Using the 2017 QHP Landscape PUF file , I was able to build a map of the Silver Gap and Silver Spams regions of that are served by Healthcare.gov
Dark red is a small gap and dark green is a large gap. The smallest gap is $.03 while the largest gap is in western Tennessee at about $97.
The intermediate processed data is available on a Google Sheet. The grayed out counties in HC.gov are the counties with only a single Silver plan. Given the way I set up my map, they were not showing anything. If I was not doing this as I was relaxing after putting the kids to bed, I would do this right, but for quick and dirty, a single Silver county is effectively a Silver Spam county. updated to show single Silver counties.
On first glance, the spreads are massive. The smallest spread in a multiple Silver county is three cents. The largest spread is just under $100. In non-HC.gov states, there are larger spreads in California.
Tennessee, Montana and, central Illinois, southeast Pennsylvania, north Texas and a few other slots seem to benefit from significant Silver Gaps of at least $40. I am very curious as to what is happening in Tennessee as almost the entire state is a massive Silver Gap strategy.
Kansas, Utah, South Carolina, Maine, New Hampshire are entirely Silver Spammed. Significant chunks of South Carolina (and south Jersey) have counties where the spread is under $1.00 between the benchmark and the least expensive Silver plans.
If anyone wants the data, please grab it and see what fun things you can do with it.
Definition update: Silver Gap is when the price spread between the cheapest Silver in a county and the benchmark, second lowest priced Silver is wide. This gives the subsidized buyers a great deal on the #1 Silver.
Silver spam is when the price spread between the #1 and #2 is tiny. The buyers of the #1 Silver do not get a meaningfully better deal.
Betty Cracker
From what I gather on the Twitters, the Republicans who’ve made their careers constructing fig leafs to cover the party’s ugly bits (racism, misogyny, xenophobia, etc.) are fixating on the Obamacare premium hike forecasts as an October surprise that can rescue Trump, or at least cut their down-ballot losses.
Trump has taken up the anti-Obamacare talking point with renewed vigor. But I don’t think that line of attack will get much traction. The truth is, the Republicans offer no alternative except a return to the predations of the free market, and non-stupid people already know how much that sucks.
Richard Mayhew
@Betty Cracker: even more importantly the rate hikes hit <4% of the population
Hal
@Richard Mayhew: I saw a abc news article yesterday posted by a conservative friend on Facebook doing his usual March to socialism, Obamacare sucks line. What’s so fundamentally irritating to me is the people attacking the plan hikes in Congress aren’t affected and have no intention of fixing the issues. Even my friend had private health insurance, so why care so much?
BtW, Any chance of a post about the rate hikes?
Vhh
Please define in plain language Silver Gap and Silver Spam. Whiid is better/worse? Jargon not helpful here.
TS
@Richard Mayhew: Yet the media imply that every citizen of every state are impacted by these rises – where does the 4% come from – the pundits are certainly not going to tell us – using the rise to attack Sec Clinton.
Baud
@Betty Cracker:
Hillary got that question in the town hall. She responded very well.
Betty Cracker
@Richard Mayhew: That seems like an important metric.
@Baud: Saw that. And Trump just spluttered nonsense about competition across state lines, the same bullshit the GOP has been selling forever. But now that news organizations are covering rate hike projections, people like ambulatory cream cheese sculpture Hugh Hewitt and other Republican jackasses are touting it as the development that can arrest and reverse Trump’s free fall. Not bloody likely.
Big R
I’m meeting with our health policy expert Wednesday to talk about what might be causing the silver spam/silver gap choice, or what effects it might have. Might be interesting.
Hurling Dervish
Are you really going to make me try to figure out what you mean. Y “silver spam” and “silver gap”?
Richard Mayhew
@TS: 4% is the size of the individual market getting hit by 12% or higher rate hikes
Richard Mayhew
@Vhh: silver Spam… The price spread between the #1 and #2 Silver plans is very small so subsidized buyers do not get a great deal on the cheapest Silver.
Silver Gap the price spread is wide. Subsidized buyers get a great deal on the cheapest Silver.
For instance in western Tennessee where the gap is $90, an individual making $24000/year can buy the cheapest Silver for tge price of a decent six pack
HinTN
Tennessee, we could fuck up a wet dream.
HinTN
@Richard Mayhew: Where is the subsidy break point, i.e. the income at which the subsidy disappears? That’s the subject of my previous comment, which I might have to retract.
HinTN
@Richard Mayhew: Yeah, but it’s a yuuuuuge talking point with my well paid, employer subsidized heath care coworkers. Bah
Vhh
@Richard Mayhew: Thanks I live in TN and have a friend who needs to change insurers and is very worried and poorly informed about ACA. He thought his family of 5 would not get subsidies because income above level of 28K. I looked things up and explained that that number is multiplied by family size.
p.a.
From Duncan Black:
cat
If anyone is still here. I was confused by the spreadsheets data. I hope this description will help others.
Every plan has two records. One record is where the plan is compared to the lowest silver and the second record is where it is compared to the benchmark, second lowest priced silver plan.
The field SLS_PLAN_ID is not actually an ID but is a flag that denotes this record as the benchmark the other records in the country are compared against. It does seem when there are only two silver plans in a county both plans flagged. I don’t know if that is a bug in the data or a special case.
IMO you will also have to get the raw data do any other analysis since the google doc is limited to just the data needed to recreate the image in the OP. Things like how often a provider is the benchmark, the lowest, or the highest price have to be cross-referenced back to the original data.
ding7777
@Richard Mayhew: If the formulary changes the co-pay cost from a % to a $ then the actual expense may be higher for some than a simple rate hike
Richard Mayhew
@cat: Let me clean up the data set
cat
@Richard Mayhew:
Only if you feel the need for yourself.
I would be curious about the amount of business strategy leakage the healthcare.gov data has in it, but then I realize I am not a magpie and stop chasing the shiny baubles.
Matt McIrvin
@Betty Cracker: Fox News was flogging the Obamacare premiums hard, from what I saw at lunchtime. It doesn’t seem like a story that will turn Donald Trump’s campaign around–part of the problem is that it’s not really a signature issue for Trump; it’s more of a Congressional Republican thing. Maybe they can make some hay out of it.
Richard Mayhew
@cat: The error in the data set is how I miscorrected for the counties where there is only a single Silver plan … easy enough to fix once I have some time. I’m sharing the data with enough other people, it should be a clean data set.
Richard Mayhew
@Richard Mayhew: Data updated
Badtux
For the person asking where the 4% comes from, it’s actually 5% of Americans now who get their health coverage on the individual market, according to the latest numbers from the Kaiser Family Foundation. And a few of those are still on the old non-marketplace individual insurance because they don’t qualify for the subsidies and see no reason to sign up via the marketplace. Thus the 4%. Everybody else gets their health insurance through their employer or through the government (51% of health care costs in the United States are covered by the government).
In short, the ACA price hikes affect a fairly small percentage of Americans and of those, only the non-subsidized ones (the ones above the 400% cut-off) are *really* affected. I don’t have stats on what percentage are subsidized and which are not. Anybody have those stats?
Badtux
Okay, found a number on the subsidies. Government attorneys claimed that 86% of enrollees in the ACA exchanges receive subsidies. In short, these rate hikes appear to be largely affecting 14% of 4%, or less than 1% of the U.S. population. Not that these numbers exist out in the wild in the memetic mindset of the voters, every single one of them is probably absolutely convinced that their insurance premiums are going to double next year.
Steely
Ok, I actually have ACA coverage. The 4% number may not be a big deal to most of you…..unless you happen to be one of the 4%!!! I am on it because I am self-employed and therefore am compelled to have coverage by the law. First year of the ACA was ok. I had to take less coverage in order to get a decent premium, but that was ok. The total premium was slightly lower than my previous private plan, plus I received a subsidy, so for me personally it was a good deal. Second year rolls around and the total premium went up about 20%, but the subsidy remained the same…so I had to eat the entire 20% increase. Now I was about equal in out of my pocket premium cost to where I was before on my private plan. It was a wash. Now the 2017 info arrives and the total premium increased by a whopping 67%, but again the subsidy again stays roughly the same resulting in my actual out of pocket premium going up 321%! Now I’m paying way more than I did with my pre-ACA private plan for roughly equivalent coverage. However, to make matters worse, they discontinued my plan and the equivalent plan is an HMO that does not include my doctor. I think the story not being told in the media is how the subsidies are not increasing and everyone is being funneled into the baseline “2nd cheapest silver plan”, which for me is poor coverage. Just thought I would throw out a real-world example.
Panurge
@Badtux:
It seems a disproportionate number of my friends are part of that subset of America (and whaddaya know, they’re all white males, too). Of course, they don’t seem to be saying THEY have the problem–it’s always “someone they know”.
Panurge
On second thought, I do see guys complaining about their own premiums occasionally. Still, it’s as if they don’t even think they can shop around and they have to take what’s on the exchanges.
Steely
@Panurge:
FWIW, each of the ACA years I have shopped around on both the exchange and private insurance. I have found the providers do not offer comparable plans cheaper than what is offered on the exchange. Anyway, what I threw out as a personal experience in a previous post will be further clarified on Nov. 1 when the exchanges are open and I can see what my other options are. At the moment, I only know what my current plan (albeit an equivalent since they dropped my actual current plan) will cost. Perhaps another similar plan will reduce my 361% increase, but I am not expecting that. Last year the total number of plans available shrunk. Will be interesting to see if the trend continues for 2017. I would love to see the ACA work, but it appears all the initial criticisms are coming true.