As the final deadline for final 2018 individual market rates to be locked in and the contracts signed, more states are coming into focus, and the pattern continues to be remarkably consistent.
In Mississippi, I originally pegged the requested rate hikes across the two individual market carriers (technically three, but "Freedom Life" is a phantom carrier with only 2 alleged enrollees) at 16.1% if CSR payments are made and 39.6% if they aren't. It turns out I was off by a bit, however, because I didn't realize that BCBS of Mississippi was only selling policies off-exchange next year. That means the CSR issue won't impact them either way, since none of their enrollees would receive the assistance anyway.
There's only two carriers participating in Mississippi's individual market next year (plus Freedom Life, which once again is just a shell company here). They're asking for 16.1% average rate hikes, and since there's no mention in any of the filings about CSR payments not being made or the mandate not being enforced, I'm assuming that increase doesn't account for those factors.
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I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
UPDATE: This story has, thankfully, gone quite viral since I originally posted it yesterday morning. One important clarification: I estimated the monthly cost for treatment at around $5,200. According to Ms. Nichols in this local story about the situation in the Clarion-Ledger, the cost for her daughter’s treatment/medication is around $2,000; the balance appears to be for her husband, who also has diabetes. This actually makes the family more sympathetic, because she’s only asking for state assistance for her daughter’s portion of the bill.
In addition, according to the updated local story, the message appears to have gotten through to Rep. Guice (at least to the point that he's issued an apology, anyway):
Guice, who told The Clarion-Ledger Tuesday morning "I don't do interviews" and declined to comment, issued an apology Tuesday night.
For most of the states I'm analyzing, I have hard enrollment numbers for the insurance carriers requesting rate hikes over 10%; it's the remaining companies (the ones seeking hikes of less than 10%) which are generally the big unknowns.
Assuming subsidies remain in place, none of the individual plans available in Mississippi’s exchange have requested double digit rate increases for 2016. The only exchange plan requesting a rate increase of ten percent or more is a small group plan from United HealthCare. Rate increases of at least ten percent are published on Healthcare.gov’s rate review tool, and the only individual market Mississippi plans on the list are off-exchange.
A hospital group in cash-strapped Illinois says the state might be able to set up a health insurance exchange at a lower cost by "leasing" the federal government's technology, an option that could appeal to as many as 34 states where subsides could be jeopardized by an unfavorable U.S. Supreme Court decision.
Why has the law been such a flop in a state that had so much to gain from it? When I traveled across Mississippi this summer, from Delta towns to the Tennessee border to the Piney Woods to the Gulf Coast, what I found was a series of cascading problems: bumbling errors and misinformation; ignorance and disorganization; a haunting racial divide; and, above all, the unyielding ideological imperative of conservative politics. This, I found, was a story about the Tea Party and its influence over a state Republican Party in transition, where a public feud between Governor Phil Bryant and the elected insurance commissioner forced the state to shut down its own insurance marketplace, even as the Obama administration in Washington refused to step into the fray. By the time the federal government offered the required coverage on its balky HealthCare.gov website, 70 percent of Mississippians confessed they knew almost nothing about it. “We would talk to people who say, ‘I don’t want anything about Obamacare. I want the Affordable Care Act,’” remembered Tineciaa Harris, one of the so-called navigators trained to help Mississippians sign up for health care. “And we’d have to explain to them that it’s the same thing.”
This is the third 2015 rate change update today; I had already reported on the 25% drop on one of the companies operating on Mississippi's exchange a few weeks ago, but this makes it official, and also reveals that the 2nd provider (there's only 2 on MS's exchange) is only requesting to raise their rates by 6.5%:
This Just In: From the Paul Gallo Show, the Mississippi Insurance Dept. and Cover Mississippi: One of the 2 insurance companies operating on the ACA exchange in Mississippi plans on cutting their rates by a whopping 25%!
The caveat is that we still don't know what the other company's rate plans are, nor do I know what that 25% rate cut was in the first place, but this is still excellent news:
A solid number, a fairly solid date (assuming 3/16) and a confimation that it's private QHPs only, since they include the 3/01 number:
Jarvis Dortch, program manager and staff attorney for Mississippi Health Advocacy Program, said federal figures show roughly 32,000 Mississippi residents had enrolled in health exchange coverage through mid-March. That's up from the 25,554 who had enrolled by the end of February, but still thousands short of the original projection that 46,000 would enroll in the first five months.
Mississippi started March with 25,554 as of 3/01, so this means they went up 2,946 in about 14 days (3/01 - 3/15), or 210/day. However, this is actually a 28% drop from February's 293/day. So far, out of 15 states which have provided March data, 10 are showing daily average increases from 116% to 295%, 1 is holding steady (Rhode Island) and 4 are showing a slowdown...but the overall increase over February is 176% as of today.
OK, as noted a little earlier, I underestimated the February HHS Report for Exchange-based Private QHP enrollment by about 4.2%:
My Projection: 902,800 (4.202 million total)
Actual Enrollments: 942,833 (4.242 million total)
I'm perfectly happy to have underestimated. As for where the extra 40,000 enrollments came from, my initial guess would be that California, in particular, started ramping up their big March blitz a bit earlier and more successfully than I figured, which, again, I'm absolutely fine with.Update: Nope, actually, California's numbers plummetted in the 2nd half of Feb due to that ugly technical outage; see below for details.
I'm busily plugging the new enrollment numbers into the spreadsheet even as I type this, and will be updating with various notes and observations, so keep checking in.
OK, I've entered the QHP data; a couple of things to note:
UPDATE: On the down side, I was off by 4% this time around.
On the up side, I UNDERESTIMATED:
Actual Feb. enrollments: 942,833, for a total of 4,242,325 thru 3/01/14.
Sarah Kliff at Vox just announced that the February HHS report is expected to be released today at around 4:00pm. A few items in anticipation of that:
As I've noted several times, I'm projecting the report to total around 902,000 exchange-based private QHP enrollments for the month of February (technically 2/02 - 3/01)
If accurate, this would bring the cumulative total of exchange-based private QHP enrollments to 4.202 million (from 10/1/13 - 3/01/14)
From the data I have, the average daily enrollment rate in February was almost identical to that of January, which had about 1.146 million QHP enrollments. HOWEVER, the January report included five weeks of data (12/28 - 2/01), while the February report will only include four weeks (2/02 - 3/01). Therefore, even at the same daily average, it'll be about 20% lower no matter what.
If you want to get REALLY specific, call it 902,800 and 4,202,292.
I've been dead-on target 6 times in a row without hyping up my projections beforehand. This time I am hyping myself up beforehand, so I'll probably be way off...but as long as I've UNDERestimated the tally, I'll be perfectly fine with that...
The report will be released in about 5 minutes, but my kid gets home from school in about 10, so it'll be a good 20 minutes before I can really post anything. Feel free to follow Sarah Kliff of Vox in the meantime!
Mississippi:Private up to 2,000 from 802(h/t Steve Mullinax, aka rsmpdx)
Transcript from Jeffrey Hess of Mississippi Public Radio, NPR Audio:
Only two insurance companies are offering plans in Mississippi, and they only overlap in four of the state’s 82 counties. However, those two companies appear to be betting that the web site problems and skepticism about the exchange in general are passing. One of the two companies, Humana, launched a late-December ad campaign to drive more people to the site, says spokesman Mitch Lubitz. “There’s been a ramp-up as the HealthCare.gov web site has gotten easier to use and there have been other options for people to go on and get information and enroll.” Mississipi’s Insurance Commissioner Mike Chaney says the improvements to the enrollment process are good, but he’s still skeptical they’ll be able to get enough people signed up this year. “From zero to ten, I’d give it a confidence level of about a three.” Hess: “That’s still not very good.” Chaney: “That’s not, but it’s better than where I was, a one, a week before last. “Chaney says the unofficial count is around two thousand people enrolled, but he says if the confidence trend continues upward, his confidence will rise to a five.”