New legislation will allow Vermont insurers to load cost of CSR only onto on-exchange silver plans for 2019
For 2018 coverage, Vermont, North Dakota and the District of Columbia were the only states that didn’t allow insurers to add the cost of cost-sharing reductions (CSR) to premiums after the Trump Administration cut off federal funding for CSR. In most states, insurers were allowed to either add the cost of CSR to all silver plan premiums, to all on-exchange silver plan premiums, or, in a few cases, to all metal-level plan premiums. But in Vermont, North Dakota and DC, insurers simply had to absorb the cost of CSR, estimated at $12 million a year in Vermont.
Vermont wraps up 2018 open enrollment for Vermont Health Connect
News Release — Department of Vermont Health Access Dec. 19, 2017
Vermonters who Didn’t Complete Plan Selection Urged to Call this Week
WATERBURY, VT – State officials reported that nearly 23,000 Vermonters had confirmed a 2018 health plan and qualified for financial help to make the plan more affordable. Total enrollment in qualified health plans, which typically includes 46,000 small business employees and 11,000 individuals who don’t qualify for financial help, is expected to surpass 80,000. While enrollment will be similar to past years, this year’s earlier deadline means fewer members will experience gaps in coverage. In past years, nearly 2,000 members missed out on January coverage.
Vermont has been pretty much on radio silence for the past two years. They issued fairly regular enrollment data reports in 2014 and 2015, but last year there was nary a peep; the only mid-season enrollment report with Vermont data was the official one released by CMS in early January.
Vermont was one of the first states I analyzed back in the late spring; obvoiusly a lot has changed since then, so I updated/revised my analysis of their requested rate hikes for 2018 a couple of weeks ago, with requested average increases of 11.9% if CSR payments are made or 21.6% if they aren't.
Yesterday, Louise Norris gave me a heads up that the Vermont regulators have issued their approved rate increases for the two carriers operating on the individual and small group markets in the tiny state. This makes Vermont the 4th state to announce their approved rates for next year, joining Oregon, Maryland and New York.
As noted in the Virginia and Maryland updates, I've started going through the earlier state rate filings and revising them to include:
Updated/revised carrier rate filings;
Additional market withdrawls and/or expansions;
Corrections to CSR factor impact, etc.
The original versions of each state writeup includes screen shots of the actual filing documents and explainers behind specific requests; I don't have time for that with most of the updates, so I'm bundling several states together. Here's Connecticut, Oregon and Vermont's revisions:
Vermont is the 4th state to post their initial 2018 rate filings. Vermont has a couple of unusual policies re. their healthcare market: First, while they do technically have an off-exchange individual market, those policies are all fully ACA-compliant QHPs and are tracked exactly the same as on-exchange QHPs, meaning this dashboard report from February includes just about all of their individual market enrollees: 28,775 on exchange + 5,662 off-exchange, for a total of 34,437 ACA-compliant enrollees. Vermont didn't allow transitional plans, so aside from an unknown number still enrolled in grandfathered plans, that should represent their entire individual market.
As I've noted before, until today, there was one state which I had no OE4 data for whatsoever: Vermont (which is ironic given their historic support of healthcare reform, including Sen. Bernie Sanders). This blank has been filled in by today's supplemental CMS/ASPE report: 29,021 QHP selections as of 12/24, which is actually quite a bit higher than I expected for the state (my target for VT is only 30,000 total through 1/31).
Last month I noted (well, after Louise Norris called my attention to it) that after 2 years of restricting all individual market enrollments to their still-buggy ACA exchange, the state of Vermont actually reversed this policy for 2016 by allowing individuals to enroll in ACA-compliant policies directly through the carriers after all.
This actually goes against the recommendations I just wrote about yesterday, leaving the District of Columbia as the only other exchange to require all indy plans to run through it), but given how many technical problems Vermont seems to still be having with their platform, I can understand them allowing direct enrollment for the time being. I stand by my recommendation that every state should eventually move everything onto the exchange in the future, however.
I noted back in February that Vermont Health Connect, VT's ACA exchange, has remained essentially silent since last fall, issuing only 2 press releases since Open Enrollment started last November (one of which was about a new plan comparison tool, the other of which was about some sort of Medicaid-related dealine). In other words, they haven't publicized their 2016 enrollment numbers whatsoever...the only reason I have data for VT at all is thanks to the official ASPE reports from the HHS Dept. This is a stunning 180º turnaround from 2015, when they were issuing detailed reports on a regular basis.
As I noted last week, Your Health Idaho has released their final official OE3 number. I had previously noted that there were only 8 states in which the exchanges appeared to have performed worse on private policy enrollment in 2016 than they did in 2015, and that most of those had special circumstances:
Over the past few months, I've ranted repeatedly about what a stupid, short-sighted, petty move it is of Kentucky Governor Matt Bevin to shut down the kynect ACA exchange, for a variety of reasons...most of which center around the fact that the kynect exchange has been operating smoothly since the moment it launched in October 2013. In other words, there's very little reason to kill kynect, and plenty of reasons to keep it operational.
If you take a look at the State-by-State chart, you'll notice that in addition to a few clarifications here and there, there are 5 states (well, 4 states +DC) all the way at the bottom labelled "NO DATA YET".
California insists, just like last year, on doing this weird thing where they release the number of new enrollees who have signed up on a fairly regular basis, but the number of renewals by current enrollees is kept a secret all the way into January. I have no idea why they do that, and it's pretty important given that we're likely talking about somewhere between 1.0 - 1.3 million people here.
On the other hand, at least they've posted data on their new additions. DC, Idaho, Kentucky, New York and Vermont haven't even done that much as of this writing.