Connecticut

The Access Health CT board held their monthly meeting this morning, including their first official 2017 Open Enrollment Period enrollment numbers. This slide is a little confusing but I think I've figured it out:

If I'm reading this correctly, it looks like they currently have 85,250 people enrolled in effectuated exchange policies. 9,455 have actively renewed/re-enrolled into either their existing policy or a different one, plus another 5,570 brand-new enrollees who have signed up, for a total of 15,025 QHP selections for 2017.

What's confusing me is that they also say that "100,275 are currently enrolled"...which you only get by adding all 3 of those numbers together, which makes little sense to me.

I'm watching the livestream of the AccessHealthCT board meeting. Among other stuff, they're announcing three major changes/improvements for OE4:

First, it sounds like ConnectCare (the largest carrier on the CT exchange) is jumping on the "standardized plan" bandwagon, by offering what they call "Passage" exchange plans:

  • HMO-style, $5 co-pay for Primary Care Physician (PCP) visits (pre-deductible)
  • The Silver "Passage" plan would have a flat $50specialist co-pay
  • High-quality PC network included
  • Simple/easy to understand standardized plans
  • also offering "Passage" plans to small group / Medicare enrollees

--Standardized plans help but not enough; still lots of confusion about process, what's included/not included, etc; launching 4 retail "ConnectiCare Centers" to help people shop, enroll, member services, billing/payment issues, health/wellness assessments, education/outreach events

--CliniSanitas: Multicultural health delivery for hispanic/etc. members (3 centers; 100% bilingual services)

RATE REVIEW:

Over the past week or so there was a lot of tense negotiations and confusion about whether or not ConnectiCare, the 2nd largest carrier on Connecticut's exchange and the largest in CT's individual market overall, would bail on participating on AccessHealthCT next year. They bumped up their rate hike request not once but twice, from 14.3% to 17.4% to 27.1%, and when state regulators stuck with 17.4% and refused to budge any higher, they threatened to file a lawsuit and drop out of the exchange. As of last Friday, it looked like they were indeed pulling out.

I waited until yesterday (Tuesday) to post anything because I wanted to be sure about where things stood...but then, a few minutes later, it turned out that CTCare reversed itself at the last minute after all:

Days after declaring it would leave the state’s health insurance exchange, ConnectiCare has decided not to drop out of the marketplace, much to the relief of many — including Gov. Dannel P. Malloy.

Lots of stuff happening fast & furious these days as #OE4 approaches. Instead of individual posts, I'm gonna cram 7 state updates into a single one...and am also cheating a bit by cribbing off of excellent work by Louise Norris over at healthinsurance.org (which is fair, since she also gets some of her data from me as well):

ALABAMA: Here's what my requested rate hike table looked like for Alabama on August 1st:

Updates: Norris Confirms that:

The Connecticut average requested rate hike has jumped around a lot over the summer. It started out at roughly 21.3% back in June, then increased to 22.2% after the HealthyCT Co-Op announced they were closing up shop. Then, several of the carriers submitted revised rate hike requests, bumping the average up further to around 26.8%.

Well, over the holiday weekend, the CT Mirror reports that the CT Dept. of Insurance released their response to the requests. There were also yet more last-minute filing changes. I've updated the spreadsheet with both the final requests as well as the approvals...but there are a copule of major blank spaces I still have to fill in:

Most Connecticut health insurance plans sold through individual and small group markets will undergo steep rate hikes next year, although in some cases, the prices will not go up by as much as carriers had sought.

OK, make that four states in which at least one major carrier has submitted an updated rate filing request since I originally estimated the statewide average.

Back in June, Connecticut's insurance dept. announced that the half-dozen carriers offering individual policies in the state were requesting an average rate hike of 21.3%:

Shortly after that, however, HealthyCT became the latest ACA-created Co-Op to fail, meaning their 16,000 or so current enrollees will have to shop around for new coverage next year. I revised the numbers accordingly and the average request bumped up a bit to 22.2%...

From an AccessHealthCT press release:

ACCESS HEALTH CT PROVIDES TRANSITIONAL MEDICAL ASSISTANCE ENROLLMENT UPDATE
2,846 individuals have enrolled in a new healthcare plan

Hartford, Conn. (July 8, 2016) - Access Health CT (AHCT) CEO Jim Wadleigh provided an update today on enrollment of approximately 13,811 parents and caregivers who will lose their Transitional Medical Assistance (TMA) on July 31st when they no longer meet the HUSKY A eligibility requirements due to a change in legislation last year. As of July 7, 2016, 2,846 individuals have enrolled in a new healthcare plan via the exchange. Of those, 1,966 applications have been re-determined eligible for coverage in a HUSKY program through the integrated eligibility system with the Department of Social Services, and 880 have enrolled in a Qualified Health Plan (QHP) with AHCT.

OK, this blows. Last year, you'll recall that about a dozen of two dozen ACA-created Co-Ops melted down, one after another, throughout August, September and October. There were a lot of reasons behind their failure, but one of the biggest ones had to do with the infamous Risk Corridor Massacre brouhaha.

As I noted last fall, "Risk Corridors" were one of three programs put into place by the federal government which are intended to smooth the way for the insurance carriers as they try to navigate the rocky, uncertain terrain of the new health insurance landscape under the ACA. Two of the programs--Risk Corridors and Reinsurance--were never intended to last more than the first 3 years of the exchanges anyway (that is, they've always been scheduled to be discontinued at the end of 2016). Unfortunately, due to the GOP yanking the rug out from under the Risk Corridor program, only 13% of the money which was supposed to be paid out to the eligible carriers ever was last year, causing several co-ops (and at least one private carrier) to go belly-up...and leaving many of the remaining co-ops on very shaky financial ground.

The third program, "Risk Adjustment", is permanent. Risk Corridors were set up to shift funds from carriers which lost more than a certain amount of money from carriers which earned more than a certain amount of money. Risk Adjustment, on the other hand, is designed to shift funds from carriers which happened to enroll lower-risk enrollees to those which enrolled higher-risk enrollees. This may sound similar on the surface, and I'm assuming there's quite a bit of overlap between the two in practice, but that's an important distinction.

Thanks to commenter "Junaed S" who directed me towards this simple, cut 'n dry PDF from the Connecticut Dept. of Insurance detailing the requested rate hikes for the CT individual and small group markets for 2017:

In a classic case of missing the forest for the trees, I posted two very wonky, detailed entries over the past couple of days about Minnesota and Connecticut's latest enrollment numbers...but completely missed one crucially important data point.

Investor's Business Daily's Jed Graham picked up on some of my work for his post today, including the enrollment data for both Minnesota and Connecticut...but in addition to that extra data point (which I'll come back to in a moment), he also nabbed the latest number out of a third state, Oklahoma, from one of Adam Cancryn's updates on what I'm calling the UnitedHealthcare Disenrollment Odometer:

The go-to journalist in Connecticut for all things Obamacare-related is Arielle Levin Becker. Judging from her feed this AM, it sounds like she's livetweeting the monthly AccessHealthCT board meeting. Here's her key points:

CT exchange enrollment down about 9.2 percent from end of open enrollment. Also about 2% shift from subsidized to unsubsidized.

— Arielle Levin Becker (@ariellelb) April 21, 2016

CT exchange getting about 3,100 enrollments through special enrollment periods each month.

— Arielle Levin Becker (@ariellelb) April 21, 2016

Out of 116k members at end of open enrollment, 18.8k canceled covg or had it terminated; 7,983 people have signed up.

— Arielle Levin Becker (@ariellelb) April 21, 2016

To be clear: UnitedHealthcare dropping out of almost all of the 34 states they're operating in this year is not good news by any means. So far they've only confirmed sticking around Virginia and Nevada, while confirming that they won't be available in 13 others so far: AR, CT, GA, LA, MI, MO, NE, NC, OK, PA, TN, TX, WA.

However, it's also worth keeping in mind that in many of these states, United has a pretty small presence to begin with. Case in point: Connecticut:

LT. GOVERNOR WYMAN, ACCESS HEALTH CT CEO WADLEIGH STATEMENTS ON UNITED HEALTHCARE ANNOUNCEMENT

(HARTFORD, CT) – Lieutenant Governor Nancy Wyman, Chair of the Access Health CT (AHCT) Board, and AHCT CEO Jim Wadleigh today issued the following statements on the announcement that in 2017, United Healthcare is pulling out of most state healthcare marketplaces:

Thanks to Richard Mayhew for bringing this to my attention (and Arielle Levin Becker for the story):

About 8,000 CT exchange customers didn’t pay first bill

About 8,000 people who signed up for coverage through the Connecticut’s health insurance exchange missed the deadline for their first payment and lost coverage, exchange CEO Jim Wadleigh said Monday.

“This number is bigger than we were anticipating,” Wadleigh said. Just over 116,000 people signed up for private insurance through Access Health CT, the state’s exchange, during the open enrollment period that ended Jan. 31. “The fact that all these customers have not made their first payment was kind of a shock to even us.”

Very nicely done, Access Health CT:

In all, 116,019 Connecticut residents signed up for private insurance through the state’s health insurance exchange, Access Health CT, during the open enrollment period that ended last week, officials said Monday.

That figure is slightly higher than the 110,095 who signed up during last year’s enrollment period and exchange officials’ goal for this year of signing up 105,000 to 115,000.

Connecticut only improved over last year by about 5.4%, but much of that is because, according to the Kaiser Family Foundation, CT only had around 62,000 uninsured people eligible for APTC assistance to begin with (they also have around 100K more uninsured who'd have to pay full price if they enrolled via the exchanges, but those people can get the same policies off-exchange anyway, and many very well might have done just that).

AccessHealth CT reported 104.4K QHP selections as of 1/05 a week or so ago. They just posted a new quickie update via Twitter:

So far this year we've had 15,214 new QHP customers, for a total of 108,830. #AHCTBoDMeeting

— Access Health CT (@AccessHealthCT) January 21, 2016

For the record, that also means 93,616 renewals from last year.

They also confirmed later that these numbers are as of 1/19, so that's an additional 4,467 in 14 days, or 319 per day on average.

They'll almost certainly reach their own target of 105K - 115K QHPs, but to achieve my target of 125K they'll have to ramp things up to over 1,300 per day for the remaining 12 days of open enrollment, which is probably pushing it (120K might be doable, however).

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