Connect for Health Colorado Logo

via Connect for Health Colorado, Colorado's ACA exchange:

DENVER— Today, President Biden signed the Inflation Reduction Act into law. In addition to tackling issues such as climate change, health care and prescription drug costs, the legislation will extend the expansion of Affordable Care Act marketplace premium tax credits through 2025.

Connect for Health Colorado’s Chief Executive Officer, Kevin Patterson, released the following statement:

Access Health CT Logo

via Access Health CT, Connecticut's ACA exchange:

  • The bill extends enhanced subsidies for three more years and helps bring down costs for Connecticut residents who need financial help to pay for the cost of their health insurance premiums

HARTFORD, Conn. ( August 12, 2022) — Access Health CT (AHCT), Connecticut’s official health insurance marketplace, today announced Connecticut residents who purchase health insurance on the exchange will continue to receive enhanced subsidies thanks to the Inflation Reduction Act (IRA). The enhanced subsidies, which were set to expire at the end of the year, are advanced premium tax credits that help Connecticut residents pay for the cost of their monthly health insurance payments. This financial help is now extended for three more years.

Pennie Logo

via Pennie, Pennsylvania's ACA exchange:

  • Pennsylvanians can access these savings and enroll in 2022 coverage at pennie.com if they are experiencing a qualifying life event, Pennie’s Open Enrollment begins November 1st and runs until January 15th for 2023 coverage.   

Harrisburg, PA – August 16, 2022 –  

The Inflation Reduction Act (IRA) passed earlier this month by Congress and signed into law today by President Biden, will save hundreds of thousands of Pennsylvanians from experiencing increases in what they pay for their health coverage through Pennie next year.  The IRA extends the enhancements to Affordable Care Act (ACA) premium subsidies originally created by the American Rescue Plan (ARP) which were set to expire at the end of the year.  Thanks to this new law, Pennsylvanians will be able to receive these enhanced subsidies through 2025.   

This is a Big F*cking Deal for millions of people.

Last July, President Biden issued an executive order which, among other things, included this provision:

Hearing Aids: Hearing aids are so expensive that only 14% of the approximately 48 million Americans with hearing loss use them. On average, they cost more than $5,000 per pair, and those costs are often not covered by health insurance. A major driver of the expense is that consumers must get them from a doctor or a specialist, even though experts agree that medical evaluation is not necessary. Rather, this requirement serves only as red tape and a barrier to more companies selling hearing aids. The four largest hearing aid manufacturers now control 84% of the market.

In 2017, Congress passed a bipartisan proposal to allow hearing aids to be sold over the counter. However, the Trump Administration Food and Drug Administration failed to issue the necessary rules that would actually allow hearing aids to be sold over the counter, leaving millions of Americans without low-cost options.

CMS Logo

via the Centers for Medicare & Medicaid Services:

  • An estimated additional 34,000 people are now eligible for essential care for a full year after pregnancy, thanks to the American Rescue Plan and the Biden-Harris Administration’s efforts to strengthen maternal health coverage.

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy in Hawaii, Maryland, and Ohio. As a result, up to an additional 34,000 people annually – including 2,000 in Hawaii; 11,000 in Maryland; and 21,000 in Ohio – will now be eligible for Medicaid or Title XXI-funded Medicaid expansion CHIP coverage for a full year after pregnancy. With today’s approval, in combination with previously approved state extensions, an estimated 318,000 Americans annually in 21 states and D.C. are eligible for 12 months of postpartum coverage. If all states adopted this option, as many as 720,000 people across the United States annually would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.

UPDATE 8/16/22: President Biden officially signed the Inflation Reduction Act into law this afternoon!

Annnd there you have it: In a strict party-line 220-207 vote, the Inflation Reduction Act (a stripped-down version of the Build Back Better Act, which was originally branded as the American Families Plan) finally passed the U.S. House of Representatives after passing the U.S. Senate 51-50 (with Vice-President Harris as the tie-breaking vote) on Sunday. I presume President Biden will be holding a big, formal signing ceremony sometime next week.

A big chunk of the bill is related to climate change, of course, and another large chunk of it is purely related to deficit reduction. As for the healthcare provisions, here's a summary of what's included:

Texas

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.

The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

Texas' annual health insurance rate filings are kind of a mixed bag in terms of transparecy. Hardly any of the carriers have Uniform Rate Review Template (URRT) forms or Rate Filing Justification Form Part II available (these are the documents which generally include the actual number of people enrolled in the policies for each market for that insurance carrier), and the Actuarial Memorandum (Part III) is heavily redacted for most of them, making it very difficult to lock in the actual enrollment numbers.

Georgia

Back in April, I did some minor champagne cork popping after the Centers for Medicare & Medicaid Services rightly put the kibosh on the so-called "Georgia Access Model" waiver pushed by GOP Governor Brian Kemp:

The Georgia Access model would eliminate the use of HealthCare.gov, transitioning consumers to decentralized enrollment through private web-brokers and insurers. The state would establish its own subsidy structure to allow for 1) the subsidization of plans that do not comply with all the ACA’s requirements; and 2) enrollment caps if subsidy costs exceed federal and state funds.

There's not a single part of the paragraph above which shouldn't be setting off major alarms:

South Dakota

In South Dakota, there are only 2 carriers offering individual market coverage next year. Avera has around 21,800 enrollees; Sanford has roughly 23,900. The weighted average rate increases requested are around 11.4%.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.3%.

UPDATE 11/01/22Well, it looks like the individual market filings were approved as is. I'm guessing the small group carrier filings were as well, though I don't know that for sure.

Montana

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.

The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

In Montana, there are only 3 carriers offering individual market coverage next year. I have hard enrollment numbers for one of them; for the other two, I'm assuming equal enrollment for each based on a rough assumption of ~52,000 total indy market enrollees statewide.

Assuming this is fairly close, that would put the weighted average rate increases at roughly 8.8%. If not...well, the unweighted average would be 9.3%.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.9%.

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