Rhode Island

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

HealthSourceRI hasn't posted any official press release yet, but this story by Rob Borowski in Providence Business News covers all the basics:

PROVIDENCE — HealthSource RI, the state’s health insurance exchange, reports 31,000 people have signed up for health care coverage about a month into the open enrollment period for the 2019 plan year ending Dec. 23, 3,600 enrollments ahead of where they were at this point last year.

Last year at about this time during open enrollment, HealthSource RI had counted about 27,400 people enrolled for health insurance through the exchange, according to HealthSource RI Director Zachary W. Sherman.

Sherman said the agency has seen many people renewing existing coverage either manually or automatically.

“We’re pleased with where we are with sign-ups,” Sherman said.

It’s Time to Start Shopping for Health Insurance

HealthSource RI offers the cheapest insurance in RI, nearly half of customers pay less than $100 per month for coverage

EAST PROVIDENCE, RI (October 29, 2018) – Rhode Islanders: it’s time to put health insurance on your shopping list. Individuals and families looking for coverage starting January 1, 2019 should pick and pay through HealthSource RI by December 23.

“HealthSource RI has the cheapest health insurance in Rhode Island, and I’m proud of the work we’ve done to keep costs as low as possible,” said Governor Raimondo. “I urge Rhode Islanders looking for coverage to explore HealthSource RI’s quality, affordable options.”

And now it’s easier than ever to pick the medical and dental coverage from Rhode Island’s leading insurance companies. Rhode Islanders can visit HealthSource RI’s new and improved English and Spanish websites at HealthSource RI.com, plug in some basic information, and quickly compare their options and estimate their savings. 

via U.S. News & World Report:

Later Wednesday, [Democratic Governor Gina] Raimondo held her own news conference to sign an executive order that, among other steps, directs the state to seek to codify in state law protections for people with preexisting conditions, dependents up to age 26, prescription drug benefits and maternity coverage in case federal action is taken to weaken the Affordable Care Act.

Rhode Island has one of the highest insured rates in the country, and Raimondo said she was defending "Rhode Islanders' access to high-quality, affordable health coverage."

I'm not quite sure what an executive order has to do with codifying ACA protections into law, since that's really up to the state legislature to do, but I guess it at least kicks their butts into gear?

This is also refreshing to hear from a Republican challenger:

Rhode Island is kind of an interesting state this year. The smallest state geographically and one of the smallest population-wise, they only have two carriers offering individual market coverage: Blue Cross Blue Shield and Neighborhood Health Plan. Way back in May both carriers submitted their preliminary 2019 ACA policy rate increase requests, averaging around 9.7% overall. What's most noteworthy is that unlike most other states, both carriers are mostly blowing off 2018 ACA sabotage factors like mandate repeal and #ShortAssPlans. Blue Cross isn't adding anything to account for the negative risk pool impact, while Neighborhood (which holds slightly more than half of the market share) is only tacking on about 2% in response.

This Just In...

State’s Market Stability Workgroup Recommends Immediate Action to Protect Rhode Islanders from Federal Threats to Health Insurance Access and Affordability

Posted on June 27, 2018 | By HealthSource RI

EAST PROVIDENCE, R.I. (June 27, 2018) – Rhode Island must act “without delay” to protect consumers from rising health coverage costs brought on by federal policy changes according to a report issued to Governor Raimondo by the state’s Market Stability Workgroup.

“People representing a wide variety of viewpoints engaged in lively discussions over the course of 8 weeks,” said Workgroup co-chair Bill Wray, Chief Risk Officer at the Washington Trust. “The fruits of those discussions are in this report. All of us – consumer advocates, business groups, health insurers and providers – were able to broadly agree on how best to protect Rhode Island’s insurance markets.”

Rhode Island is the 5th state (to my knowledge) to officially post their preliminary 2019 individual market rate change requests.

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%.

HealthSource RI, Rhode Island's ACA exchange, released preliminary 2018 Open Enrollment data awhile ago, but this morning they released their final, official demographic data breakout, and there's a lot going on here:

HealthSource RI sees 5% enrollment increase and nation leading lowest benchmark plan cost
State-based marketplace sees rise in enrollment of “young invincibles”

I don't write much about Rhode Island outside of the actual Open Enrollment Period each year, and I almost never write about the ACA's "SHOP" (Small Business Health Options Program...which should really be labelled SB-HOP) these days (the program has never enrolled more than perhaps 200,000 people nationally at most)...but both the state and the program could use a little love, so what the heck:

HealthSource RI for Employers enrolls its 700th small business

RUMFORD, RI (March 6, 2018) – HealthSource RI for Employers today announced it has hit a major milestone. The health insurance marketplace for small employers has now enrolled its 700th small business. These 700 local businesses reflect over 5,200 Rhode Islanders.

This just in from HealthSourceRI:

Between November 1 and December 31, 2017, 33,021 individuals selected a plan through HealthSource RI. Though Open Enrollment has ended, customers who began, but did not complete, the enrollment process by December 31 will be able to finalize their 2018 enrollment process between January 1 and January 23. HealthSource RI is communicating directly with customers who are eligible for this opportunity. For this reason, final 2018 Open Enrollment figures will not be available until later in the month.

At HealthCare.Gov, around 66,000 stragglers/special case enrollments were added to the total between 12/16 - 12/23, which would translate into around 250 more people in Rhode Island, give or take. Of course, HC.gov also lost 145,000 enrollees due to people dropping their renewals/etc, but RI's exchange is structured a bit differently, with auto-renewals being added on day one, so most of those folks likely already dropped out before the 12/31 tally anyway. My guess is the final total will end up around 33.2K.

via U.S. News & World Report:

PROVIDENCE, R.I. (AP) — Rhode Island's health insurance exchange says time is almost up to purchase coverage for 2018.

HealthSource RI says Sunday is the last day to choose and pay for a 2018 health plan through the exchange for residents who don't receive affordable health coverage through an employer.

HealthSource RI said Friday that more than 32,000 people have signed up and many new enrollees are 18 to 34 years old.

Last year, about 30,000 people enrolled.

HealthSource RI says it wants to remind people they need to purchase insurance for 2018 to avoid a tax penalty.

Rhode Island has now officially beaten last year's total of 29,456 QHP selections, though they're still way down from the 34,670 they achieved two years ago. Of course they still have until tomorrow (New Year's Eve deadline), so they might be able to come close. At a minimum, RI is now at least 8.6% ahead of last year.

via the Providence Journal:

HealthSource RI enrollment far exceeds projections

Updated Dec 22, 2017 at 7:48 PM

More than 30,700 have already signed up, and hours at the walk-in and call centers have been extended in anticipation of a surge in enrollments leading up to the Dec. 31 deadline.

PROVIDENCE — Rhode Island has outpaced projected sign-ups for Obamacare next year with more than 30,700 residents now enrolled in health insurance through the state-based health insurance exchange.

HealthSource RI officials expected to see around 30,000 people in total enrolled by the end of December. With a little more than a week to go and the last days of open enrollment typically the busiest, numbers are sure to increase.

via email from HealthSourceRI:

At week six of Open Enrollment nearly 29,000 Rhode Islanders have enrolled in coverage, which is about five percent more than last year. HealthSource RI continues to see an increase in new customers. We have more than three times the number of new enrollees this Open Enrollment period compared to the previous. HealthSource RI is pleased to see an increase in customers age 18-34, often known as “young invincibles.” While 25 percent of our renewing customers are age 18-34, 34 percent of our new customers fall into this age group.

Rhode Island is a tiny state, of course, so this doesn't necessarily mean much nationally, but it's great news across the board nonetheless.

According to the CMS Public Use File, Rhode Island's official tally as of 12/10/16 was 27,555 enrollees; 29,000 is indeed 5.2% higher. In fact, they only need 500 more people to beat their OE4 numbers, though they'd have to add another 5,700 to reach the all-time Rhode Island record of 34,670 set in OE3.

OK, that headline is a bit of clickbait, I admit.

Rhode Island is a tiny state, so any number change is gonna look pretty outsized, but this is still an eye-opener:

In Rhode Island, enrollment this year is five times higher in the first week than it was last year, said Zach Sherman, the director of HealthSource R.I. An early outreach campaign by the state seems to have paid off with more than 500 people enrolling, compared to 109 people in the first week last year.

I've received a hard number direct from the exchange: It's actually 604 new enrollees through 11/07, versus 126 new enrollees in the first 7 days last year.

I first looked at Rhode Island's proposed rate hikes back in early July. At the time, the average increase for the two carriers participating in RI's individual market was 10.5% assuming CSR reimbursement payments are guaranteed for 2018. If they weren't guaranteed, however, I estimated at the time that an additional 19 percentage points would be added into the mix, based on an estimate by the Kaiser Family Foundation.

However, I realized a little later on that I was misinterpreting KFF's analysis; they were referring to how much they estimated silver plans would go up due to the lost CSR funds, not all metal levels. Furthermore, for Medicaid expansion states (which includes Rhode Island) they estimated the average was only 15%.. Based on these factors, the impact across the board on Rhode Island should have only been around 10.3%.

Rhode Island just released their 2018 Individual and Small Group market rate hike requests, and they're pretty straightforward. For the small group market, I don't have the weighted market share for each carrier, but overall it ranges from 5.8 - 12.8%, with an unweighted average of 8.8%.

On the individual market, as with 2017, there's only two carriers participating in 2018: BCBS of RI and Neighborhood Health Plan. They're asking for a 13.8% and 5.0% increase respectively, with a weighted average of 10.5%.

BCBS gave their enrollment as around 27,000; for Neighborhood, I estimated theirs based on dividing their projected total member months by 12 to get 16,345. RI's on-exchange enrolment was 29,456 during Open Enrollment this year, so that would leave roughly 12,800 off-exhange enrollees, for roughly a 2:1 on/off-exchange ratio, which sounds about right.

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