Tennessee: Correction re. final 2019 #ACA rate changes: 12.4% DROP (vs. ~22% drop w/out #ACASabotage)


Time: D H M S

When I last posted about 2019 ACA-compliant individual market premium changes in Tennessee back in August, I noted that premiums statewide had gone from dropping 5.7% to dropping 10.8% on average after the Trump Administration first stated that they were going to unnecessarily "freeze" the ACA's Risk Adjustment fund transfers in response to a lawsuit ruling only to reverse themselves a week or so later and state that they were going to go ahead and process RA fund transfers after all.

In other words, the Trump Administration once again deliberately caused a panic across the industry only to "save" the industry from the very threat which they had posed in the first place.

In any event, here's what I thought the Tennessee's premium situation looked like when the dust settled:

It turns out I made one important error--note that while I have hard enrollment numbers for Blue Cross Blue Shield and Cigna Health, I didn't have Oscar's enrollment number at the time so I estimated it at around 31,000 enrollees based on the total statewide market. It turns out I was wrong about this. Here's the official number from Oscar's rate filing:

The purpose of this memorandum is to present justification for a rate increase for Oscar Insurance Company’s (Oscar) individual market plans in Tennessee, effective January 1, 2019.

This justification is intended to comply with the requirements of Section 2794 of the Public Health Service Act as added by Section 1003 of the Patient Protection and Affordable Care Act (ACA). This justification may not be appropriate for purposes or scopes beyond those described above and, therefore, should not be used for other purposes.

This letter specifically addresses products with rate increases in excess of 15% requested for Oscar’s individual market plans, which impacts 14,107 members as of March 31, 2018.

With Oscar's market share cut in half, Tennessee's statewide average drops a bit further, from -10.8% to -12.4%. I also knocked down my estimate of the #ACASabotage impact from 12% to 10% based on data from other states which indicate which the individual mandate being repealed and #ShortAssPlans being expanded likely aren't having quite as much of a negative impact on the ACA risk pool as originally feared.

With those changes in mind, here's what Tennessee looks like now:

Unsubsidized enrollees are paying around $803/month on average in Tennessee this year. a 10% sabotage impact means that they're paying $80 more than they would otherwise, or around $960 more apiece for all of 2019.

Combine this with the $1,400 or so #ACASabotage hit this year from last year's sabotage by the Trump Administration (primarily his cutting off CSR reimbursement payments, along with other deliberate actions he took to destabilize the market) and that's a whopping $2,360 extra per unsubsidized enrollee over the 2-year period (2018 - 2019).