START OF 2018 OPEN ENROLLMENT PERIOD

Time: D H M S

California

    Covered California (CA's ACA exchange) just issued the following press release:

    Covered California Keeps Premiums Stable by Adding Cost-Sharing Reduction Surcharge Only to Silver Plans to Limit Consumer Impact

    • In the absence of a federal commitment to continue funding cost-sharing reduction (CSR) reimbursements through the upcoming year, Covered California health insurance companies will add a surcharge to Silver-tier products in 2018.
    • However, because the surcharge will only be applied to Silver-tier plans, nearly four out of five consumers will see their premiums stay the same or decrease, since the amount of financial help they receive will also rise. Those who do not get financial help will not have to pay a surcharge.
    • Financial help means that in 2018, nearly 60 percent of subsidy-eligible enrollees will have access to Silver coverage for less than $100 per month — the same as it was in 2017 — and 74 percent can purchase Bronze coverage for less than $10 per month.
    • California and individual markets across the nation still need a clear commitment that the federal government will continue to make CSR payments to promote lower premiums, save taxpayer money and ensure health insurance companies participate.

    9/25/17: SEE IMPORTANT UPDATE BELOW!

    The fact that the Graham-Cassidy bill, like all of the prior Republican "replacement" healthcare bills, screws over people on both Medicaid and the individual market starting in 2020 is hardly news. A few provisions of the ACA are stripped out and/or bastardized immediately (and some, like the individual mandate penalty, are even repealed retroactively), but for the most part the pain doesn't start for another 2 years, well after the midterms are over.

    However, JP Massar called something to my attention this morning:

    Graham-Cassidy, Sections 102 and 103:

    Section 102: Modification and Repeal of Premium Tax Credits

    Here it is...the Big Kahuna! Covered California just issued a detailed press release and accompanying PDF brochure breaking out their proposed 2018 market participation and rate changes:

    Covered California Releases 2018 Rates: Continued Stability and Competition in the Face of National Uncertainty

    Covered California remains stable, with an average weighted rate change of 12.5 percent. The change is lower than last year and includes a one-time increase of 2.8 percent due to the end of the health insurance tax “holiday.”

    The competitive market allows consumers to limit the rate change to 3.3 percent if they switch to the lowest-cost plan in the same metal tier.

    Here's yesterday's press release from Covered California referred to by Dan Mangan of CNBC a little while ago:

    New Analysis Shows Potentially Significant Health Care Premium Increases and Drops in Coverage If Federal Policies Change

    • California’s premiums could rise by 28 to 49 percent in 2018, and up to 340,000 consumers could lose individual market coverage if changes are made to existing federal policies.
    • The potential rate increase would mean billions of dollars in additional federal spending. The 1.2 million consumers who do not receive subsidies would bear the entire brunt of these increases.
    • The potential decrease of 340,000 insured consumers would not only represent many individuals losing access to potentially life-saving care, but it would result in a sicker risk mix in the individual market and higher premiums for everyone.

    SACRAMENTO, Calif. — A new analysis shows the dramatic consequences facing Californians if federal policies are changed from the current structure and there is no longer direct federal funding of cost-sharing reduction (CSR) reimbursements and the individual shared responsibility payment is not enforced when a consumer chooses not to purchase coverage.

    The analysis found that Covered California health plan premiums could rise up to 49 percent if two key elements that have been in place for the past four years are changed: Cost-sharing reduction reimbursements are no longer directly funded as reimbursements to carriers, and the shared individual responsibility payment is not enforced.

     

    I noted a week or so ago that according to David Anderson of Balloon Juice, rumor has it that many insurance carriers are making their actuaries work overtime to put together multiple rate filings for 2018 based on several different outlooks:

    • Trump/Price/GOP quit screwing around, officially fund CSR reimbursements, enforce the mandate penalty and generally implement the ACA in good faith.
    • Trump/Price/GOP cut off CSR funding but otherwise enforce the law somewhat reasonably
    • Trump/Price/GOP cut off CSR, don't enforce the mandate, keep mucking around with half-assed repeal/replacement bills
    • (etc, etc...several possible scenarios)

    Today the California Insurance Commissioner, Dave Jones, made a formal announcement that this is exactly what CA insurance carriers will be allowed to do, and he isn't pussyfooting around with the reasons for the policy change either:

     

    Watch the 4-minute clip above and weep.

    If you can't hear it, here's the transcript of California Democratic U.S. Senator Diane Feinstein's response when asked how (not if, mind you...how) she would support moving to a Single Payer healthcare system:

    She starts out by making an incredibly tone-deaf and inaccurate statement about single payer:

    "If by ‘single payer’ you mean that it’s going to be a complete takeover by the government, of healthcare, then I am not there.

    IMPORTANT: This is my county-level estimate for California. The congressional district breakout will be following soon.

    Update 2/17/17: (SEE BELOW: CONGRESSIONAL DISTRICT BREAKOUT ADDED!!)

    Regular readers know that I started out the "How Many Could Lose Coverage..." project at the state level, then moved into analyzing the county-level data, before finally tackling the hardest challenge: Breaking them out by Congressional District.

    The state level table includes all 50 states (+DC), while I managed to break out the county level data for 34 states so far before moving into the Congressional District analysis by popular demand. There, I've managed to crunch the numbers for 43 states so far.

    OK, I'm a bit confused by Covered California's press release just now:

    Covered California Finishes Fourth Open Enrollment With More Than 412,000 New Consumers and Strong Participation From Young Enrollees

    • New plan selections met enrollment projections for the fourth open-enrollment period.
    • Nearly 50,000 consumers signed up for health care coverage in the final two days before the Jan. 31 deadline.
    • Strong finish and overall enrollment are credited to effective work by Certified Insurance Agents and enrollers and robust television, digital, print and outdoor advertising that ran throughout the open-enrollment period.
    • The crucial demographic of young adults ages 18–34 accounted for 37 percent of enrollment, contributing to a healthy risk mix for 2017.

    SACRAMENTO, Calif. — Covered California announced Monday that it finished the open-enrollment period with 412,105 new consumers signing up for health coverage.

    First Minnesota's ACA exchange, MNsure, announced an 8-Day "don't call it an extension!" Special Enrollment Period mainly targeted at providing a 25% premium discount for those who don't qualify for the normal federal APTC/CSR financial assistance.

    Now, Covered California has announced their own 4-day "Overtime" period, although this is more of the standard "waiting in line" variety:

    Covered California Gives Consumers More Time to ‘Cross the Finish Line’ as It Prepares for Surge of Enrollment

    • Consumers must begin the application process by the end of Jan. 31 and complete their enrollment by the end of Feb. 4.
    • Thousands of Certified Insurance Agents and Community Enrollment Partners are ready to provide free and confidential in-person assistance.

    SACRAMENTO, Calif. — Covered California announced it is giving consumers who attempt to enroll by the Jan. 31 deadline four more days to complete their enrollment.

    The last time Covered California released enrollment data, they gave a hard number for new enrollees (258,158) but left the number of people renewing their policies a bit vague ("approximately 1.3 million"). I later learned that the actual number of renewals had been rounded up, so I'm assuming it's actually around 1.27 million; this gives a total of 1.53 million QHP selections as of January 3rd.

    Today, CoveredCA issued another update, touting a new enrollee survey which concludes that in California, at least, people don't seem to be shying away from enrolling in spite of the ugly ACA repeal rhetoric coming out of Washington, DC:

    Covered California Enrollment Continues at Strong Pace; New Research Suggests ACA News Coverage Is Not Deterring Consumers

    Between the big December deadline (for January coverage) having passed and the holiday season, the actual OE4 enrollment data has been pretty sparse the past few weeks. A few minutes ago, however, Covered California broke the enrollment news drought (no pun intended) with a press release which, while not primarily focused on the actual enrollment data, nonetheless includes a solid update:

    Covered California Brings Health Care Within Reach and Shows How Consumers Can Save by Shopping

    FOR IMMEDIATE RELEASE  •  Dec. 16, 2016

    Covered California Enrollment Continues to Surge for January Coverage

    Deadline Extended to Dec. 19 to Align With Federal Marketplace

    • Consumers now have through midnight on Monday, Dec. 19 to sign up and have their coverage begin starting Jan. 1.
    • More than 67,000 new consumers selected a plan during the past four days.

    SACRAMENTO, Calif. — Covered California is extending a key enrollment deadline for coverage starting Jan. 1 in order to align with a new federal announcement made yesterday that extends the deadline for HealthCare.gov states. 

    Consumers enrolling through Covered California will now have through Monday, Dec. 19 at midnight to sign up for health care coverage that will begin on Jan. 1. 

    Covered California hopes that by aligning the deadline with HealthCare.gov it will reduce any confusion that consumers may experience after hearing yesterday’s federal announcement, and give consumers the time they need to sign up for coverage.

    Just yesterday, Covered California reported 1.2 million renewals (including auto-renewals) of current ACA exchange enrollees, plus another 139,000 new QHP enrollments.

    Today they've updated that to tack on another 14,000 new QHPs yesterday alone, bringing the grand total up to around 1,353,000 to date:

    Covered California Extends Enrollment Deadline as Consumer Interest Continues to Grow

    • Consumers now have until midnight on Dec. 17 to sign up for health care coverage that will begin on Jan. 1.
    • More than 25,000 new consumers selected a plan during the past two days, which is more than enrolled at this time last year.
    • Open-enrollment plan selections continue to surge ahead of last year’s pace.

    SACRAMENTO, Calif. — Thanks to a strong increase in demand, Covered California is giving consumers more time to sign up for health coverage that will start on Jan. 1.

    Covered California, the largest state-based ACA exchange (making up over 12% of national exchange QHP enrollments) has only posted one enrollment report so far this period. At the time, they reported 308,000 QHP selections, of which 263,462 were active renewals by existing enrollees and 44,885 were new enrollees signing up. This was as of November 15th...15 days into the enrollment period.

    On the one hand, only 14.5% of these are new, which is disturbingly low. On the other hand, part of the reason for this is because so many current enrollees actively renewed...helped, no doubt, by CoveredCA's new policy which allowed them to do so an entire month early (starting on October 1st).

    Just moments ago, CoveredCA issued new enrollment data:

    Covered California Enrollment Surging as Critical Deadline for Coverage Approaches

    Covered California, the largest ACA exchange outside of HealthCare.Gov, just held their board meeting and released some key enrollment data for the first couple of weeks of the 2017 Open Enrollment Period:

    EARLY PROGRESS FOR NEW SIGN UPS

    44,885

    Individuals have selected health care plans as of November 15, 2016. This enrollment reflects a period in which Covered California did not conduct media or enrollment promotion until after November 12th .

    Compares to approximately 50,700 for same period 2015 (when Covered California had conducted extensive media and “bus tour” efforts to promote enrollment).

    OK, so new enrollments are down about 11% from last year, but as they note, they deliberately held off on actively promoting/advertising until after the election this year.

    In a pleasant surprise, 

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