Besides the possibility of a Circuit Court ruling tossing some/most/all/any parts of the Affordable Care Act out on the basis of a troll lawsuit, the fall has been boring, mostly business as usual for the 2020 rate cycle. Iowa has a really nice public facing data set with county and rating area level final premiums. That has been my big news for the past couple of weeks.
Over the summer, there have been a couple more states that had their 1332 reinsurance waivers approved. None of these waivers are ground breaking. They all fundamentally mix some state funds with subsidies in order to bring some financial relief to the non-subsidized population. Each of them has their own flavor and approach. They all should (mostly) work as anticipated.
Rate increases have been fairly low. Some states and some insurers had big rate decreases. Insurers are going back into markets that they ran from in 2017 and 2018. The non-subsidized market is a mess with the healthier chunks of that market going to the lightly regulated and/or underwritten alternatives or running uninsured while the sicker chunks are getting punched in the nose with premiums. But that is not a new story.
2019 and now, 2020 look like they could be years that are mostly running on auto-pilot for the Exchanges. We should expect lower enrollment as more states have expanded Medicaid so that will move a lot of folks off Exchange and into the Medicaid bucket. We should also expect to see the lack of outreach show up in fewer new enrollments, but the CSR Silverloading will provide strong price support for people who are currnetly signed up, thus increasing year over year retention.
From a policy perspective, boring is what 2020 will be. And for health insurance, boring is usually a good thing. Insurance should be boring as a business. Assess risk, price risk, collect premiums and pay claims. There are ways to do those things efficienctly and effectively and there are ways to screw those things up royally, but these are fundamentally boring activities. In a different political world, bragging about boring would be a win.
Ahhh well, wake me up when September ends….
On The Road: Havana, Cuba
satby
This May I go on Medicare. Looks like it’s going to cost me more than my exchange Silver plan. Not sure how I feel about that. Not even considering any of the Medicare Advantage plans since none of them seem to have national coverage and after next year I want to do some serious traveling. But I’ve barely begun to compare them anyway.
Mike S (Now with a Democratic Congressperson!)
Maybe as news gets out about the large Medical Loss Ratio rebates going out people will pay attention. (Ha, I kid. No one will pay attention!) But I just got a $700 MLR rebate check from Capital Blue Cross of PA for 2018. I expect a bigger one for 2019 next September. Why isn’t Drumpf claiming credit for these checks?
joel hanes
Insurance should be boring as a business.
Banking too, also.
I wonder if it’s possible for
“Make FIRE sector businesses boring”
to be a plank in the Democratic platform.
It’s certainly an implication of much of Warren’s portfolio.
Jeanne
I was thinking about you this weekend. I attended a small event for Tom Brier who is running for PA 10th congressional district. Hopefully he will beat Scott Perry. There were probably 25 questions asked and almost every one had something to do with healthcare. Either Medicaid expansion (me regarding mental health clients), people priced out of market who have chosen to self pay and a small business owner who pays almost $100,000 per year for his 3 employees but can’t afford it for themselves. It was depressing. These are mostly people who make too much for subsidies and frustrated by the ACA and “government”. Tom had really good answers but healthcare is all these people care about. They would love for healthcare to be boring.