END OF 2018 OPEN ENROLLMENT (MASSACHUSETTS)

Time: D H M S

Washington State

MARYLAND:

In today's speech at the Howard University College of Medicine, HHS Secretary Sylvia Burwell started ramping things up for the 2016 Open Enrollment Season (which I'm gonna designate #ACA2016 unless someone else comes up with something better) by dropping some data points.

Among these was this one: 

Almost half of the uninsured individuals who are likely eligible for Marketplace plans are between the ages of 18 and 34.

This is really important, because only about 28% of those who enrolled in exchange-based policies this year fall into the 18-34 range, which is a problem from an actuarial/risk pool perspective. Younger people are generally healthier, so the insurance companies prefer to have a higher percentage of them in their risk pools in order to help keep premiums/deductibles from increasing too quickly.

If "almost half" of the 10.5 million uninsured people eligible for the ACA exchanges are in the 18-34 range, that's roughly 5 million young adults who the exchanges need to target.

Way back in early June, Washington State reported that the overall average requested individual market rate increases for 2016 came in at 5.4%, which is pretty darned good.

Just now, the state insurance commissioner reported that the approved weighted average increase next year will be even lower: Just 4.2%:

OLYMPIA, Wash. –The Office of the Insurance Commissioner has approved 136 individual health plans from 12 insurers who will offer them to the Exchange, Wahealthplanfinder, for sale in 2016. The Washington Health Benefit Exchange Board is scheduled to certify the approved insurers and their plans at its board meeting later today.  

The companies requested an average rate change of 5.4 percent, but 4.2 percent was approved.

In nearly every state, the official "enrollment number" used in the HHS Dept's ASPE reports has been the number of QHP selections completed...whether or not the enrollee actually pays their first monthly premium. Naturally, this led to a lot of fuss and bother about "How many have PAID???" last year (and this year as well, though to a lesser extent). In the end, the answer in 2014 turned out to be roughly 88%, with an additional 4% or so gradually dropping their policies over the course of the year and another 5% dropping theirs once the 2015 season opened up. In 2015, so far it looks like the 1st-month-paid percent is a bit higher, more like 90%.

Most news outlets mushed the two figures (non-payments and attrition) together, but I keep them separate, and Washington State is one reason why. Unlike most states, the Washington ACA exchange only reports their exchange policies after the first monthly premium has been paid. As a result, while their official numbers seemed a bit weak back in February (160,732 vs. their stated goal of 230,000), the silver lining is that it was also a "cleaner" figure; I didn't have to lop off 10% of the total, since WA "pre-purged" it for me.

Yesterday I posted about Healthcare.Gov's new "Rate Review" tool, and how, while it's very handy for seeing which comapanies are trying to jack up their premium rates by more than 10% next year (and allowing public comment on them), it's essentially useless for trying to calculate the overall average rate increase in a given state (or in some cases, even for a given company in that state).

I used Connecticut as an example: The actual statewide, weighted average increase request is around 7.7%, but if you only use the Rate Review database as your source it makes it look like it's over 18%.

Here's an even better example: Washington State.

Thanks to Rebecca Stob for the heads up.

On the one hand, Washington State, like Oregon, has a nifty, easy-to-use web-based searchable database for their 2016 rate request filings, yay!

On the other hand, when you get into the details, some of it can be pretty confusing stuff. In 2014, there were 8 companies approved for the WA exchange. For 2015, there were 10 companies, plus 2 more which didn't make the cut. For 2016, a total of 17 companies/subsidiaries have requested approval to sell on the individual market. There's no guarantee that all 17 will be approved to sell in the state, but I'm assuming they all will be for the time being.

There's actually 18 listings, however, because Lifewise split their policies into two entries...one of which is "grandfathered" policies only, and is therefore not relevant for the table below...although this does answer the question "how many people are sill enrolled in Grandfathered policies in Washington State?" The answer appears to be just 15,677 people...out of 343,348 total in the individual market, or only 4.5% of the total.

Earlier today I posted updated exchange enrollment numbers out of Washington State; as of 4/17, ACA exchange QHPs were up to 170,000 currently enrolled out of about 177K paid enrollments and perhaps 200K total selections.

This evening, another piece of the puzzle is filled in : OFF-exchange QHPs in WA:

The office of the state insurance commissioner estimated 170,000 people bought private insurance outside the state marketplace during the open enrollment period. That’s about the same as last year.

Well, now. After all my dead ends, that was remarkably...simple and to the point.

This Just In...

Washington Healthplanfinder Enrolls 170,000 in Qualified Health Plans; 16,000 Enroll through Spring Special Enrollment Period
Enrollment Continues for Residents with Qualifying Life Events

FOR IMMEDIATE RELEASE: April 22, 2015

OLYMPIA, Wash. – Washington Healthplanfinder today announced that 170,101 Washingtonians have currently signed up for a Qualified Health Plan or renewed their health coverage through www.wahealthplanfinder.org. Of the total number of Qualified Health Plan enrollees, more than 16,000 enrolled during the spring special enrollment period.

The spring special enrollment period, which ran from Feb. 17 to April 17, was previously available to Washingtonians who recently became aware of the tax penalty for not having health insurance or were unable to complete their applications due to technical issues by the Feb. 15 deadline.

In the midst of a pretty quiet week data-wise, the Washingotn HealthPlanFinder had a pleasant surprise: An extremely comprehensive enrollment report which breaks down their 2015 numbers every which way possible and, of particular importance to me, also includes data up through March 9th (as opposed to the Feb. 21st cut-off of most of the other state exchanges).

As an additional bonus, the accompanying press release also brings the QHP enrollment numbers even further up to date...right up through March 25th, I think (the PR doesn't specify the exact date of that number, but it's a few thousand higher than the enrollment report so I'm assuming it includes the 16 extra days).

First up: The top-of-the-fold numbers:

Washington Healthplanfinder Enrolls 165,000 in Qualified Health Plans; Annual Enrollment Report Released

Special Enrollment Opportunity Still Available through April 17

FOR IMMEDIATE RELEASE: March 26, 2015, 10:00 am PST

Now that the King v. Burwell Supreme Court oral arguments are out of the way (with radio silence expected until they announce the decision sometime in June) , the next Big Development to keep an eye on ACA-wise is...Tax Season! There will be plenty of stories about how many people have to pay back some/all of their 2014 tax credits, how many will receive additional tax credits...and, most germane to this site, how many additional people enroll via the exchanges to avoid having to pay (most) of the higher tax penalty next year for not being covered in 2015 during the Tax Filing Season Special Enrollment Period (SEP), or #ACATaxTime as I prefer to call it.

This is about as minor of an update as I can post; the actual hard enrollment number is slightly lower than the 160K figure that I already had, but it's still good to have specific data, plus it's broken out into more detail. Plus, the SHOP data is here as well (such as it is):

Open Enrollment Numbers (All Numbers Effective as of February 15, 2015)

Individual Marketplace

An hour ago I wrote about the WA HealthplanFinder re-launching a special Tax Season enrollment period which effectively just extends the enrollment period out by an extra 2 months. However, the press release wasn't posted openly on their site.

They just made it official...and along the way provided a rough QHP enrollment update:

Washington Healthplanfinder Closes with Surge in Enrollment, Announces Spring Special Enrollment Opportunity for Washingtonians to Avoid 2016 Penalty

Residents who were unaware of tax penalty may still have time to enroll

FOR IMMEDIATE RELEASE: Feb. 16, 2015, 10:00 a.m. PST

Tami Luhby of CNNMoney deserves a shout-out for hunting down this notice from the Washington HealthPlanFinder (it's not officially posted publicly on their website yet that I can tell):

This is the first year residents who are filing their 2014 federal taxes may incur a penalty through the IRS on their tax return if they failed to have health insurance for more than three consecutive months in 2014. Given that some residents may become aware of the penalty for the first time this year, Washington Healthplanfinder will open a Special Enrollment Period for these individuals so they can get coverage and avoid the penalty for not having coverage in 2015. These individuals as well as those who were unable to meet the Feb. 15 deadline can apply for the Spring 2015 Special Enrollment Period.

I've confirmed that Rhode Island's weather-induced enrollment extension is indeed state-wide and is of the "full" variety (ie, people can start the application process, not just finish it), through February 23rd. This is exactly the same policy that the Massachusetts exchange announced the other day.

Also, a late-breaking extension announced from Maryland.

11:45pm: OK, add the DC exchange to the pile.

9:00am 2/16/15: OK, HHS/CMS has clarified the specifics for the 37 Healthcare.Gov states.

11:50am 2/16/15: Idaho's policy took some work to decipher...

2:24pm 2/16/15: ...and Minnesota...

As I noted last week, Washington State is doing things a bit backwards from just about every other state...instead of reporting the total number of QHP selections and then, in a few cases, also reporting the number of enrollees who have actually paid their first premium, the WA HealthBenefit Exchange is only reporting enrollments after they've made their first payment.

On the one hand, I wish every state was reporting this number. On the other hand, unlike MA & VT (which report both numbers) or Rhode Island (which is reporting both, but only including the total selections after subtracting those who are past-due on their payments), WA isn't including the total selections at all. This makes things a bit tricky for me, since I'm trying to report both numbers.

As a result, what I'm doing for the moment is assuming the standard 88% payment rate, which means that today's announcement of 139,000 QHP enrollments should mean roughly 158,000 total selections:

Yesterday I lamented the fact that the Washington State ACA exchange seemed to be seriously lagging behind just about every other state in terms of achieving their 2015 QHP selection target, with only 132K QHPs to date vs. the 215K that they were hoping to reach this year (not to mention my personal target of 250K, which turns out to have been way out of line).

I figured that they're on track to only end up with perhaps 180-190K by 2/15, coming up 25K - 35K short of their goal.

However, IBD's Jed Graham (who has been on fire lately; this is the 2nd important point he's brought to my attention this week) reminded me that last year, unlike every other state except Massachusetts, Washington only reported paid enrollments, not total plan selections. If that's true this year as well, he noted, then I've been missing roughly 12% of WA's total all along (put another way, I should be plugging that 132K number into the paid column, not the total column).

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