, the weighted statewide average was roughly 35%.

While I haven't seen any press releases or news stories about it, when I looked at HealthCare.Gov's rate review database this morning, I saw that they have fianl (approved) rate increases listed for all of the Kansas listings. In most cases the requests were approved as is; in Coventry's off-exchange plans, however, are being increased more than requested, giving the following.

I should also note that according to Louise Norris, Medica is also entering the Kansas exchange for the first time, which means there's no "increase" to list since there's no current rates to compare them to.

The good news about Kansas is that 5 of the 6 carriers which have submitted 2017 individual market rate filings included their current enrollment totals in a clear, easy to see format...and the 6th one is (once again) "Freedom Life" which, judging by the dozen other states they've popped up in, almost certainly has only 1 or 2 enrollees (or none at all) anyway.

The bad news is...well, the requested rate hikes are pretty ugly: About 35.3% on weighted average.

Also, is it really necessary for Blue Cross Blue Shield to operate under three nearly-identical names? Really?

Thanks to JJGomez127 for the heads up:

Kansas health insurance marketplace may gain company offerings for 2017

TOPEKA, KS — Ken Selzer, CPA, Kansas Commissioner of Insurance, said today that Kansas health insurance consumers may have additional company options for coverage in the federallyrun marketplace for 2017.

“Health insurance options filed now for the individual market show that competition will likely continue for Kansans’ health insurance policies,” Commissioner Selzer said.

Filings with the Kansas Insurance Department as of May 2 show two additional carriers may participate in the marketplace. Medica, a non-profit, Minnesota-based company, and Coventry Health and Life are companies that have filed for the 2017 open enrollment period.

Medica Insurance Company is set to offer a number of plans, and Coventry is proposing Exclusive Provider Organization (EPO) Network plans. Both companies have filed to offer plans off the federally-facilitated marketplace as well.

When UnitedHealthcare announced last month that they were making good on their threat last fall to pull out of the individual market in over two dozen states next year, it caused shockwaves across the health insurance industry. It is an important development, as around 800,000 people will be impacted.

When Humana announced last week that they plan on pulling out of the individual market in at least 5 states next year, it was interesting and a bit of a bummer, but not nearly as earthshattering, because only about 25,000 people will have to shop around and find a new carrier.

Today, it is my duty to announce that Celtic insurance has also decided to pull out of the entire individual insurance market (both on and off-exchange) across at least 6 states, including:

This is really just a summary of my last 4 posts. I've combed through the SERFF databases for every state which uses the system for rate filings, and while very few have the actual 2017 rate filing requests listed yet, at least 4 of them have official individual market exit letters submitted for 2017 from Jane Rouse, the Product Compliance Process Owner for Humana Insurance Co:

This list may grow as additional state filing data and/or press releases come out from Humana, but assuming these are the only 4 states Humana is bailing on, the news isn't quite as bad as it appears at first.

To keep things in perspective, add the 4 numbers above up and it's 25,512 people across 4 states with a combined population of 21.8 million. Put another way, these 25.5K people represent only 2.9% of the 875,700 people Humana currently has enrolled in individual policies (both on & off exchange) nationally.

To be clear, I'm not saying this is a good development; when you combine it with the recent UnitedHealthcare Dropout Odometer it's more of a drip-drip-drip sort of thing. But it isn't disasterous for the exchanges either (at least not yet).

UPDATE: I've been informed by a reliable source that Humana is also dropping out of the individual market in Nevada next year, although I don't have any actual enrollment data there. Humana is not currently participating on the Nevada exchange, however, so any dropped enrollments would be OFF-exchange only. In fact, I'm pretty sure that the only individual market enrollees Humana has in Nevada are grandfathered policies anyway, so the numbers should be pretty nominal there.

Yep, sure enough, Humana is following UnitedHealthcare out the door of multiple states next year. That's 1,800 people impacted, although they're all OFF-exchange only:

OK, the bad news is that the requested 2016 individual market rate increases in Kansas were somewhere around 28%, with some as high as 38%. This would have looked something like this:

Ouch. The good news (well...relatively good, anyway), is that in the end, the approved rate hikes are considerably less...although still not pretty:

Premiums for Kansas health insurance plans offered in the federal marketplace won’t increase as much as originally proposed, state Insurance Commissioner Ken Selzer said Tuesday.

Kansas Insurance Commissioner Ken Selzer said Tuesday that premiums for health insurance plans offered in the federal marketplace won’t increase as much as originally proposed.

Hmmm...the headline looks bad, but when you read further it's clearly a matter of perspective more than anything else:

Maryland's health insurance exchange improperly billed the federal government $28.4 million, a Department of Health and Human Services audit reported Friday.

An inspector general's probe found a lack of oversight and internal controls, not criminal wrongdoing, was the cause of the exchange's problems since the marketplace opened in 2013.

I have a ton of ACA-related stories cluttering up my in-box again; here's some of the more interesting ones, all regarding ACA Medicaid Expansion:

MICHIGAN:

For months now, I've been a bit obsessed with figuring out how my home state's Medicaid expansion enrollment has managed to reach as high as 21% more people than were supposedly even eligible for the program. Estimates last year ranged from 477,000 - 500,000, yet enrollment in Healthy Michigan (Gov. Snyder's name for Obamacare Medicaid Expansion) currently sits at a whopping 579K, less than 1 year into the program.

Presented without comment:

How Brownback Is Relying On O-Care To Close Kansas' Huge Budget Hole

Kansas Gov. Sam Brownback (R) is calling all hands on deck to fix his state's huge self-imposed budget crisis, which nearly cost him re-election this year, and the staunch conservative is now receiving an assist from an unlikely source: Obamacare.

The state's well-documented budget troubles came after Brownback's dramatic reductions in taxes since taking office in 2011. With its revenue drying up and cash reserves depleted, Kansas is staring at a $280 million hole in its $6.4 billion FY 2015 budget, which ends in June.

Brownback offered his proposal for closing that hole last week, a mixture of spending cuts and transferring funds from other parts of the budget to fill it. And second biggest of those transfers is $55 million in revenue from a Medicaid drug rebate program that was bolstered under the Affordable Care Act.

The short version then is this: Obamacare is helping Kansas address its fiscal crisis -- even if Brownback's administration seems loath to admit it.

I'm kicking myself for not writing up a full post on this issue, since it's the issue which most directly connects today's election to ACASignups-specific issues, but thankfully, Sam Stein and Jeffrey Young have done a fantastic job anyway. The key takeaway is this:

There are two threads of conventional wisdom heading into Tuesday's midterm election. The first is that the election doesn't much matter. Regardless which party controls the Senate, President Barack Obama will still occupy the White House, which means gridlock will remain, if not escalate. The second is that, when it comes to Obamacare, the status quo will remain in place for at least the next two years. Senate Republicans may push for repeal votes. But Obama will veto them. Smaller reforms may pass. But the law will mostly remain intact.

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