The Scoop: health insurance news – August 19, 2020

Our weekly round-up of state and national headlines regarding individual health insurance and health reform

Unless Arizona's Supreme Court overturns a Maricopa County judge's ruling, a healthcare reform measure (the Stop Surprise Billing and Protect Patients Act) will not appear on Arizona's ballot this fall. | Image: vesperstock / stock.adobe.com

Maricopa County judge rejects Arizona healthcare ballot measure

Unless Arizona’s Supreme Court overturns a Maricopa County judge’s ruling, a wide-ranging healthcare reform measure (the Stop Surprise Billing and Protect Patients Act) will not appear on Arizona’s ballot this fall. About a year ago, volunteers began gathering signatures in an effort to get the initiative on the 2020 ballot in Arizona. The measure is citizen-led, but has had substantial backing from a California-based healthcare workers’ union (the Service Employees International Union-United Healthcare Workers West, or SEIU-UHW West).

Nearly 238,000 signatures had to be gathered by July 2, 2020, and supporters of the ballot initiative turned in 385,000 signatures (some reports indicate that 425,000 signatures were submitted). But a judge in Maricopa County ruled last week that 150,000 of those signatures were not valid, for a variety of reasons. Judge Pamela Gates also ruled that the brief summary of the ballot measure that was presented to state residents during signature gathering efforts was potentially misleading, noting that it didn’t clarify that pre-existing condition protections included in the ballot measure would only apply to fully insured health insurance plans, and not to self-insured plans. (This is not unique to this ballot measure; self-insured plans are regulated by the federal government rather than state rules, so changes made as a result of state ballot measures do not apply to self-insured plans.)

The ballot initiative is designed to preserve health insurance protections for people with pre-existing conditions (in case the ACA is overturned or repealed), prevent surprise balance billing, improve hospitals’ infection control standards, and boost hospital workers’ pay. This Friday, August 21, is the deadline for the Arizona Supreme Court to decide whether the measure will appear on the November ballot.

New York extends COVID special enrollment period through Sept. 15

New York’s COVID-related special enrollment period has been extended again, and will continue through September 15. The state’s special enrollment period, designed to allow uninsured residents an opportunity to enroll in health coverage amid the pandemic, had been scheduled to end last Saturday. But Gov. Andrew Cuomo announced yesterday that it would continue until mid-September.

There are also ongoing COVID-related special enrollment periods in California (through August 31), Washington, DC (through September 15), and Maryland (through December 15).

Two insurers join Nevada exchange; exchange insurers’ proposed rate increases average 7.5%

Nevada – which was in danger of having no participating insurers in the health insurance marketplace just a few years ago – is gaining two new exchange insurers for 2021. Friday Health Plans will offer coverage statewide, and SelectHealth will offer coverage in Clark and Nye counties.

The three existing insurers in Nevada’s exchange have proposed overall average rate increases amounting to 7.5 percent.

Average premiums to increase by 1.8% in New York individual market

Earlier this summer, New York’s individual-market insurers filed proposed rates for 2021 that amounted to an overall proposed average rate increase of nearly 12 percent. But last week, New York’s Department of Financial Services published the approved rate changes, and nearly all of them are smaller than the insurers initially proposed – dramatically so, in some cases. Overall, the approved rate changes amount to an average increase of 1.8 percent in the individual market, which is the lowest percentage increase approved by NYDFS in the last decade. In the small-group market, insurers in New York had proposed an average rate increase of 11.4 percent, and NYDFS approved an overall average rate increase of just 4.2 percent.

Average premiums to increase by 1.4% in Montana individual market

Rate changes for 2021 have been finalized in Montana, with an overall average increase of about 1.4 percent for the state’s three individual market insurers. The increases range from no change for Health Care Service Corporation (BCBSMT) to a 5 percent increase for PacificSource. Last month, in announcing the average rate increases that the insurers had initially proposed, Montana’s insurance commissioner, Matt Rosendale, clarified that he believed rates should not be increasing at all for 2021. The insurance commissioner in Montana does not have the authority to reject rate proposals, but Rosendale’s office announced this week that two of the three insurers have since revised their rate proposals, resulting in a smaller overall average rate increase for 2021. PacificSource, which had proposed the largest percentage increase initially, kept their proposed rates unchanged.

Average premiums to increase by 3.5% in Vermont’s individual and small-group market

In May, the two health insurers that offer coverage in Vermont’s merged individual and small-group market proposed an overall average rate increase of about 6.8 percent for 2021. Hundreds of Vermont residents submitted comments objecting to the proposed increases, and the Vermont Office of the Health Care Advocate recommended that no rate increases be approved at all. Last week, the Green Mountain Care Board did approve rate increases for both insurers, but they’re smaller than the insurers had proposed. The overall average rate increase will be about 3.5 percent, with a 4.2 percent average increase for BCBSVT and a 2.7 percent average increase for MVP.

IRS announces percentage of income Americans will have to pay for benchmark plans in 2021

The IRS has published its annual update to the percentage of income that people are expected to pay, after premium subsidies are applied, for benchmark health insurance plan. We outline all of the details here, including examples of how the numbers work at different income levels and how the premium amounts change from one year to the next.

The short story is that the percentage of income people have to pay for the benchmark plan is slightly higher at all income levels for 2021. (Some years it increases, some years it decreases; 2021 is a year that it’s increasing). But the poverty level also continues to increase, and subsidy amounts are based on a person’s income relative to the poverty level. So the end result is that people will generally only be expected to pay more for the benchmark plan if they also experience an increase in income from 2020 to 2021.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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