A Democrat running for governor in Michigan is supporting a tax increase to pay for a statewide government-run health-care system, going further than his party’s candidates in other parts of the country who are also calling for expanded coverage.
The past two days have brought a flurry of 2019 premium rate change filings, with Washington, New York, Maine, DC and Pennsylvania putting their preliminary cards on the table. These join 5 other states which had already posted their early numbers, so I now have 10 compiled.
Now that I have a solid amount of state data to work with, I figured I should write up a tutorial to explain my methodology. This has become especially important the past two years since there's some new factors to consider.
Health Insurance Plan Rates Stabilize, Offer More Choice for Consumers Despite Federal Government Sabotage
Harrisburg, PA – Insurance Commissioner Jessica Altman today announced that health insurance rates in Pennsylvania have moderated significantly, counter to the national trend, after Wolf Administration efforts to combat the effects of sabotage on health insurance markets by the federal government and specifically the Trump Administration to dismantle the Affordable Care Act (ACA). Importantly, the filings indicate that rate increases in Pennsylvania will be significantly more modest in 2019 than other states and many consumers will see more choices in their local markets as a result of Pennsylvania's efforts to increase competition.
One important twist: A few months back I remember reading that Maine, like several other states, was considering establishing some type of reinsurance program along the lines of successful programs in Alaska, Minnesota and Oregon. I also remember reading that the Maine version was unusual--it would actually involve reestablishing an old, discontinued state program which was still on the books but had been mothballed for years. However, I never got around to doing a write-up about it.
Members of local advocacy group Charlottesville For Reasonable Health Insurance had provided testimony at the Virginia General Assembly and organized an email campaign, helping to ensure passage of the bill through the legislative session. Introduced by Sen. Creigh Deeds and effective July 1 2018, SB672 will allow self-employed people to take advantage of the much more affordable health plans in the small group business marketplace, without having to hire employees.
...Charlottesville and surrounding counties (Albemarle, Green, Fluvanna) have by far the most expensive healthcare premiums in the nation in 2018. Rates more than tripled for consumers buying coverage on the ACA Individual Exchange, making comprehensive insurance unaffordable for people who do not qualify for subsidy assistance. A typical family of four is being charged $3000 per month for high deductible plans.
A state court in Maine has ruled that Gov. Paul LePage (R) must submit the paperwork necessary to move forward on expanding Medicaid under the Affordable Care Act to cover about 70,000 more low-income people in the state.
In her ruling, state judge Michaela Murphy slammed LePage’s health department for unilaterally blocking the expansion’s implementation since voters overwhelmingly approved it by ballot initiative last November.
“The Court concludes that the Commissioner’s complete failure to act cannot be considered substantial compliance,” she wrote, ordering the governor to submit the necessary paperwork to the federal government by June 11.
It wasn’t immediately known whether LePage planned to appeal the decision.
PREDICTION: Yeah, he will. He's out of office in seven months, and I'm willing to bet he's gonna continue doing everything possible to drag this out until his replacement takes office in January.
OLYMPIA, Wash. – Eleven health insurers filed 74 health plans for Washington state’s 2019 individual and family health insurance market, with an average proposed rate increase of 19.08 percent. There are no bare counties, although 14 counties will have only one insurer selling through Washington’s Exchange, Washington Healthplanfinder.
As I noted last week, insurance carriers in North Carolina were supposed to have submitted their preliminary 2019 premium rate change filings as of May 21st. Unfortunately, as I also noted last week, those "deadlines" appear to be more "guidelines" in many states, with North Carolina among them; there's no publicly-available premium change data available yet.
Insurers that wish to offer individual market coverage in North Carolina in 2019 had to file rates and forms by May 21, 2018. The two insurers that offer 2018 coverage in the North Carolina exchange — Cigna and Blue Cross Blue Shield of North Carolina — have both filed rate for 2019. Although the filings do show up in SERFF, they have very little publically available data at this point.
I just received the following from a healthcare broker, who I trust from past communication exchanges, who wishes to remain anonymous. I'm presenting it as sent, with the only changes being breaking it out into paragraphs for readability & with their state's identifying information removed.
Over the past few weeks I've noted that a half-dozen states or so (Maryland, New Jersey, Vermont, Hawaii, California and Illinois) have been pushing through a long list of bills/laws at the state level to either protect the ACA from sabotage or even strengthen it. Meanwhile, other states have either expanded Medicaid under the ACA (Virginia, of course) or have locked in ballot measures to do so this fall (Utah, Idaho). Finally, several states have announced they're joining dozens of others to take advantage of "Silver Loading" or full-on "Silver Switching".
As shown below, things are pretty cut & dry in Rhode Island; they only have 2 carriers participating in the individual market (Blue Cross Blue Shield and Neighborhood Health Plan). BCBSRI is asking for a 10.7% average increase, while Neighborhood is requesting 8.7% overall.
The estimated market share ratios are based on this press release from HealthSourceRI, the state ACA exchange. That doesn't include the final numbers or the off-exchange enrollment, but it should be pretty close, as there are only 2 carriers and their requested increases are so close to begin with it wouldn't make much difference. The weighted average is 9.3%.
Establish a robust reinsurance program to significantly lower insurance premiums for individual market enrollees,
Protect people from out-of-network "balance billing", and
Cancel out Trump's expansion of "Association Health Plans"
In addition, New Jersey already outlawed "Short-Term Plans" (and "Surprise Billing") before the ACA was passed anyway.
Well, until today, there was some lingering doubt about the first two bills (which are connected...the reinsurance program would be partly funded by the revenue from the state-level mandate penalty), as Gov. Murphy was reportedly kind of iffy about signing them. As I understand it, he's been supportive of both ideas but is concerned about the potential budget hit in case the mandate penalty revenue doesn't raise enough to cover its share of the reinsurance program.