Charles Gaba's blog

2019 OPEN ENROLLMENT ENDS (most states)

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Press Release: NY State of Health Drives Home the Importance of Affordable Health Coverage with Ridesharing Partnerships
Nov 9, 2018

Collaborations with Lyft, Uber, Independent Drivers Guild Reach Drivers Across NYS 

ALBANY, NY (November 9, 2018) – NY State of Health, the state’s official health plan Marketplace, today announced it is partnering again during the Open Enrollment Period with ridesharing companies Lyft and Uber, and with the Independent Drivers Guild. Through the partnership, tens of thousands of drivers throughout New York State will be urged to visit the Marketplace to shop for and enroll in quality, affordable health insurance. Open Enrollment for 2019 coverage began November 1. Consumers must enroll by December 15, 2018 for coverage beginning January 1, 2019.

MNsure, Minnesota's ACA exchange, posted a Week One enrollment update yesterday, and while it's generally positive, there's not much in the way of the key data I'm always seeking:

MNsure Update on First Week of Open Enrollment
November 8, 2018

ST. PAUL, Minn.—MNsure CEO, Nate Clark, issued the following statement recapping the first full week of open enrollment:

“This year’s open enrollment continues to go smoothly with consistently low wait times throughout the first week. With lower rates across the state, we have seen a steady stream of Minnesotans signing up for health coverage. We encourage Minnesotans to visit MNsure.org to see if they are eligible for exclusive tax credits that could lower their monthly premiums.”

This year to date, MNsure has renewed more people into coverage than ever before. Open enrollment figures will be released next Wednesday (11/14) at MNsure’s public board meeting at 1 p.m.

By the numbers 
As of end of day, November 7 

FULL DISCLOSURE: HealthSherpa has a paid banner ad at the top of ACASignups.net.

A year ago, I posted the following about HealthSherpa:

Here's the Wikipedia entry for HealthSherpa:

HealthSherpa is a California-based technology company focused on connecting individuals with health coverage. The site was initially developed as an alternative to research plans from Healthcare.gov, and now provides individual health, dental and vision benefits to both part-time employees and retirees. As of February 2017, over 800,000 people have been enrolled in individual health coverage through HealthSherpa.

First, I want to clarify that I'm not shilling for HealthSherpa here. They aren't paying me for this post. I have no idea whether their customer service is awesome or sucks or anything like that.

About a year ago I did a little back-of-the-envelope number crunching regarding the insanely stupid way in which the Affordable Care Act handles the Hyde Amendment.

In U.S. politics, the Hyde Amendment is a legislative provision barring the use of federal funds to pay for abortion except to save the life of the woman, or if the pregnancy arises from incest or rape. Legislation, including the Hyde Amendment, generally restricts the use of funds allocated for the Department of Health and Human Services and consequently has significant effects involving Medicaid recipients. Medicaid currently serves approximately 6.5 million women in the United States, including 1 in 5 women of reproductive age (women aged 15–44).

One of the biggest stories playing out nationally in the aftermath of the 2018 election is the Georgia gubernatorial election saga, in which corrupt-as-hell Republican Secretary of State Brian Kemp currently holds a narrow lead (50.3% vs. 48.7%) over former Democratic minority leader of the Georgia House of Representatives Stacey Abrams.

Under Georgia law, if no candidate ends up with more than 50% of the total vote, the top two candidates move on to a run-off election, so if Kemp's lead ends up dropping by around 13,000 more votes as the thousands of remaining ballots are counted, it's on to a run-off between the two.

Covered California, the largest state-based ACA exchange for the largest state in the country, actually launched their 2019 ACA Open Enrollment Period over three weeks ago, on October 15th.

They still haven't posted any 2019 enrollment numbers, which I find rather irritating, but they did just send out the following press release regarding a promotional bus tour they're doing which highlights a couple of interesting data points:

Covered California Launches Iconic Bus Tour to Promote Enrollment and Show How “Life Can Change in an Instant”

As I noted a few days ago, now that the 2019 ACA Open Enrollment Period is actually underway and the approved individual market premium rate changes have been posted publicly for every state, I'm finally able to go back and wrap up my 2019 Rate Hike Project for the nine states which I was still missing final numbers for.

As I further noted, the approved rates in most of those states didn't change much compared to the preliminary/requested rate changes I had already analyzed earlier this year:

*(for comparable days...see below)

In past years, this blog post would be a pretty big deal for me, given that it's all about the very core of this website: ACA Signups. As both enrollees, carriers, analysts and reporters have gradually become more used to the annual Open Enrollment Periods, however, these Weekly Snapshots, while still extremely useful, have become somewhat mundane.

"Weeks" are measured from Sunday - Saturday regardless of what day November 1st falls on, thus the partial week being tallied. Last year, HealthCare.Gov enrolled over 601,462 people in the first four days of Open Enrollment, with 464,140 current enrollees manually renewing their policies and 137,322 new enrollees signing up. How about this year? Here's the official report from CMS:

OK, it's 3:00 in the morning, and I've been running around either canvassing, phone banking, attending various election night events or simply watching/tweeting about the results as they came in from around the country as well as here at home, so forgive me if this is kind of disjointed and scattershot. I'll have more coherent thoughts in the coming days...after I've gotten some sleep and recouperated.

Michigan:

  • With Gretchen Whitmer winning as Governor, ACA Medicaid expansion is mostly safe for the next four years. Unfortunately, it looks like the Dems will come up short in both the state House and Senate (though they made impressive gains in each), which probably means a stalemate on the issue.
  • The net effect will likely be that the just-passed work requirement law will end up going into effect after all starting January 1, 2020, which will almost certainly lead to tens of thousands of Michiganders losing coverage anyway, unless Whitmer is somehow able to convince a still-GOP controlled state legislature to modify the law back to where it stands today.

I realize this may seem a bit late in the game seeing how the 2019 ACA Open Enrollment Period has already started, but I do like to be as complete and thorough as possible, and there were still 9 states missing final/approved premium rate change analyses as of yesterday which I wanted to check off my 2019 Rate Hike Project list.

Fortunately, RateReview.HealthCare.Gov has finally updated their database to include the approved rate changes for every state, which made it easy to take care of most of these.

Nebraska has a slightly confusing siutation, which is surprising since Medica is the only carrier offering ACA policies in the state, When I first took a look at the requested premium changes for 2019 back in August, it looked like the average was around 1.0%...that was based on splitting the difference between the 3.69% and -2.60% listings, since the filing form was redacted and I didn't know what the relative market split was between Medica's product lines.

I realize this may seem a bit late in the game seeing how the 2019 ACA Open Enrollment Period has already started, but I do like to be as complete and thorough as possible, and there were still 9 states missing final/approved premium rate change analyses as of yesterday which I wanted to check off my 2019 Rate Hike Project list.

Fortunately, RateReview.HealthCare.Gov has finally updated their database to include the approved rate changes for every state, which made it easy to take care of most of these.

West Virginia's requested average rate increase was among the highest in the country for 2019--a weighted average of around 14.9%.

However, while state insurance regulators left one of the three carriers offering individual market policies alone, they knocked the other two down substantially: CareSource was lowered from around 13.1% to 9.5%, while Highmark Blue Cross Blue Shield was lowered from an average of 15.9% to 9.0%.

I realize this may seem a bit late in the game seeing how the 2019 ACA Open Enrollment Period has already started, but I do like to be as complete and thorough as possible, and there were still 9 states missing final/approved premium rate change analyses as of yesterday which I wanted to check off my 2019 Rate Hike Project list.

Fortunately, RateReview.HealthCare.Gov has finally updated their database to include the approved rate changes for every state, which made it easy to take care of most of these. In addition, in a few states the insurance department has also posted their own final/approved rate summary.

I realize this may seem a bit late in the game seeing how the 2019 ACA Open Enrollment Period has already started, but I do like to be as complete and thorough as possible, and there were still 9 states missing final/approved premium rate change analyses as of yesterday which I wanted to check off my 2019 Rate Hike Project list.

Fortunately, RateReview.HealthCare.Gov has finally updated their database to include the approved rate changes for every state, which made it easy to take care of most of these. Making things even easier (although not necessarily better from an enrollee perspective), in three states the approved rates are exactly what the requested rates were for every carrier: Alabama, Mississippi and Utah:

In the pile-on among Republican-controlled states to impose work requirements on ACA Medicaid expansion enrollees earlier this year, I somehow missed this one:

Wisconsin waiting to hear about requiring work, drug screening for Medicaid recipients

Wisconsin is still waiting to see if the federal government will let it require childless adults on Medicaid to be screened for drugs and work if they are able.

Gov. Scott Walker’s administration also asked in June to add premiums and co-pays for some adults without dependent children on Medicaid, which the federal government also must authorize.

The changes, which Walker said would help people move from public assistance to the workforce, can’t start until a year after approval by the Centers for Medicare and Medicaid Services, or CMS.

...Under Walker’s proposal, childless adults on Medicaid would have to submit to a drug test or enter drug treatment if drug screening called for it.

The timeline is the same but recent changes mean that Vermonters who take a few minutes to compare plans will find more choices and more financial help than ever before

Open Enrollment is the annual period when new applicants can use the marketplace to sign up for health and dental plans for the coming year. It is also the time that existing members have the option to change plans – an option that many more members than usual will want to consider.

What’s new?

  • Much more financial help - Subsidized members will receive over $1,200 more in premium subsidies in 2019 than they received in 2018. This is because the premiums for Blue Cross Blue Shield of Vermont (BCBSVT) and MVP Health Care (MVP) on-exchange silver plans are increasing significantly. Premiums for silver plans drive federal subsidies—so when the premiums for silver plans increase, subsidies also increase. Premium subsidies can be used on any metal level plan, bronze through platinum (see illustration of what the typical member pays in 2018 vs. 2019).

In other words, Vermont has finally jumped onboard the #SilverSwitcharoo Express!

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