END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

Idaho

A week ago I noted that total Idaho exchange enrollments had reached around 87,000 people as of 11/30. Today Your Health Idaho confirmed that they're "nearing 90,000" enrollments for 2018, which is about where they expected it to be at this point. They also noted that call volume and web traffic are still ahead of last year.

Not much else to say other than ID has reached about 90% of their highest enrollment tally (they had 101,073 QHP selections in 2016 and 100,082 last year) with a week left to go. Last year they had enrolled 91,509 people as of December 10th, but of course the final deadline is a week from today instead of January 31st this time around, so they'd need to add another 10,000 over the next week to match last year's tally.

Thanks to "Andy the Dog" for the heads up:

Kelly said about 90,000 people were insured through the exchange at any given time this year. (People could enroll or cancel during the year.) And at the end of last year’s open-enrollment period, more than 100,000 were signed up for coverage.

This month, the exchange has renewed 86,300 customers for 2018 plans. The new sign-ups are much lower, in the hundreds. Kelly said total enrollment so far — 2017 customers being rolled over into 2018, plus the new sign-ups — exceeds 87,000.

“That number has grown every day in the last several weeks,” he said.

Less than 10 percent of people who were auto-renewed for 2018 plans have canceled so far, he said. More people could cancel by the deadline, though; last year, almost 30 percent of auto-renewed plans had been canceled when the dust settled on the enrollment period.

Your Health Idaho just sent out the following press release:

Preview Health and Dental Plans on Your Health Idaho
Shorter Enrollment Period November 1 - December 15

BOISE, Idaho – Today, Idahoans can get a preview on YourHealthIdaho.org of the 299 health and dental insurance plans being offered on the exchange in 2018, and how much help may be available to them.

“Insurance rates will be higher next year, but tax credits will increase to keep pace. Idahoans are often surprised at how much they can save on their health insurance through the exchange. “By going online now, consumers can check to see if they are eligible for tax credits to lower the cost of premiums,” said Pat Kelly, Your Health Idaho executive director. Consumers can take the savings information to comparison shop for the right plan.

The Idaho Insurance Dept. has made things pretty easy for me. While they don't break out the individual market enrollment numbers by insurance carrier, they do provide the statewide, weighted average of those enrollees: 27% approved vs. the 38% average which was requested  requested (assuming no CSR reimbursement payments)

Idaho is a bit of an odd duck when it comes to the ACA. On the one hand, they're the only state completely controlled by Republicans to set up their own ACA exchange (Kentucky's much-lauded "kynect" exchange was created by Democratic Governor Steve Beshear by executive order...and was then promptly scrapped the moment that incoming GOP Governor Matt Bevin took office). On the other hand, they're also the only state with their own exchange not to expand Medicaid. (As an aside, ID is also the only state to start out on the federal exchange the first year before breaking out onto their own exchange website).

It feels almost silly for me to spend so much time crunching the average 2018 rate hike numbers at this point. Between the (supposedly failed?) GOP repeal effort and Donald Trump's ongoing sabotage efforts--including what could be him officially pulling the plug on CSR reimbursements as early as sometime today--it's probably a bit of a futile effort. Besides, a dozen other wonks/analyses have already confirmed what the Kaiser Family Foundation projected months ago and which I've been proving on a state-by-state basis for months now: The CSR threat is causing average rate hikes of around 20 points on average, and the threats to individual mandate enforcement are tacking on another 4-5 points on top of that, beyond the ~10 points which rates would normally be increasing on average.

However, I've plugged in 21 states, so I might as well finish the job. With that in mind, the state of Idaho has done most of the dirty work for me:

Between updating the "Who could lose coverage" graphics, prepping for my town hall thing last night and updating the 2018 Rate Hike project, I've gotten way behind on my "Who's saying 'screw rate hikes, I'm just gonna bail completely next year' updates. Let's take care of that now, OK? The first three updates are courtesy of Louise Norris writing for healthinsurance.org; the fourth is vai Kimberly Leonard for the Washington Examiner:

IDAHO: BridgeSpan is out, 4 carriers staying put:

Insurers in Idaho had to submit forms for 2018 plans by May 15, but they have until June 2 to file rates. Mountain Health CO-OP, SelectHealth, PacificSource and Blue Cross of Idaho all filed forms to continue to offer Your Health Idaho plans in 2018.

The Washington Post features an interesting story by Robert Samuels about Idaho's ongoing failure to come up with a solution to their self-imposed "Medicaid Gap" problem:

Here in Idaho, Gov. C.L. “Butch” Otter, a Republican, vowed to come up with a replacement after declining to fully embrace the Medicaid expansion that was offered as part of the Affordable Care Act. He’s tried to persuade his heavily Republican legislature to set aside their hands-off views about the government on this issue. Studies have been conducted. Proposals have been put forward. But after four years, lawmakers have come up with no alternative.

“While it is clear there is broad agreement on the fact there is a problem, agreement on what to do about it is another story,” Otter wrote in a statement to The Washington Post.

Your Health Idaho just released their final OE4 enrollment tally, and it's not bad at all:

A record number of Idahoans signed up for health insurance coverage through the statebased health insurance exchange during the latest open enrollment period, which ended on January 31.

“Over the last three months, more than 105,000 people selected a health insurance plan through the exchange,” said Pat Kelly, executive director of Your Health Idaho. “We have never seen more interest in Your Health Idaho. We know changes are coming to the health insurance marketplace but we want our customers to know our entire team remains committed to serving them and providing them with access to affordable health insurance options.”

In total, 105,977 Idahoans signed up for coverage through Your Health Idaho during the 2017 open enrollment period.

For the past three years, Idaho has been the leader in per-capita enrollments for state-based exchanges. YHI is currently waiting on nationwide enrollment numbers to determine how it ranks for the 2017 open enrollment period.

Welp.

Record Number of Idahoans Select Insurance through Your Health Idaho
Lawmakers Get Update on State’s Health Insurance Exchange

BOISE, Idaho – Your Health Idaho (YHI) executive director Pat Kelly went before lawmakers on Wednesday to give them an update on the third year of operations for Idaho’s state-based health insurance exchange. YHI set new records for enrollment during 2016 and led state-based exchanges across the country in per capita enrollment.

“Lawmakers’ choice to keep the federal government out of Idaho’s health insurance decisions and to do things our way has benefited Idaho immensely,” said Kelly. “Your Health Idaho gives consumers options when it comes to selecting a health insurance plan and we keep more money in Idahoans’ pockets by having lower assessment fees than the federal government.”

In federally managed states, consumer fees are set at 3.5percent. In 2016, YHI’s board of directors set the state’s assessment fee at 1.99 percent. To date, lower health insurance assessment fees have saved Idahoans more than $15 million.

I actually missed this press release because it wasn't posted on their website in the usual spot, but someone at Your Health Idaho just forwarded this to me:

December 16, 2016 • Enrollment Numbers Up at Idaho Health Insurance Exchange

Business as Usual at Your Health Idaho as Enrollment Numbers Climb

BOISE, Idaho - Early enrollment numbers show a record number of Idahoans are enrolling for health insurance through the state-based health insurance exchange, Your Health Idaho. Over 98,000 Idahoans have selected a 2017 health insurance plan since open enrollment began on November 1, 2016. The numbers were announced at today's board of directors' meeting.

Nearly 85 percent of Idahoans currently enrolled in a plan on the exchange receive a tax credit to help offset monthly premium costs. Your Health Idaho is the only place in the state offering individuals premium tax credits.

With the repeal of the ACA supposedly looming next year, it's worth remembering that the ACA was based in large part on a state-level program in Massachusetts, implemented by, of course...Mitt Romney. Obviously there are a lot of differences beyond simply ramping "RomneyCare" up to the national level, but at least in terms of the "3-legged stool" of the ACA exchanges (guaranteed issue, individual mandate, subsidies to help lower income enrollees), it's essentially the same.

If the law really is repealed at the federal level, some blue states where it's working pretty well would likely switch back to their own state-level versions. In addition to Massachusetts presumably just reverting back to RomneyCare again, states like California, Washington State and Connecticut seem like likely contenders.

And then there's...Idaho.

As i noted back in August:

I don't write about Idaho much, which is a bit surprising when you think about it because it's kind of a unique state when it comes to the ACA exchanges. Most states never set up their own exchange platform. A dozen or so set them up and are still using them. Two states (Massachusetts and Maryland) scrapped their original, failed platforms and completely overhauled them. Three states started out with their own platform but gave up when they failed, moving home to the mothership (HealthCare.Gov). One state, New Mexico, was supposed to move off of HC.gov after the first couple of years, but changed their mind and is still hosted by the federal platform. Oh, and there's also Kentucky, which is scheduled to scrap their perfectly-functioning tech platform for absolutely no good reason other than the petty whim of their new Governor, Matt Bevin.

And then there's Idaho.

OK, this is earlier than I expected...Your Health Idaho has decided to be first out of the gate with official 2017 ACA Exchange Window Shopping: 

October 1, 2016

Preview Health and Dental Plans on Your Health Idaho

BOISE, Idaho – Starting today, Idahoans can get a preview on YourHealthIdaho.org of the 225 different health and dental insurance plans being offered on the exchange in 2017.

“Before open enrollment begins on November 1, Idahoans can preview and compare different health and dental insurance plans to figure out which one best meets their needs,” said Pat Kelly, executive director of Your Health Idaho. “There are not only more plans being offered this year than ever before, but customers can see the size of the plan’s network to get a full perspective on the choices available to them.”

Prior to the 2017 open enrollment period, health insurance carriers will reach out to their customers to inform them of any changes to their current plan, including differences in rates and deductibles.

The final rate approvals for the Idaho indy market are either positive or negative, depending on your POV. On the one hand, the statewide weighted average is roughly 24%. On the other hand, this is 4 points lower than the 28% requested average from the carriers. As I noted in June, Idaho is among the only states which also posts exactly how much each carrier earned in premiums and paid out in claims for both last year and this year to date, giving some insight into which carriers are making a profit or taking a loss on the indy market:

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