END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

Colorado

A few days ago I noted that based on a rather cryptic press release from Connect for Health Colorado, I deduced that C4HCO had enrolled a minimum of 53,000 people in 2018 ACA exchange policies as of December 7th. Today, however, Louise Norris has clarified that the actual 12/07 tally in CO was 59,590...and that this does not include auto-renewals, as some of the other state-based exchanges have already done:

OK, I'm reaching a bit with this one. The press release put out today (December 8th)  by Connect for Health Colorado doesn't actually include any hard QHP selection numbers; all it says is this:

As I have said, the pace of plan selections continues to run ahead of all previous years but there are plenty of people yet to act to avoid a gap in coverage. Our message remains: Don’t leave money on the table. We know from our own survey that too often Coloradans who are eligible for financial help assume that they make too much to get an Advance Premium Tax Credit.

OK. Last year (OE4) was Colorado's best year so far, with 161,568 QHP selections as of 1/31/17. According to the CMS Public Use File, they hit 42,796 as of 12/03/16 and 59,407 as of 12/10/16. That's an average of 2,373 per day between 12/04 - 12/10, which means they should have reached a minimum of 52,288 QHPs as of 12/07/16.

This just in...

Connect for Health Colorado® Reports Increase in 2018 Medical Plan Selections

DENVER —  More than 43,000 Coloradans selected healthcare coverage for 2018 through the state health insurance Marketplace in November, a rate 29 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®.

“With only two weeks left to enroll for January coverage, I am pleased with the pace of plan selections,” said Connect for Health Colorado CEO Kevin Patterson.  “I know people are busy this time of year but I encourage everyone who buys their own health insurance to check to see if they qualify for financial assistance, review the available plans, and complete an enrollment before the last-minute rush. Many will be surprised that they qualify for financial help.”

A week or so ago, Connect for Health Colorado reported that they'd enrolled 22,650 people in ACA exchange plans as of November 14th, up a full third over last year by the same date. Today they've posted their third week numbers, and while things have started to slow down, they're still running 25% ahead of last year.

Given the whole Silver Load/Silver Switcharoo craziness, I was mildly surprised to see that the ratio between Bronze, Silver and Gold have barely changed year over year, and in fact Silver has inched upward by a few points...until I remembered that Colorado is among the few states which went with the "broad load" model, spreading the additional CSR cost across all metal levels both on and off the exchange. This makes the similar metal level spread more understandable, but it also makes the 25% enrollment increase even more surprising, since subsidized enrollees will pay pretty much the same (no more or less) than this year, but unsubsidized enrollees are seeing their rates shoot up no matter where they go. As you can see below, the average premiums for unsubsidized enrollees ("NFA" = "Non-Financial Assistance) is 36.6% higher this year than last.

Connect for Health Colorado® Reports Increase in 2018 Medical Plan Selections

DENVER — Between Nov.1 and Nov. 15, more than 22,000 Coloradans selected health coverage for 2018 through the state health insurance Marketplace, according to new data released today by Connect for Health Colorado®.

“I am glad to see the number of initial sign-ups during the first two weeks of Open Enrollment,” said Connect for Health Colorado® CEO Kevin Patterson.  “There has been some confusion about healthcare coverage this year. I want everyone to know that the financial help to buy health insurance is still available for next year. I urge everybody buying their own health insurance to take a minute on our site, ConnectforhealthCO.com, to check to see if they qualify and then review their options and complete their enrollment before the last-minute rush.”

When I last looked at Colorado's 2018 rate hike summary in early September, it appeared that they were looking at an overall average rate increase of either 33% or 41% without CSR reimbursement payments depending on your interpretation of a state DOI quote, or 26.7% assuming CSR payments are made. The confusion wasn't really cleared up much by the later announcement that Colorado is going with the "Broad Load" strategy for their "lost" CSR reimbursements.

Today I checked in with the Colorado DOI again, and they've posted the official, presumably final rate increases, assuming no CSR funding:

About a month ago, Colorado was among the first states to release their approved 2018 individual market rate hikes. At the time, the average unsubsidized rate increases assuming CSR payments are guaranteed for all of 2018 averaged around 26.7% statewide.

As for CSR payments not being made, however, the press release accompanying the rate tables was more vague; it stated that they would be "up to" 14 points higher, but didn't clarify whether that would apply to every individual plan or only the Silver policies, which is how most other states appear to be handling it. I assumed the "no-CSR" average would be roughly 32.9% if the load is only dumped on Silver plans, but 40.7% if spread across all metal levels.

More recently, Louise Norris (who lives in Colorado herself) gave me the bad news: That "up to 14 points" is being spread across everything:

(sigh) Colorado's state insurance division just released their approved 2018 rate increases (busy day!), and the situation appears to be similar to Maine: The average requested rates which I thought already assumed no CSR reimbursements appear to have assumed CSRs would be paid after all:

Division of Insurance approves health insurance premiums for 2018
Commissioner: Measures to stablize market for 2018 must happen by Sept. 30

DENVER (Sept. 6, 2017) – The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), has approved the individual and small group health insurance plans for 2018. Average premium changes within each market - individual and small group - as well as the average change for each insurance company are listed below.

The Colorado Dept. of Regulatory Agencies has made it pretty simple for me:

Division of Insurance releases preliminary 2018 health insurance information
Final approval expected in late September / early October

DENVER (July 14, 2017) – The Colorado Division of Insurance, part of the Department of Regulatory Agencies (DORA), today released the preliminary information for proposed health plans and premiums for 2018 for individuals and small groups. From this point until August 4, Colorado consumers can comment on these plans.

All counties in Colorado
As the Division of Insurance noted in its June 21 news release, based on the plans filed, there is at least one insurance carrier planning to offer individual, on-exchange plans in every Colorado county. However, the insurance companies have indicated to the  Division that they may be forced to reevaluate their participation in the marketplace if the lack of clarity at the federal level continues.

Of the 31 states which have expanded Medicaid under the Affordable Care Act, only a handful issue regular monthly or weekly enrollment reports.

I noted in February that enrollment in the ACA's Medicaid expansion program had increased by around 35,000 people across just 4 states (LA, MI, MN & PA).

It's early June now, so I checked in once more, and the numbers have continued to grow. I have the direct links for 5 states now (including New Hampshire)...

While I've been embroiled in the sturm und drang at the national level, Louise Norris of healthinsurance.org has been reporting on some important stuff happening at the state level:

HAWAII:

Hawaii no longer has a SHOP exchange; Lawmakers consider bill to preserve the ACA and expand Medicaid to 250% FPL

As of 2017, Hawaii no longer has a SHOP exchange for small businesses. The State Department of Labor and Industrial Relations has an FAQ page about this.

...Hawaii’s waiver aligns the ACA with the state’s existing Prepaid Health Care Act. Under the Prepaid Healthcare Act, employees who work at least 20 hours a week have to be offered employer-sponsored health insurance, and can’t be asked to pay more than 1.5 percent of their wages for employee-only coverage (as opposed to 9.69 percent under the ACA in 2017). 

The official enrollment report won't actually be released until a little later, but Connect for Health Colorado just posted the following: (it's dated 2/03 but just went live on their site today):

CEO Blog: End of Open Enrollment Update

Posted on Friday, February 3, 2017

Today marks the end of our fourth and by far most successful Open Enrollment period. The number of plan selections ran 12% ahead of last year’s pace and the volume of last-minute customers Monday and Tuesday led us to extend sign-ups for three days for those who started the process before Tuesday’s deadline.

I share this information with extreme gratitude to our dedicated staff, our Assistance Network, our Broker partners, our health insurance company partners and the many other supportive stakeholders who helped us move forward with our shared mission no matter the headwinds we encountered along the way.

There's no specific number listed, but last year's official Open Enrollment Period QHP selection total for Colorado was 150,759 people.

Now that Minnesota, California and especially HealthCare.Gov (with Trump's blessing???) have issued overtime/extension periods of one type or another, this isn't particularly surprising to read, but Connect for Health Colorado is joining the Overtime Bandwagon as well:

Connect for Health Colorado® Extends Enrollment Deadline in Response to Surge in Sign-ups
Posted on Tuesday, January 31, 2017

DENVER — Connect for Health Colorado® today announced it is giving consumers who attempt to enroll by the Jan. 31 deadline three more days to complete their enrollment.

Individuals who began the enrollment process by midnight Tuesday will have until 6 p.m. Friday, Feb. 3, to choose a health insurance plan that will be in effect March 1, 2017. Friday will be the last day to purchase coverage this year, except for customers who experience a qualifying life change event, such as marriage, divorce, having a child, losing your employer-sponsored insurance, or moving to Colorado.

It feels a little odd to be alternating estimates about how many people could lose their coverage in each state with the number signing up for it at the same time, but that's where we are: Remember, there's still 6 more days for people to enroll for 2017 coverage starting in February, and 16 days after that to sign up for coverage starting in March.

My last enrollment update for Colorado ran through December 18th; at the time the tally was 139,509 Medical QHPs via Connect for Health CO.

Today they issued another update:

Connect for Health Colorado Reports Increase in Healthcare Plan Selections for 2017 Coverage

DENVER —  More than 158,000 Coloradans selected healthcare coverage for 2017 through the state health insurance Marketplace through Sunday, January 8, a rate 18 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®.

Hot off the presses from the Colorado exchange (CO is one of six states which stuck with the original January enrollment deadline):

DENVER — More than 144,000 Coloradans selected healthcare coverage for 2017 through the state health insurance Marketplace through Sunday, December 18, a rate 18 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®.

“We have seen a definite increase in the pace of sign-ups during the first half of this Open Enrollment period,” said Connect for Health Colorado CEO Kevin Patterson.  “These Coloradans have protected their health and their finances with healthcare coverage next year. I encourage anyone who does not yet have health insurance for 2017 to go to our site, Connectforhealthco.com, check to see if they qualify for financial assistance, review the available plans, and complete an enrollment. They can have coverage in place February 1 if they act by January 15.”

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