You may be able to get lower costs on monthly premiums. These lower costs are handled with a tax credit called the Advance Premium Tax Credit. But these tax credits can be applied directly to your monthly premiums, so you get the lower costs immediately. Visit HealthCare.gov to see if you can get coverage outside Open Enrollment: http://hlthc.re/R6AlFe
The Maryland Insurance Administration held a second rate review hearing on Monday to address the revised increase on rates requested by CareFirst. Sarah Li, Chief Actuary for the Maryland Insurance Administration, opened the hearing with a number of specific questions including some that advocates share:
Why are CareFirst’s Maryland premiums so much higher than those for DC subscribers?
Are Marylanders being asked to subsidize DC residents’ premiums, as the DC Insurance Commissioner has frozen CareFirst’s rates for 2017?
CareFirst CEO, Chet Burrell, offered a detailed explanation of the revised rate request, citing nearly $300 million in losses during their first three years in the exchange and an “older, sicker” population than anticipated. He also stated that there was no subsidization of DC residents by Maryland consumers, and that the lower rates in DC were largely due to the fact that, unlike in Maryland, DC’s risk pool includes both the small groups and individual market.
In response, several consumers provided their individual perspectives on the negative impact CareFirst’s requested rates would have on their own families and others like them, including small businesses who insure through the individual market. Chris Jakubiak, president of Jakubiak & Associates, Inc., has put off hiring additional employees because of the cost of health insurance, and Dan Meszler, a self-employed engineer, has had to leave the market entirely. Other consumers provided written comments on-line, as did the Health Education and Advocacy Unit of the Attorney General’s Office, noting “Consumers who stay in these individual plans … will never get their money back if excessive increases are allowed based on inaccurate or erroneous data and assumptions.”
Consumer Health First first presented its case for rejection of the rate request in its Baltimore Sun OpEd. At Monday’s hearing, we strongly urged Commissioner Redmer to not only reject CareFirst’s new request, but to cut its initial request. Jeananne Sciabarra, Executive Director, was joined by Jay Angoff of Mehri & Skalet, who prepared our initial analysis. They reiterated the negative impact that the proposed premiums would have on consumers’ pocketbooks and then laid out a substantive case for rejecting the CareFirst request. In addition to the affordability issue, they noted:
Rate increases of this magnitude will push the healthiest consumers from the market altogether, or to other carriers, leaving CareFirst with only the sickest members, thus requiring large increases next year, and so on. In addition, these rates will discourage the young and healthy from entering the market, disrupting one of the core principles of the Affordable Care Act.
These rate increases contradict the CMS report from last Thursday showing that, nationwide between 2014 and 2015, there has been little change in the cost per enrollee in the ACA individual market.
As Mr. Angoff noted “There is just such a disconnect of such a magnitude between the CMS data and the CareFirst data, it just doesn’t make sense.”
For a complete summary of Ms. Sciabarra’s testimony, click here.
Landover, MD–Prince George’s County has been awarded $1.6 million for FY2017 by the Maryland Health Benefits Exchange (MHBE), the administrator of Maryland’s health insurance marketplace, to provide enrollment assistance, education and outreach to Prince George’s County residents as a newly established consumer assistance organization. The term of the renewable grant began July 1, 2016 and runs through June 30, 2017.
Known as “Prince George’s County Health Connect,” the program will be administered by the Prince George’s County Department of Social Services (DSS); and is comprised of four primary partners: the Prince George’s Health Department, the Primary Care Coalition (PCC), Mary’s Center, and Health Care Dynamics International (HCDI); and four Prince George’s County-based nonprofits: CASA, Community Clinic, Inc. (CCI), Heart To Hand, and Sowing Empowerment & Economic Development (SEED).
Prince George’s County Health Connect joins seven other regionally-based MHBE consumer assistance programs across the state. Previously paired with Montgomery County as one operation, Prince George’s County and Montgomery County will now operate independently but cooperatively. Both counties geographically comprise the Capital Region.
“We are excited about the award, and the opportunity for Prince George’s to be a consumer assistance organization. We have one of the most diverse counties in the entire state. As a program, we will have enhanced flexibility to meet the diverse needs of our residents,” said Gloria Brown, Director of the Department of Social Services.
The partner organizations will utilize certified navigators to provide in-person assistance to help residents learn about, apply for and enroll in health insurance, including Medicaid (MA), and the Maryland Children’s Health Program (MCHP), as well as primary care insurers, specialty care insurers, dental insurers, and others. Navigators and community health workers will also educate residents on insurance usage. The free services are mandated by the state, in accordance with the Patient Protection and Affordable Care Act (ACA) law established in 2010.
“We’re excited to add a partner with a history of great outreach work in Prince George’s County that is committed to reinforcing our efforts to provide outreach and enrollment in that part of the state,” said Carolyn Quattrocki, Executive Director of MHBE. “The partnership in this region, as well as others throughout Maryland, will allow us to better assist and inform communities across the state and to help ensure that everyone has access to affordable health coverage.”
MHBE launched the connector program in 2013, the first year of open enrollment for health insurance under ACA. Since then, Maryland has been one of the fastest growing states in the country for health insurance enrollment.
According to MHBE, more than one million Maryland residents have been enrolled in health insurance, including Medicaid through the Maryland Health Connection, of which more than 140,000 of those who enrolled are Prince George’s County residents. The next open enrollment period runs November 1, 2016 through January 31, 2017.
About Maryland Health Connection: Maryland Health Connection (MHC) is the state-based health insurance marketplace for individuals and families to compare and enroll in health insurance, as well as determine eligibility for Medicaid and other assistance programs, federal tax credits and cost-sharing reductions.
http://www.princegeorgescountymd.gov/CivicAlerts.aspx?AID=369
CareFirst isn’t the only insurer requesting unprecedented double digit rate increases. Many insurers are simply leaving the marketplace altogether or drastically reducing their involvement, citing enormous financial losses.
On Tuesday, Aetna announced that it too, will walk away from more than two-thirds of the exchange markets it participated in this year. Aetna will maintain a presence in just four states – Delaware, Iowa, Nebraska and Virginia – down from 15 states this year. Aetna’s withdrawal means that in at least one county in Arizona with nearly 10,000 enrollees, there will be no ACA insurers or products available.
Other providers leaving, or reducing participation in the market include:
At Monday’s MIA hearing, Chet Burrell, CareFirst CEO, cited concerns that the Maryland ACA marketplace could be left with just two providers, CareFirst and Kaiser Permanente, given the uncertainty surrounding the potential Anthem/Cigna merger and Evergreen’s risk adjustment lawsuit.
Voices are cautioning that this is not a doomsday scenario, but rather reasonable and not unexpected shifts in the marketplace as it reacts to a new and complex law affecting millions in diverse insurance markets. An OpEd in yesterday’s New York Times calls for ongoing reforms to ACA, and Bloomberg’s Megan McArdle presents a reasoned piece outlining eight different scenarios for the future outcome of the ACA – all of which are hopeful.
