The final unsubsidized rates are down about one point more, down 6.3% from 2018 rates. However, as all three current carriers clearly noted in August, the repeal of the ACA's individual mandate and expansion of short-term and association health plans (aka #ShortAssPlans) still caused a significant premium increase, which means without those factors, 2019 rates would likely be down significantly more...likely nearly 20% instead of 6.3%:
Arizona has only three carriers offering individual market policies next year. Blue Cross Blue Shield of AZ has nearly 40,000 enrollees and is keeping rates virtually flat, but specifically states that yes, they baked in extra costs to account for Congressional Republicans repealing the ACA's Individual Mandate and due to Trump's expansion of #ShortAssPlans (see screenshot below).
Centene is dropping rates by over 5 points. I don't know their exact enrollment/market share, so I'm forced to assume it's similar to last year's 95,000. Again, they call out both #MandateRepeal and #ShortAssPlans, but don't include a specific percentage for either (they did, but it was redacted in the public filing).
Finally, Cigna is dropping their 2019 premiums by a whopping 18.2% even with sabotage factors, which again are referenced in the filing. I don't know their enrollment either, but amd assuming it's roughly 16,000 since Arizona's total ACA indy market is around 150,000 people.
To the best of my knowledge, there are only 2 insurance carriers offering ACA-compliant insurance policies in Arizona next year: Blue Cross Blue Shield of AZ and Centene (branded as HealthNet).
Back in early August, BCBSAZ announced that they were asking for a relatively modest 7.2% rate increase next year in the 13 counties (out of 15 total) where they were offering individual plans. They also explicitly stated that if it weren't for their concerns over whether or not the Trump Administration would guarantee reimbursing their CSR expenses, they'd be keeping the 2018 rates flat year over year. Granted, this is after a massive rate increase for 2017, but it was still welcome news, and once again underscored how much damage the Trump sabotage factor is.
This isn't a full analysis, since I only have 2018 rate hike data for one of Arizona's carriers so far...on the other hand, AZ only has a couple of carriers on the individual market these days anyway. From AZCentral:
The Affordable Care Act insurer in 13 of Arizona's 15 counties plans to raise average rates across all plans a moderate 7.2 percent next year.
But Blue Cross Blue Shield of Arizona officials said the rate increases would be flat if President Donald Trump's administration did not plan to eliminate a key Affordable Care Act funding source.
7.2% isn't bad at all...of course, that comes after last years massive 57% average rate hike. Still, 0% would obviously be much better than 7%...
Trump suggested in a weekend tweet that " ... bailouts for insurance companies and bailouts for members of Congress will end very soon" unless Congress acts quickly on a new health bill.
Of the 31 states which have expanded Medicaid under the Affordable Care Act, only a handful issue regular monthly or weekly enrollment reports.
I noted in February that enrollment in the ACA's Medicaid expansion program had increased by around 35,000 people across just 4 states (LA, MI, MN & PA).
It's early June now, so I checked in once more, and the numbers have continued to grow. I have the direct links for 5 states now (including New Hampshire)...
OK, this appears to be quickly turning into my next project thing. The methodology here is pretty much the same as the other states; the only major difference is that while I do know the total Medicaid enrollment for each county (as of December 2016), I don't have that broken out between traditional and expanded Medicaid. Fortunately, I have a hard state-wide number for that: Around 398,000, or roughly 20.8% of the state-wide total. I've therefore multiplied each county number by 20.8% to get a rough estimate of the ACA expansion tally for each.
Like Texas, I'm also no longer expecting Arizona to beat last year's Open Enrollment total by much. Assuming 209K QHP selections, there should be around 125K indy market enrollees and 399K Medicaid expansion enrollees who'll be in a world of hurt post-repeal, or roughly 524,000 altogether.
The ACA exchange in Arizona has hadsome prettydramaticturns over the past month or so. When the dust settled, every county in the state will still have at least one carrier offering plans on the exchange...although only one. Anyway, today the AZ DOI joined Pennsylvania and Michigan in releasing their final approved rate hikes for both the individual and small group markets:
Arizona’s Pinal County Gains Health-Law Exchange Insurer
Blue Cross Blue Shield of Arizona will offer plans on the Affordable Care Act exchange in Arizona’s Pinal County next year, resolving a situation that drew a national spotlight because it represented a major challenge to the mechanics of the health law.
When Aetna Inc. announced last month that it would withdraw from the exchange in Arizona, among other states, it left Pinal at risk of becoming the first U.S. county without a single insurer selling exchange plans. Aetna had been expected to sell exchange plans in Pinal County, where approximately 10,000 people had signed up for ACA plans.
When I last crunched the numbers for the 2017 individual market in Arizona, the average requested rate hike statewide was a whopping 68%. However, that was before Aetna dropped their bombshell about dropping out of the exchanges in 11 states (AZ included), leaving about 6,400 residents receiving ACA tax credits in Pinal County with no subsidized policy options whatsoever.
Since Aetna had intended on requesting a jaw-dropping 85.8% average rate hike if they had stuck around, this technically meant that the average requested hike for the other carriers would have dropped somewhat, although this would be limited by Aetna only having about 7% of the individual market in the state.
