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PPACA World 2017: Filing Day!

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In most states, health insurers are supposed to file individual major medical rate proposals for 2017 with regulators by the end of today.

The Centers for Medicare & Medicaid Services (CMS) wants proposed 2017 rates for any plans to be sold through posted on a public comment website by May 25, according to the official CMS filing schedule.

The final qualified health plan (QHP) form and rate filings are supposed to be in the menu intake system and ready for CMS review by Aug. 23.

See also: For, 2017 menu season starts April 11

Regulators in states with state-based exchange programs can set different filing schedules. Many states have already given insurers a few extra days to get in their filings. State and federal regulators could end up extending the deadlines further, just as they have adjusted other Patient Protection and Affordable Care Act (PPACA) health insurance and public exchange program parameters.

But individual health market watchers could have a much better picture of what the 2017 market might be like by the end of the week.

Many health insurers have expressed their frustration with health insurance market oversight this spring by eliminating agent commissions for individual policies outside the ordinary open enrollment period. UnitedHealth Group Inc. (NYSE:UNH) said it will withdraw from the PPACA exchange programs in all but a handful of states. Humana Inc. (NYSE:HUM) implied that it also might withdraw from many state exchange programs, and it has already sent several states market withdrawal notices.

Carriers started with PPACA Consumer Operated and Oriented Plan (CO-OP) loans filled many exchange program slots in 2014 and 2015. About half of the CO-OPs are gone. 

But Andy Slavitt, the acting CMS administrator, testified at a congressional hearing in April that he expected PPACA exchange shelves to be reasonably well-stocked in 2017. 

See also: Andy Slavitt expects health insurers to ‘fill shelves’ in 2017 [With video]

New York state insurance regulators reported a few days later that they believe the New York State of Health should have full shelves in 2017.

Oregon appears to be on track to have nine active individual product issuers, with rate increases ranging from 14.5 percent to 36 percent.

More hints about the 2017 individual health market are coming out now. 

For a look at what we found today, read on. 

Kathleen Sebelius

1. Kathleen Sebelius

Kathleen Sebelius — one of the mothers of the PPACA exchange system — went on Bloomberg Television to defend it.

Sebelius is a former Kansas insurance commissioner, a former National Association of Insurance Commissioners president and a former U.S. Health and Human Services (HHS) secretary.

CMS, an HHS agency, set up the PPACA exchange system while Sebelius was the HHS secretary.

“The new markets are fairly fragile,” Sebelius told a Bloomberg interviewer, according to a Bloomberg summary of the interview. “Insurers are moving in and out … You’ll see some push and pull over the next couple of years.”

But Sebelius said that it looks as if PPACA and the exchange system have helped hold health insurance cost increases down.

See also: Ks. Insurers Backing Health Risk Pool Bill


2. Dave Dillon

Dave Dillon, a fellow of the Society of Actuaries (SOA) and a vice president at Lewis & Ellis, an actuarial consulting firm, helps regulators in seven states review health insurance rate filings.

He startled some individual health market watchers earlier this month when he estimated in a commentary that the overall, underlying rate of increase might be about 7 to 14 percent. The major drivers for that overall hike are an increase in medical costs of about 5 to 9 percent, and changes in the PPACA risk-management programs, Dillon said.

See also: PPACA World 2017: Rates might not be THAT bad

In an interview this week, Dillon said that another adjustment, for what insurers have learned about how PPACA really works, could have a big effect on insurers’ premiums.

The 2017 premiums are the first individual health premiums that issuers will be able to set with a full year of PPACA-rule experience and risk-management program data in hand.

“I do believe there are still companies struggling with underpricing,” Dillon said.

Dillon added that he also believes other issuers overpriced their coverage and are now in the process of lowering rates.

And Dillon believes that, aside from the 2016 exchange plan issuers that have already announced moves to pull back from the exchange system, most 2016 exchange plan issuers will be returning to the exchange system next year.

Insurers and actuaries seem to have been busy preparing rate filings, Dillon said.

Because the actuaries only started to get full-year experience data for 2015 in March, and they had to get the rate filings completed by today, “there’s a lot of burning the candle at both ends,” Dillon said.

Data network

3. The interwebs

In Maine, the Press Herald is reporting that Aetna (NYSE:AET), Anthem (NYSE:ANTM), Harvard Pilgrim and Community Health Options have all filed 2017 rates.

Aetna is asking for an increase of 14.2 percent; Anthem, 14.1 percent; Harvard Pilgrim, 18.7 percent; and Community Health Options, a CO-OP, 22.8 percent.

In Florida, the Palm Beach Post says Blue Cross and Blue Shield of Florida (Florida Blue) accidentally posted proposed 2017 rates early. The Post is reporting it saw preliminary proposed Florida Blue rate increases ranging from about 5 percent to about 12 percent. 

In Vermont, regulators say Blue Cross and Blue Shield of Vermont (Vermont Blue) is asking for an average annual increase of 8.2 percent, with plan increases ranging from 5.2 percent to 10.9 percent. MVP is asking for an average rate increase of 8.8 percent, with plan increases ranging from 3.5 percent to 13.5 percent.

Vermont Blue’s rate filing shows that it suffered a loss equal to about 1.9 percent of revenue on its 2015 individual health business and hopes to earn a 1 percent profit margin this year.

For Vermont Blue, the index rate, or base rate for coverage, would be $504 per member per month.

See also:

Milliman: How PPACA World really worked in 2014

How sick are PPACA enrollees? Blues: Very

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