Come for the politics, stay for the snark.

When do we start airlifting the women and children out of Texas?

Thanks to your bullshit, we are now under siege.

the 10% who apparently lack object permanence

The line between political reporting and fan fiction continues to blur.

Republicans are the party of chaos and catastrophe.

After dobbs, women are no longer free.

I have other things to bitch about but those will have to wait.

Baby steps, because the Republican Party is full of angry babies.

“The defense has a certain level of trust in defendant that the government does not.”

Come for the politics, stay for the snark.

That’s my take and I am available for criticism at this time.

You don’t get rid of your umbrella while it’s still raining.

They fucked up the fucking up of the fuckup!

Let’s not be the monsters we hate.

Red lights blinking on democracy’s dashboard

The most dangerous place for a black man in America is in a white man’s imagination.

I’d like to think you all would remain faithful to me if i ever tried to have some of you killed.

If rights aren’t universal, they are privilege, not rights.

Their boy Ron is an empty plastic cup that will never know pudding.

Hell hath no fury like a farmer bankrupted.

Someone should tell Republicans that violence is the last refuge of the incompetent, or possibly the first.

This must be what justice looks like, not vengeful, just peaceful exuberance.

Do we throw up our hands or do we roll up our sleeves? (hint, door #2)

Sometimes the world just tells you your cat is here.

You are here: Home / Anderson On Health Insurance / Spread-em

Spread-em

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Right now, as I am looking at the initial rate filings (compiled by KFF and Charles Gaba), I feel like I am back into my CSR thought process of last summer. I am seeing a very different universe than the political class. Last summer, I was arguing that if CSR was terminated, the incentives would not line up for a reinstatement. I also noted that the bump in advanced premium tax credits that were not supported by the underlying claims cost would make 1332 waivers easier to file.

This year, I am convinced that ACA rate announcements won’t have a meaningful influence on the midterms for either party.

Right now, Charles Gaba is tracking a national rate increase and it is a single digit increase:

And this 8% estimate is probably going to be higher than the actual final rates.

Several states have 1332 waivers for reinsurance that are working their way through the approval process. CMS has been approving straight forward waivers in a timely manner. Reinsurance will knock several states’ initial rate requests down by several points or more. We should also expect to see lower final rates than initial rates in Virginia because they are expanding Medicaid. Medicaid expansion moves a sicker than average population out of the QHP risk pool and into the Medicaid pool. It also takes out a good chunk of the Silver Load gap as the 100-138% FPL population had qualified for 94% AV Silvers which were the biggest chunk of the CSR incremental bump. The same logic may apply in Maine once their Medicaid expansion is finalized.

Finally, for the subsidized population, it looks like significant chunks of the buying population will be seeing better deals if they are willing to switch plans. This will be what the healthy and price sensitive will do.  Larger spreads means cheaper prices for subsidized buyers if they do not buy the benchmark silver plan.

At this point, I am beating a mostly dead horse, but this seems to be very clear to me that rates will be a MEH event this fall.

The argument this fall will be over values and priorities, not pain shocks.

Reader Interactions

9Comments

  1. 1.

    Yarrow

    At this point, I am beating a mostly dead horse, but this seems to be very clear to me that rates will be a MEH event this fall.

    Thanks for keeping updated on this, David. It’s too bad that health insurance rates and won’t be an issue for Dems to run on, but on the other hand it certainly looks like we’ll have lots of other issues available to us. Like the other party being full of traitors. That kind of thing.

  2. 2.

    polyorchnid octopunch

    I’ve been skimming through this series over the last year or so. As a person who lives in a jurisdiction with sane health insurance (i.e. mandatory and it covers everyone whether they can afford to pay premiums or not) I have to say that it’s completely insane how health insurance works in the US.

  3. 3.

    Aang

    Since the price differential between silver and gold plans is closing, it seems like it would be a pretty small political lift to transfer CSR to gold plans and make gold plans the new benchmark.

    This would drop silver down to give more options, including 0 premium silver plans for some and more affordable silver plans for those at the upper income limits, also shifting the average purchased plan’s actuarial value further uphill.

    Any downsides? How would having access to a gold benchmark plan compare to a Medicare plan (in a Medicare for all scenario)?

    Thanks, your commentary is very helpful throughout.

  4. 4.

    John

    Health insurance is no longer affordable for many of us who make too much for subsidies. Seriously I’m thinking about going without next year.

  5. 5.

    Aang

    @John: I hear that, my parents are also in that situation. Dem Senators have introduced a bill to address this, but it’s not going anywhere until they are back in control. I hope they make a couple simple fixes like this before they jump into a Medicare for all fight.

  7. 7.

    ? ?? Goku (aka Amerikan Baka) ? ?

    @Yarrow:
    I wonder if running on the fact that Republicans tried to repeal the ACA last year would be a winner or that’s too long ago?

  8. 8.

    J.A.F. Rusty Shackleford

    OT – Reports on NYT that Cohen recorded Trump discussing payments to Playboy Bunny McDougal before the 2016 election.

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