Regular readers know that I spent countless hours last summer tracking down the requested average 2016 rate change filing forms for every single state in the country, and then compiling them into my best guesstimate about the overall, weighted average rate changes for the individual policy market in each state and nationally.

In the end, I came up with a national projected weighted average increase of 12-13%, although I also made sure to note that I expected the effective average to only be around 9% after the dust settled...due to people shopping around.

As it happens, I turned out to be pretty much dead on target: The "presumptive" average (ie, assuming every single enrollee stayed with the same policy whenever possible) ended up being 11.6% nationally, while the effective average ended up being 8%.

(Originally Posted 6/09/16)

Every year, Republicans insist that the ACA is guaranteed to cause a rate hike "death spiral" as increasing premiums cause healthier people to drop out of the individual exchange market, causing higher medical expenses, causing even higher premiums, causing more healthy people to drop out and so forth...and every year, for three years in a row so far, this has failed to be the case nationally. While premiums have obviously continued to increase for many people, the individual insurance market has grown each year, from around 11 million in 2013 to 15.6 million in 2014, around 17 million last year and up to 19-20 million or so today.

IMPORTANT: This is really just a placeholder for Georgia's 2017 average rate hike requests, because it's extremely spotty and partial so far. I'll update it once I'm able to actually track down the bulk of Georgia's individual market enrollment and rate hike request numbers.

Thanks to Don Kramer for finding an article in Georgia Health News from back in May, in which healthcare reporter Andy Miller posts some of the 2017 requested GA rate hikes from some of the carriers in the state...but it remains frustratingly incomplete, and he doesn't provide any links to the actual filings themselves. I can't find anything listed on the Georgia Insurance Dept. website, GA doesn't appear to use the SERFF database, and GA isn't posted at the Rate Review database yet either, so I'm stumped as to how Miller got ahold of these numbers. I've asked him about this, and will update this entry if/when he responds (or if/when any of the above sources posts Georgia's data anyway).

Remember the Hobby Lobby and Little Sisters of the Poor Supreme Court cases, in which each protested the ACA's requirement that healthcare plans covered by employers include contraceptive coverage?

Well, guess what? It turns out there's another "Obamacare contraceptive requirement" case which chugging along through the federal court system, and a federal judge just ruled against the government again. This time, however, instead of an employer having a problem with providing contraception for "sincerely felt" religious reasons, it's the enrollee who's getting the vapors over the prospect of being required to receive the coverage.

As reported by the "Religion Clause" blog (h/t to Patrick O'Mahen and Greg Lipper for the heads up):

The Dept. of Justice is suing to block both of the big mega-mergers between Aetna/Humana and Anthem/Cigna.

Meanwhile, Humana just released their quarterly earnings report [correction: their 2017 Earnings Guidance Report]...and there's some big news buried in it.

Thanks to Zach Tracer for the heads up:

Commenter "M E" just asked an important question about the Land of Lincoln debacle:

Likely stupid question here, but if they were doing this bad financially that they couldn't even make it though all of 2016, then how come when requesting their 2016 rates last year they (apparently) asked for less than a 10% bump?

I mentioned this yesterday in my "back from vacation" post, but it's important enough to deserve a separate follow-up post...especially given the clarification about the coverage cut-off date:

Land of Lincoln coverage will end Oct. 1 for individual enrollees

Land of Lincoln Health's insurance coverage for its individual enrollees will end Oct. 1, according to the Illinois Department of Insurance.

The agency posted the news on Land of Lincoln's website. A green banner now greets visitors to the website with the headline, "Important notice to all members" with a link taking them to information about the Chicago-based insurer's impending shutdown. The notice comes a week after the agency moved to seize control of the financially troubled Chicago-based insurer.

Back in early May, Covered California, the largest state-based ACA exchange in the country, issued their proposed 2016-2017 budget, which included this tidbit:

California’s health insurance exchange estimates that its Obamacare premiums may rise 8 percent on average next year, which would end two consecutive years of more modest 4 percent increases.

The projected rate increase in California, included in the exchange’s proposed annual budget, comes amid growing nationwide concern about insurers seeking double-digit premium hikes in the health law’s insurance marketplaces.

...Insurers in California have submitted initial rates for 2017, but the final figures won’t be known until July after state officials conduct private negotiations.

Last Wednesday, I noted that I was taking off for a week on a family camping vacation, and that...

I'm sure nothing of any significance whatsoever will happen in healthcare news over the next 5 days, right?

I guess I should've known better. Within minutes of my posting that, I saw this...

• New data on insurers' ACA struggles
• Burwell on the law's future
• And much more in our special Obamacare issue:

— Dan Diamond (@ddiamond) July 13, 2016

...which included feature stories about:

No more posts this week; back on Monday. I'm sure nothing of any significance whatsoever will happen in healthcare news over the next 5 days, right?

Why yes, I'd be very interested in having you pay me to post on my own website. That's incredibly generous of you!

Oh, wait...


In a move, the timing of which I'm sure was completely unrelated to, and in no way whatsoever coordinated with, Hillary Clinton releasing her official healthcare plan and Bernie Sanders immediately endorsing it, President Obama yesterday became the first sitting President in U.S. history to have an article published in JAMA, the Journal of the American Medical Association.

As the Huffington Post's Jeffrey Young notes:

President Barack Obama has revived his endorsement of a government-run “public option” health insurance program that would compete with private plans on the Affordable Care Act’s exchange marketplaces.

(MOOP: Maximum Out-of-Pocket expense; please forgive my Seinfeld reference.)

When it comes to healthcare policy cost trends, my main focus has been on the average premium rate increases, which currently look (if approved as requested) like they'll go up around 22% on average next year on the individual market (perhaps half that for the small group market).

However, the other major cause of hand-wringing when it comes to healthcare costs these days are deductibles and co-pays...the out-of-pocket expenses which people may have to pay in addition to their premiums. Again, co-pays are a flat fee (usually $30-$50) which you have to pay for many doctor visits, while deductibles are the amount which you may have to pay towards various healthcare treatments/services before the insurance carrier actually starts to chip in their 60-90% of the bill. I don't think co-pays have really changed much over the years, but a whole lot of people feel that deductibles have shot up a lot since the ACA went into effect.

This is actually the second time this has happened. The first was over a year ago, when CATO Institute ACA Attack Dog Michael Cannon used my work to testify before a U.S. Senate committee how many millions of people would be screwed over by a plaintiff win in King v. Burwell. This was kind of interesting, considering that he was using that fact to support a plaintiff win in King v. Burwell; from his perspective, over 6 million people losing their APTC assistance would have actually been a positive thing. Conservatives are strange like that. Thankfully, the Supreme Court ruled against the plaintiffs, which made the whole thing moot, but whatever.

In any event, today it's happening again; thanks to twitter user "sthfrk2008" for the heads up:

Testimony of Joel C. White, President, Council for Affordable Health Coverage
Committee on Ways and Means Hearing on Rising Health Insurance Premiums Under the Affordable Care Act • July 12, 2016

Over the weekend, Hillary Clinton rolled out her official campaign healthcare platform. Much fuss is being made over the fact that it includes support for a Public Option, although as I noted at the time, that's hardly news...since she's consistently supported one since at least 2008.

As for the rest of the proposal, there's a whole lot to like...even if your name is Bernie Sanders.

In my latest exclusive entry for, I take a look at the nine major tenets of Hillary's healthcare proposal. Check it out!