HealthCare.gov Ends 2016 Open Enrollment as Some States Extend to Accommodate High Demand

For most of the country, open enrollment for 2016 Marketplace coverage ended on January 31; however at least three states—CaliforniaD.C. and Maryland—extended their deadlines, citing inclement weather and last-minute demand. At 11:00 pm on January 31, 80,000 individuals were shopping for coverage on HealthCare.gov, according to a blog post on Health Affairs, which also notes that nearly half of HealthCare.gov visitors were using phones and tablets during the last three days of open enrollment. As of January 29, 11.6 million people had signed up for or had been automatically renewed for 2016 Marketplace coverage.

CMS Provides CO-OPs With Additional Flexibility to Improve Sustainability

CMS released an FAQ clarifying that CO-OPs may sell health insurance policies other than Marketplace qualified health plans (QHPs), including large group policies, Medicaid managed care products, Medicare Advantage products, and ancillary products (such as dental and vision coverage), provided that at least two-thirds of policies issued by a CO-OP are QHPs. The FAQ also confirms that CO-OPs are not obligated to make payments on their federal loans called "surplus notes" if those payments would lead to financial distress or default, and that beneficiary claims should be paid before federal loans. Further, CO-OPs with a risk-based capital below 500% will be subject to CMS review and potentially a Corrective Action Plan, but will not automatically default on their loan agreement. CMS also stated its intent to explore changes to the requirements for serving on a CO-OP board, which could allow CO-OPs to attract new sources of financing.

Average Marketplace Premiums Increase by 6% in 2016, Report Finds

Marketplace premiums increased an average of 6% nationwide in 2016, compared to no increase in 2015, a new study by The Commonwealth Fund finds. Rate changes varied dramatically across states, with Tennessee's average premiums increasing 37%, while Florida's and Texas's average premiums decreased by 1% and 8%, respectively. Rates increased more slowly in higher-cost urban areas than in suburban and rural areas, which the report notes may reflect a higher level of insurer competition in urban areas. The authors also note that most Marketplace enrollees qualify for premium subsidies—83% in 2016—which largely protects them from the observed premium increases. The number of participating carriers declined slightly in 2016: 6% in urban areas, 7% in suburban areas, and 3% in rural areas.

Alaska and Oregon: Moda Health to Exit Individual Marketplaces

Insurer Moda Health announced it will withdraw from the individual Marketplaces in Alaska and Oregon after regulators in both states issued orders prohibiting the insurer from issuing new policies or renewing current policies. Regulators did not offer details on when current Moda policyholders will be required to transition to other carriers. Moda's departure from Alaska's individual Marketplace leaves Premera Blue Cross Blue Shield of Alaska as the only insurer that continues to issue new policies. Alaska's Division of Insurance Director Lori Wing-Heier said the State is working to bring additional insurers to the Marketplace. Oregon's individual Marketplace will have nine remaining carriers after the departure of Moda, which is the third largest insurer in the State.