START OF 2018 OPEN ENROLLMENT PERIOD

Time: D H M S

Maryland

Up until a week ago, the possibility of Donald Trump pulling the plug on Cost Sharing Reduction reimbursement payments was a looming threat every day. While it hadn't actually happened yet, most of the state insurance commissioners and/or insurance carriers themselves saw the potential writing on the wall and priced their 2018 premiums accordingly (or at the very least prepared two different sets of rate filings to cover either contingency).

A few spread the extra CSR load across all policies, both on and off the exchange. This seems like the "fairest" way of handling things on the surface, but is actually the worst way to do so, because it hurts all unsubsidized enrollees no matter what they choose for 2018 and can even make things slightly worse for some subsidized enrollees in Gold or Platinum plans.

The Maryland Health Connection is now allowing residents to comparison shop for 2018:

View 2018 health insurance plans and prices now!

MarylandHealthConnection.gov has already been loaded with plans and prices for 2018, one month before open enrollment begins. The upcoming open enrollment period will run November 1 - December 15. Health coverage will start on January 1, 2018.

  • How do I get an estimate for 2018 health insurance plans?

You can compare plans and prices through a desktop computer browser or by downloading our mobile app, Enroll MHC, on your iPhone or Android.

Click on “Get Started”- this will take you to the application portal. Next, click “Get an Estimate” on the application site. Finally, enter basic information like your county, age and income to see what coverage and financial help you may qualify for. If you choose to get an estimate, the site will take you through a scenario of what plans and pricing you could receive for 2018. You won’t actually be applying for coverage.

When I last checked in on Maryland's individual market rate hikes for next year, the picture was pretty grim: Overall requested increases of around 46%...and that assumed that CSR reimbursements are made in 2018. If you assume CSRs aren't paid, it looked even worse: A whopping 57% average increase statewide for unsubsidized enrollees. Ouch.

Today, the Maryland Insurance Dept. issued their approved rate changes for the individual and small group markets...and while they did knock the rate increased down significantly, there's still not much to be cheery about. It also includes a couple of handy additional data points:

The Maryland Insurance Administration Approves Non-Medigap Premium Rates for 2018 Small Group and Individual Markets

Open Enrollment Begins Nov. 1 in the Individual Market; Consumers Encouraged to Shop Rates

As noted the other day, now that I've compiled the initial 2018 rate filing requests for 46 states + DC (the remaining 4 states aren't public yet), it's time to go back to the earlier states I analyzed and see whether there's been any updates/corrections to my original estimates. I started running the numbers back in early May, and a lot has changed since then, with carriers dropping out of the exchanges, expanding to fill the gaps or simply refiling with revised pricing requests.

Maryland was the second state I analyzed; I originally came up with the following average:

UPDATE: As I've been warning for months, at least one of Maryland's carriers has 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.

Maryland is the 2nd state to post their initial 2018 rate filings.

Last year they had 6 carriers participating in the individual market; this year it looks like all 6 are still planning to participate:

  • CareFirst Blue Choice, Inc​
  • CareFirst of Maryland Inc.
  • Group Hospitalization and Medical Services Inc. (GHMSI)
  • Cigna Health and Life Insurance Co.​​
  • Evergreen Health, Inc.​​
  • Kaiser Foundation Health Plan of the Mid-Atlantic States​​

The initial 2018 filings for four of the six carriers are pretty straightforward. Two of them are a bit tricky, though: Kaiser Permanente and Evergreen Health.

After New York and Washington State, Maryland is the 3rd state to release their final official OE4 enrollment numbers:

NEARLY 158,000 MARYLANDERS ENROLLED IN HEALTH COVERAGE FOR 2017 THROUGH THE STATE MARKETPLACE

INCLUDING MEDICAID, 501,000 HAVE ENROLLED SINCE NOV. 1

BALTIMORE (Feb. 1, 2017) – A total of 157,637 Marylanders enrolled in private health coverage plans for 2017 by yesterday’s deadline for open enrollment, capped by the largest single-day call volume ever for Maryland Health Connection, the state’s health insurance marketplace.

Including Medicaid enrollments, more than a half-million Marylanders have newly enrolled or renewed in health coverage for 2017 through the state marketplace since Nov. 1 when open enrollment began. Maryland Health Connection now covers 1.1 million in all — one of every six people in Maryland.

Hmmm...I'm honestly not sure what this last number (1.1 million covered by the exchange) refers to...they just said it was 158K QHPs + 343K in Medicaid = 501K total.

Quickly before I leave for the evening: Just received the 12/15 enrollment number from the Maryland exchange:

  • 148,610 QHP selections total
  • 87,009 of these are auto-renewals
  • This is slightly ahead of last year's 12/15 tally

Will add to spreadsheet/etc. later this evening.

Nice catch by ME: This is actually slightly lower than last year as of the same date.

Maryland still hasn't posted an official enrollment data report for the 2017 Open Enrollment Period, but they did reveal a pretty impressive rough enrollment number yesterday:

About 130,0000 Marylanders have signed up so far for insurance plans for 2017 through marylandhealthconnection.gov. Open enrollment began Nov. 1 and lasts through January, though people who want insurance starting Jan. 1 must be signed up by Thursday. About 163,000 people were enrolled in private plans this year, an increase of 33 percent from 2015.

The article was posted yesterday (12/12), so I assume the 130K figure is as of 12/11. I'm fairly certain that this includes auto-renewals, seeing how last year their 12/15 tally stood at 150K including all renewals (both passive and automatic).

It's difficult to do an exact apples to apples comparison, however, since enrollments should be ramping up dramatically during these final few days before the 12/15 deadline, so I'm not gonna try.

I haven't written a single word about Maryland since early October. Last year their ACA exchange was very good about posting fairly regular enrollment updates; this year they've been dead silent about it so far, which is rather surprising (and no, I don't think it's because their numbers are bad...every other state I have data for seems to be doing pretty well or even better than last year so far).

Anyway, there's one bit of news out of the Old Line State (yes, I had to look it up to find out what their nickname is) today which is disappointing but not surprising when you understand the circumstances:

The Maryland Insurance Administration barred Evergreen Health from selling health insurance policies for individuals until federal and state regulators decide whether to allow the cooperative to convert to a for-profit insurer and receive a much-needed cash infusion.

On Monday, I thought that Your Health Idaho was first out of the gate with bringing their 2017 Window Shopping tool online. However, it looks like Maryland launched their all-new 2017 system the same day:

With less than one month until open enrollment begins, we want you to be armed with the knowledge you need to sign up or choose a new plan for 2017. You can now browse and compare prices online at MarylandHealthConnection.gov or on your phone or tablet through our new mobile app, Enroll MHC. Find the free app in the Play Store for Android or Apple’s App Store.
Here’s how to get started:

h/t to Esther F. for the heads up:

Amy Goldstein at the Washington Post writes:

Evergreen Health, Maryland’s version of the innovative nonprofit insurers created under the Affordable Care Act, decided Monday to become a for-profit company to avoid the possibility of a shutdown, according to its chief executive.   

If the switch is approved as expected by federal and state officials, Evergreen’s unprecedented move will leave standing only five of the 23 co-ops, or Consumer Operated and Oriented Plans, which started nearly three years ago.

...Evergreen, which covers nearly 38,000 Marylanders, has been trying for the past year to forge an arrangement with federal health officials to stabilize its finances. It enlisted help from the state’s congressional delegation and in June filed suit against the federal government.

As noted below, only around 8,000 are on enrolled in individual ACA exchange policies; the rest are either off-exchange or small/large group coverage.

A couple of weeks ago the final approved rates for Maryland's individual market were released; when plugging these into my table, my estimate of the statewide weighted average was 24.8%.

Thanks to the heads up from Louise Norris, however, I now have hard numbers from the Maryland Dept. of Insurance. I was close, but the actual weighted average is slightly higher. In addition, they've provided the small group averages as well:

The Maryland Insurance Administration Approves Premium Rates for 2017 Small Group and Individual Markets
Open Enrollment Begins Nov. 1 in the individual market; Consumers Encouraged to Shop Rates

Every once in awhile I remember what I actually do for a living (I'm a website developer, for those who don't know). That's actually a major reason I started this project in the first place...the techical meltdown of HealthCare.Gov and many of the state-based exchange sites in October 2013 fascinated me, leading me to start trying to assess just how many people were actually enrolling in the plans using the messy websites, and it spread from there.

Since then, of course, most of the exchange sites have been vastly improved. HealthCare.Gov is literally​ 100,000x better than it was in 2013 (while also now being considered among the most secure major consumer websites in the world), and has completely overhauled and streamlined their user interface and workflow process (cutting the number of screens for creating an account from around 80 down to 16). They've also added some nifty features like their Expected Total Cost, Network and Formulary tools.

Thanks to "M E" in the comments for the heads up regarding Maryland's approved rate hikes:

The cost of health insurance plans offered under the Affordable Care Act will jump 20 percent or more next year under rates to be announced Friday by Maryland regulators.

His remarks came as the Maryland Insurance Administration approved double-digit rate increases for the four companies that sell health plans through the state exchange, an online marketplace set up under the law for people who cannot buy coverage through their employer.

...CareFirst, which holds 68 percent of the market, received an average hike of 31.4 percent on its PPO plan and 23.7 percent on its HMO — the highest increases of any insurer.

...Rates in Maryland also have been typically lower than those nationally under the Affordable Care Act, so there could be some normalizing going on, said John Holahan, a fellow in the Urban Institute's Health Policy Center.

"Maryland rates have been lower than the rest of the nation so it seems some catching up should be expected," said Holahan.

Maryland was one of the first states I ran a weighted average rate request on back in May. At the time, it looked like around a 15.0% average request for the individual market state-wide:

However, as with Arizona and Tennessee, the largest carrier in the state has since submitted revised rate requests:

BALTIMORE – Commissioner Al Redmer, Jr. will be conducting a second public hearing on Monday, August 15th from 11 am – 1 pm at the Maryland Insurance Administration located at 200 St. Paul Place, 24th floor Hearing Room, Baltimore, MD 21202 to receive public input on a revised filing made by CareFirst. On July 26, CareFirst refiled its 2017 proposed rates for the individual market and requested a 27.8% rate increase for HMO plans and a 36.6% rate increase for PPO plans. CareFirst previously requested a 12.0% and 15.3% rate increase, respectively.

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