2018 MIDTERM ELECTION

Time: D H M S

New York

Thanks to Bill Hammond of the Empire Center for the heads up.

Like Pennsylvania, the New York Dept. of Financial Services made it very easy for me this year:

This chart sets forth the average premium rate adjustments that health insurers have requested from the New York State Department of Financial Services (DFS). There are 16 insurers that have submitted individual rates and 20 insurers that have submitted small group rates for 2018. These are the rates insurers have requested and are not the final premium rates DFS will approve. Under the Insurance Law, the Superintendent may deny or modify the requested rates if she finds that the insurer's request is unreasonable, excessive, discriminatory or inadequate based on sound actuarial assumptions and methods (Insurance Law §§ 3231(e)(1), 4308(c)). From the date DFS posts insurer rate applications on the DFS website, the public will have 30 days to submit comments to DFS on the proposed rates. The total percentage requested rate increase for individual and for small group on the chart below represent a weighted average that accounts for the relative share of overall enrollment for each insurer.

So, I got back from my trip to the NIHCM awards dinner in DC late last night, and am groggily attempting to bone up on all the healthcare stuff which happened while I was gone (ironic, of course, given that I was attending a healthcare-related event filled with other healthcare wonks/reporters).

In the past 2 days...

There are so many stories I could be writing right now about the fallout, potential fallout, next steps and so forth of yesterday's House vote on the AHCA. But this one in particular really says it all.

Here's an article in the Buffalo News regarding New York Republican Congressman Chris Collins (NY-27), who voted for the bill:

Watch: Chris Collins admits he didn't read health care bill

WASHINGTON – Rep. Chris Collins told CNN that he didn't read the entire Republican health care bill that the House passed Thursday.

And then he told The Buffalo News that he was unaware of a key provision in the bill that decimates a health plan that serves 635,000 New Yorkers.

Asked by CNN's Wolf Blitzer if he had read the entire health bill, Collins, R-Clarence, said: "I will fully admit, Wolf, that I did not. But I can also assure you my staff did. We have to rely on our staff. ... I'm very comfortable that we have a solution to the disaster called Obamacare."

I'm actually a bit surprised that NY State of Health is the first state exchange out of the gate with final enrollment numbers, but good for them:

Press Release: NY State of Health Announces Enrollment Surges: More Than 3.6 Million New Yorkers Secure Health Coverage

Feb 1, 2017

  • Nearly 50,000 sign up during final two days of Open Enrollment
  • An additional 800,000 New Yorkers enroll through the Marketplace since January 2016

ALBANY, N.Y. (February 1, 2017) -- NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.6 million New Yorkers enrolled in comprehensive health coverage through NY State of Health, a 28 percent increase from 2016.

“New York continues its commitment to bring affordable, comprehensive health coverage to New Yorkers” said NY State of Health Executive Director, Donna Frescatore. “New Yorkers now have access to affordable health insurance coverage, giving hundreds of thousands of previously uninsured individuals economic and healthcare security.”

With the GOP Congress still obsessed with repealing the ACA and Donald Trump doing everything in his power to sabotage the law whether it gets repealed or not, the final 5 days of the 2017 Open Enrollment Period, which would normally see a spike in enrollments regardless, is going into a bit of a panic mode. Trump and his Republican cohorts are doing whatever he can to discourage people from enrolling before the deadline, while the insurance carriers, healthcare advocates and everyone else is doing whatever they can to encourage it.

New York State of Health, the NY ACA exchange, just announced that with the 1/31 final deadline rapidly approaching next Tuesday, they're extending their customer service hours on Saturday and Sunday.

In their first enrollment update report two weeks ago, the NY State of Health exchange reported these numbers as of Christmas Eve:

The breakdown of enrollment as of December 24, 2016, is as follows:

  • Total cumulative enrollment: 3,472,214
  • Total Medicaid enrollment: 2,332,683
  • Total Non-Medicaid enrollment: 1,139,531
  • Essential Plan: 635,909
  • Qualified Health Plan: 217,995
  • Child Health Plus: 285,627

On Saturday they updated their numbers through January 19th:

Back in mid-December, just about all of the ACA exchanges bumped out their enrollment deadlines for January 1st coverage by a few days. I was mildly surprised because improvements in the bandwidth, coding, layout and support staffing have meant a smoother process towards the big last-minute surge. Still, I wasn't blown away by the development or anything, as mid-December has always seen a massive spike in enrollment.

On the other hand, this announcement by the New York State of Health exchange is very surprising:

New Yorkers Now Have Until January 18 to Enroll in or Renew Health Insurance Coverage Beginning February 1

Consumer Demand Remains High Prompting Deadline Extension

ALBANY, N.Y. (January 12, 2017) – NY State of Health, the state's official health plan Marketplace today announced that consumers now have three additional days to enroll in a health plan with coverage starting February 1. The deadline has been extended through 11:59 p.m., January 18. The previous deadline was January 15.

At long last, the New York State of Health ACA exchange has released hard enrollment numbers for the 2017 Open Enrollment Period:

22 Percent Increase Over Last Year  •  New Yorkers Show Demand for Quality, Affordable Healthcare

ALBANY, N.Y. (January 6, 2017) – NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.4 million people have enrolled in health insurance through December 24, 2016.

With almost a month to go until the end of the 2017 Open Enrollment period, participation in the NY State of Health Marketplace has already increased more than 22 percent since the last Open Enrollment period ended, January 31, 2016. Enrollment has increased in all 62 counties of the state. The overall share of New Yorkers now enrolled through the NY State of Health has reached nearly 18 percent of the state’s population.

Hat tip to Dan Goldberg for the heads up. (also thanks to Amy Shefrin)

Yesterday I crunched some numbers and estimated that, assuming a full ACA repeal w/immediate effect and no replacement, roughly 800,000 New Yorkers would almost certainly lose their healthcare coverage, including:

  • ~129,000 highly-subsidized QHP enrollees,
  • ~380,000 Basic Health Plan enrollees, and
  • ~286,000 Medicaid expansion enrollees

However, according to a major press release from NY Governor Andrew Cuomo's office this morning, I massively underestimated the Medicaid total:

Over 2.7 Million New Yorkers Would Lose Coverage
Estimated State Budget Impact of $3.7 Billion
Counties Across New York Would Lose Over $595 Million in Direct Spending
New York Residents Would Lose $250 Million in Health Care Savings Tax Credits

IMPORTANT: SEE MAJOR UPDATE/CORRECTION HERE!
ACTUAL NUMBER LIKELY TO LOSE COVERAGE: 2.5 MILLION

New York is a little different: For one thing, they haven’t actually released any 2017 Open Enrollment data yet (other than a cryptic “55K enrolled over a 3-day period", which isn't very useful). They should be up to around 200K w/out auto-renewals by now. More significantly, they're one of only 2 states (Minnesota's the other) which features the ACA's Basic Health Plan. Unlike QHPs, which are divided into subsidized and unsubsidized enrollees, the BHP program is entirely dependent on ACA financing, so if the law is repealed, all BHP enrollees are kicked to the curb, just like Medicaid expansion enrollees would be.

Oof. I've been compiling a lot of charts and graphs the past week or so based on what I thought were the most comprehensive 2017 enrollment numbers available to date. The biggest data gaps are Vermont and New York, neither of which has released any enrollment data yet...or so I thought.

However, I somehow completely forgot this post from the thick of the original December 15th deadline:

In the past three days, more than 55,000 New Yorkers have enrolled or renewed coverage through NY State of Health. The Customer Service Center has answered more than 1,000,000 calls since the start of Open Enrollment on November 1 and an average of 46,000 calls a day this week. The NY State of Health website has also experienced high traffic reaching 12,000 users in peak hours.

...This is also the first time this enrollment period that NYSoH has released any actual enrollment data: 55,000 renewals + new signups. Unfortunately, that number only includes 12/12 - 12/14...no earlier numbers are included. Still, I'll take what I can get...

And New York makes it three:

NY State of Health Deadline Extended! New Yorkers Now Have Until December 17 to Enroll in or Renew Health Insurance Coverage Beginning January 1, 2017

High Enrollment Activity Prompts Deadline Extension

ALBANY, N.Y. (December 15, 2016) - NY State of Health, the state’s official health plan Marketplace today announced that the deadline to enroll or renew coverage for a health plan effective January 1 has been extended through December 17. The previous deadline was December 15. Consumers have two additional days to enroll in a plan with coverage starting January 1.

“NY State of Health is having the busiest open enrollment period yet and we want consumers to have a little more time to select a health plan for January 1, 2017.” said NY State of Health Executive Director, Donna Frescatore.

Thanks to Dan Goldberg for the heads up:

NY State of Health: The Official Health Plan Marketplace 2016 Open Enrollment Report August 2016

It's a whopping 64 pages long. Some of it is stuff like "how many people speaking Cambodian called the support lines?" (answer: 6) and the like, but there's also a whole bunch of handy data regarding actual healthcare policy/program enrollment in the Empire State. I don't mean to be ungrateful, as this is extremely comprehensive...but it would've been far more useful if the report had included data from the end of March (or even later), as opposed to cutting off at the end of the 2016 Open Enrollment period (January 31st). Due to attrition due to people who never pay their first premium, are denied policies for legal reasons (residency status, etc) and so on, only around 82% of the 272,000 people who selected QHPs in NY during OE3 were still actually enrolled as of two months later. A good 10-12% or so never paid in the first place and another 6-8% were kicked off involuntarily for one reason or another...none of which is reflected in this report.

Still, that aside, let's take a look!

Just as I'm wrapping up calculating the weighted average rate hikes requested in all 50 states, New York just became the second state (after Oregon) to release their approved rates:

Shout-out to Zachery Tracer for the heads up for this press release from the New York Dept. of Financial Services:

DEPARTMENT OF FINANCIAL SERVICES ANNOUNCES 2017 HEALTH INSURANCE RATES

Thanks to Zachery Tracer (as well as Dan Goldberg & Cynthia Cox) for the heads up...

Well, now...this is about as cut & dry as it gets! They don't display the actual enrollment numbers for each carrier, but that's OK because the only real reason I need it in the first place is to weight the increases by market share...which the New York Dept. of Financial Services has helpfully already done!

And there you have it: A weighted average requested rate increase of 17.3% across the entire state's ACA-compliant individual market. Remember that NY never allowed transitional plans anyway, and there are likely only a handful of grandfathered plans left on the individual market, so this should cover well over 90% of the market.

They also included the Small Group market, which I take note of when available but don't really track nearly as closely as the indy market:

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