Policymakers in Washington seem to have been using dice to set individual major medical policy for the past five years.
About the only thing certain about the individual market for 2019 is that calendar year 2019 will start Jan. 1 and run through Dec. 31.
For now, until the dice roll again, it looks as if the open enrollment period for 2019 should start Nov. 1 and end Dec. 15.
HealthCare.gov — the program the U.S. Department of Health and Human Services set up to provide Affordable Care Act exchange services in states where locally based ACA exchange programs are unable or unwilling to provide the services — had registered 10,885 people to serve as HealthCare.gov agents or brokers for the 2019 open enrollment period as of Monday. That’s up 28% from the number of producers HealthCare.gov had registered a year earlier.
Here are three other strange new developments in the individual market.
1. Academic researchers talked to insurance agents and brokers.
Since policymakers began thinking about the proposals that created the Affordable Care Act, drafting the ACA, and implementing they ACA, they have surveyed health care providers, patients, employers, insurers, and nonprofit ACA exchange system helpers.
They have probably talked to their friends, relatives and baristas.
They have not spent much time talking to agents and brokers.
Kevin Lucia and colleagues affiliated with the Urban Institute recently stunned observers by talking to brokers.
They published a report, distributed by the Robert Wood Johnson Foundation, based on discussions with a representative from a national web broker, and with 22 brick-and-mortar brokers. The brick-and-mortar brokers were based in six markets suffering a high level of individual major medical market disruption: Georgia, Iowa, New Hampshire, Mississippi, Texas and Utah.
The average individual major medical gold plan premium in those markets increased somewhere from 24% to 52% between 2017 and 2018 in each of those states. In four of those states, no enrollee had a choice of three or more insurers.
A copy of the full report is available here.
Here is some of what the researchers found:
• Many brokers have (surprise!) left the individual major medical market because the number of issuers in their states have dwindled, and compensation levels have fallen.
• A Mississippi broker has seen agent comp fall to $8 per member per month, from $30.
• A New Hampshire broker said commission levels are 70% lower now than they were in 2008.
• Utah now requires insurers to offer the same commission levels for special enrollment period enrollments that they offer for open enrollment period enrollments.
• A Georgia broker said that, in that broker’s area, thanks to the effects of the ACA individual mandate and ACA coverage expansion programs, “The psychology now is to have health insurance.”