Michigan

2018 MIDTERM ELECTION

Time: D H M S

Right on top of Pennsylvania, the Michigan Dept. of Insurance has issued their final approvals for 2017 individual and small group market rate increases. As has been pretty typical this year, the final approved rates aren't all that different from what was requested; a little nip/tuck here and there, and the 17.2% average requested has been slightly trimmed to 16.7% approved for the indy market. Meanwhile, the small group average is barely noticeable: 2.6% requested, 2.5% approved. Unlike most states, the MI DOI has already done most of the heavy lifting for me, so I don't even have to use my own spreadsheet to calculate the weighted average.

Priority Health and Health Alliance Plan (HAP) is joining the "HMO only" crowd here in Michigan:

Following announcements by for-profit commercial carriers Humana and United Healthcare, nonprofits Health Alliance Plan and Priority Health are notifying agents they are pulling all PPO plans for 2017 from the Michigan health insurance exchange, Crain's has learned.

HAP has already announced it is pulling eight Personal Alliance individual preferred provider plans for individuals from the exchange and four PPO plans in the open market next year. HAP will continue to offer HMO individual plans on and off the exchange.

"We believe that these (PPO) plans do not represent the best value for the consumer," said Mary Ann Tournoux, HAP's senior vice president and chief marketing officer, in a statement. "At this time of cost-consciousness, we believe our remaining plans are the most cost-effective and offer our members and consumers greater value for their hard-earned insurance dollar."

Today is August 1st. I was hoping that most/all of the states still missing from my 2017 Requested Rate Hike project would finally make their rate filings public as of today, but apparently not (or at least, they aren't live as of 10am).

However, there's one rate request story this A.M....about Michigan, from my local paper, the Detroit Free Press:

Health plans sold on Michigan's insurance exchange could see an average 17.3% increase next year, and if recent history is any guide, state regulators could approve the insurance companies' rate hike requests without many — if any — changes.

The rate increases would mean a financial hit for taxpayers in general and the 345,000 Michiganders who buy their health insurance on the Healthcare.gov exchange, created under the Affordable Care Act, also known as Obamacare.

OK, regular readers know that I almost never write directly about Medicare-related issues (unless it's in relation to trying to figure out the total uninsured rate and so forth), and I've only even mentioned Medigap before 3 times in the history of this website. I honestly don't know much about the program except that it's basically supplemental insurance which covers treatment/services not already covered by Medicare.

However, this seems like a significant development for my home state:

Seniors can expect to pay an additional $48 to $177 per month on BCBS Medigap plans.

Nearly 200,000 seniors can expect to pay more for their Medigap supplemental health insurance plans next year -- for some older individuals, more than twice their current amount -- when Blue Cross Blue Shield of Michigan goes forward with a long-awaited rate increase that does away with what the insurer says are below-market rates.

Blue Cross today proposed the new Medigap rates that would take effect on Jan. 1, following a five-year rate freeze for its Legacy Medigap plan.

My home state of Michigan has finally published the "Part II - Consumer Justification Narrative" carrier filings for 14 of the 15 carriers offering individual market plans next year. The combined total number of current enrollees comes in at around 390,000 including both on and off-exchange numbers. Last year, Michigan had 560,000 people on the ACA-compliant individual market, so it's important to note that there's likely at least 170,000 people missing from this analysis. However, many of these are likely found here:

UPDATE: It turns out that Humana is not dropping out of Michigan entirely; they're only dropping their PPO plans, not their HMOs.

I noted last month that like UnitedHealthcare, Humana is pulling out of the individual market in multiple states next year. Unlike United, however, both the number of states and the number of enrollees impacted by Humana's withdrawl is fairly nominal; at the time I counted 5 states and around 25,000 total enrollees. Since then, Humana has confirmed that they're also dropping out of Colorado (9,914 enrollees), for a total of roughly 35,400 people nationally.

Today, I've confirmed that Michigan can be added to the list, impacting 1,717 people enrolled in off-exchange PPO plans. This brings the total to around 37,000 nationally:

 

 

Hmmmm...I'm still waiting for the Michigan Dept. of Insurance to publicly post the 2017 requested rate hikes (they aren't due until June 20th, apparently), but in the meantime, Blue Cross Blue Shield of Michigan (the largest insurer in the state) decided to issue a press release patting themselves on the back for keeping their small business average rate hike down to 2.9%:

DETROIT, June 8, 2016 /PRNewswire-USNewswire/ -- In contrast to national trends, Blue Cross Blue Shield of Michigan today announced a comparatively small statewide average rate increase of 2.9 percent for small group employers in 2017, pending state regulatory approval. This follows rate reductions that Blue Cross delivered to small employer group customers that renewed during the second half of 2015.

When UnitedHealthcare announced last month that they were making good on their threat last fall to pull out of the individual market in over two dozen states next year, it caused shockwaves across the health insurance industry. It is an important development, as around 800,000 people will be impacted.

When Humana announced last week that they plan on pulling out of the individual market in at least 5 states next year, it was interesting and a bit of a bummer, but not nearly as earthshattering, because only about 25,000 people will have to shop around and find a new carrier.

Today, it is my duty to announce that Celtic insurance has also decided to pull out of the entire individual insurance market (both on and off-exchange) across at least 6 states, including:

After a year and a half of allowing the residents of Flint, Michigan to be poisoned, GOP Governor Rick Snyder, in response to growing public pressure, finally decided to do something decent for once:

Gov. Rick Snyder said Tuesday he will seek permission from the Obama administration to allow all young people in Flint the chance to receive publicly funded health care services for lead exposure amid the city's contaminated drinking water crisis.

...The White House and federal Department of Health and Human Services did not have an immediate response Tuesday to Snyder's initiative targeting Flint residents up to age 21 through the expansion of Medicaid.

Even then, he wasn't exactly in a big hurry to do so; he waited another 3 weeks to get around to actually submitting his request:

Over the past week or so, UnitedHealthcare started making good on their threat last fall to drop out of the ACA exchanges in at least some of the 33 states that they offer individual market policies in. On April 8th they said they were pulling up stakes in Arkansas and Georgia (although they're keeping a small presence in Atlanta via their experimental "Harken Health" division). Then, last Friday, they said they were dropping off the Michigan exchange as well...and just today, Adam Cancryn noted that they're pulling the plug on Oklahoma, while Zachary Tracer says they're pulling out of Louisiana. Ugh.

Zachery Tracer of Bloomberg News reports some unfortunate but not unexpected news:

UnitedHealth Group Inc. plans to exit a third state Obamacare market as the insurer works to stem losses from its struggling Affordable Care Act business.

The insurer won’t sell policies through Michigan’s ACA exchange for next year, according to Andrea Miller, a spokeswoman for the state’s Department of Insurance and Financial Services. Georgia and Arkansas said last week that UnitedHealth will quit their exchanges for 2017.

...Fifteen insurers sold policies in the state for this year, U.S. data show.

OK, this is not only off topic, it's not even a particularly significant issue, but it bugs me because...well, frankly, because it's about my hometown.

Over on Twitter, several pundits/reporters have made this claim:

Trump dominated Oakland County Michigan, which includes Mitt Romney's hometown. ¯\_(ツ)_/¯ pic.twitter.com/wcsBcbFz7h

— Benny (@bennyjohnson) March 9, 2016

Childhood home of Willard Mitt Romney. https://t.co/BxH4b1nRUb

— Amy Sullivan (@sullivanamy) March 9, 2016

While this makes for a fun “Isn’t It Ironic??” meme, it’s not the case at all.

“Oakland County” has a whopping 1.23 million people, and includes very un-Romney cities like Pontiac, Southfield and so forth.

Andy Slavitt, acting administrator for the Centers for Medicare & Medicaid, just announced that CMS has authorized expanding Medicaid to 15,000 children and pregnant women in Flint, Michigan, as well as expanding the services provided to 30,000 current Medicaid enrollees. Here's the full press release (emphasis mine): 

HHS Approves Major Medicaid Expansion for Flint

FLINT, Mich. – Today, the U.S. Department of Health and Human Services announced that the Centers for Medicare & Medicaid Services (CMS) has approved the State of Michigan’s 1115 demonstration to extend Medicaid coverage and services to Flint residents impacted by the lead exposure. In recognition of the public health crisis in Flint, it is a top priority for the Administration and for the Department to ensure that all children and pregnant women exposed to lead in their water in Flint have access to the services they need.  Approximately 15,000 additional children and pregnant women will be eligible for Medicaid coverage and 30,000 current Medicaid beneficiaries in the area will be eligible for expanded services under this new waiver agreement.

Last month, Michigan Governor Rick Snyder stated that he was planning on asking the Obama administration to expand Medicaid to cover...

... all young people in Flint the chance to receive publicly funded health care services for lead exposure amid the city's contaminated drinking water crisis.

...The White House and federal Department of Health and Human Services did not have an immediate response Tuesday to Snyder's initiative targeting Flint residents up to age 21 through the expansion of Medicaid.

Specifically, the initiative, which is expected to be sent to the Obama administration in the next week, seeks expanding Medicaid eligibility to those affected regardless of income level. The request would also include the expansion of Medicaid coverage for people already enrolled in other forms of insurance.

UPDATE: OK, the live stream was over hours ago. I can no longer embed the entire hearing, but here's a direct link to watch it over at C-SPAN's website.

However, just to give you a taste of how jaw-dropping this hearing was, watch Rep. Elijah Cumming's question period with the head of Michigan's Dept. of Environmental Quality:

For a full write-up of the hearing, visit Eclectablog.

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