The revised version of the bill still has to be kicked back over to the state Senate for a final vote, but that's almost certain to pass, so the only thing stopping it at this point is the possibility of Gov. Rick Snyder vetoing it, which is what I figured it would come down to in the the first place.
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.
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.
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%.
More than 95% of healthcare groups that have commented on President Trump’s effort to weaken Obama-era health insurance rules criticized or outright opposed the proposals, according to a Times review of thousands of official comment letters filed with federal agencies.
The extraordinary one-sided outpouring came from more than 300 patient and consumer advocates, physician and nurse organizations and trade groups representing hospitals, clinics and health insurers across the country, the review found.
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"
(New Jersey actually already had several other "ACA protection" laws on the books in the first place, including protections against short-term plans and "surprise billing".)
In addition, new Governor Phil Murphy had alread proven that he understands and supports the ACA; within days of taking office he had already issued an executive order telling all state agencies to do everything they reasonably can to inform the public about how to enroll during Open Enrollment and so forth.
Sen. Mike SHIRKEY (R-ClarkLake) said today he's hammered out an agreement with the administration and the House on creating work requirements for Medicaid recipients.
Speaking during a taping of "Off The Record," Shirkey said, "We have a deal." All sides have signed off on the exemptions to the work requirement, but he didn't get into all fo them pending a formal announcement coming as soon as later this week.
From the wording of this, it sounds an awful lot like "all sides" appears to refer to Republican Senator Shirkey, the rest of the Republican State Senate, the Republican State House and the Republican Governor.
Shirkey confirmed that the 29-hour job requirement in the Senate bill has been pared back to 20 to which he says, "I was hoping Michigan could take a leadership position and set a new standard for that." But rather than jeopardize the entire package, he compromised.
Kris Haltmeyer, a vice president at the Blue Cross Blue Shield Association, told reporters that the premium increases were in part due to the repeal of ObamaCare’s individual mandate in the Republican tax reform bill in December...“With the repeal of the individual mandate and the failure of Congress to enact stabilization legislation, we are expecting premiums to go up substantially,” Haltmeyer said.
...He said the premium increases are “related to the loss of the mandate and then underlying medical costs.”
“Those two things have the most impact on the rate increases,” he added.
...Oh, and what comes after mandate repeal and underlying medical costs? You guessed it: #ShortAssPlans