Discover and read the best of Twitter Threads about #silverloading

Most recents (8)

You’ve got to be fucking kidding me.
According to @loujacobson of @PolitiFact, if a President promises NOT to do a thing, then TRIES to do a thing but fails because Congress shot it down, that means they "kept their promise." 2/
So if I promise NOT to commit murder, and once elected I *attempt* to commit murder but I'm stopped by the police before I can pull it off, I guess that means I get credit for "keeping my promise". 3/
Read 20 tweets
📣 This morning the Trump Admin issued a press release crowing about #ACA premiums dropping 4% thanks to their supposedly brilliant management.

I need to clear up a few things about this. 1/
First of all, it’s important to note that the 4% drop refers specifically to *benchmark Silver plans* only, and only includes 39 states. It also only includes exchange-based enrollment. These factors limit it to < 40% of total #ACA-compliant individual market enrollment. 2/
When you include *all* metal levels for *all* states both on & off-exchange, the weighted avg is ⬆️ 0.1% instead of ⬇️ 4.0%.

Obviously that’s still far better than double-digit increases, but it’s important to be as comprehensive & accurate as possible.…
Read 22 tweets
1/n #ACA Premiums and landscape files are out so here are the first thoughts:

Headline: Gross Premiums down 4% YoY

@dylanlscott @leonardkl @sangerkatz @sarahkliff @bobjherman @caitlinnowens @rachanadixit
2/N Lots of things are happening.

The biggest one is that 2018 was so massively overpriced that 2020 (these rates) are still reflecting that problem. 2 different pricing scenarios get us to the same point with different stories
3/N 2018 was a huge policy shock for pricing with massive uncertainty on #CSR leading to insurers either running from the market entirely, retrenching or jacking up rates

As soon as CSR Terminated (October 2017), #Silverloading differentially increased silver premiums by a lot
Read 16 tweets
⚠️⚠️⚠️ ADVANCE WARNING: Long wonky MLR rebate thread ahead! All 50 states + DC!
One of the provisions of the #ACA is the “Medical Loss Ratio” provision, which requires health insurance carriers to spend a minimum of 80% or 85% of their premium revenue on actual healthcare/medical claims. It’s 80% for the Individual & Sm. Group markets, 85% for Lg. Group. 1/
Simple version: If an insurance carrier spends *less* than 80% (85%) on medical claims, weighted over a 3-year average, they have to *pay back* the excess to the policyholders.

So, if they bring in $100M in premiums & only pay out $75M in claims, they have to rebate $5M. 2/
Read 88 tweets
🗣 THREAD: A Kinda, Sorta Deep Dive into the 2020 NBPP!…
The #NBPP2020 is a long, wonky document from CMS which basically lays out the rules for the 2020 #ACA Open Enrollment period. Most of it is basic stuff like setting the dates (Nov. 1 - Dec. 15th) and the like, but it also makes some tweaks to the subsidy formula and so forth. 1/
As you can imagine, some of these changes are pretty benign, but others will have big implications for #ACA enrollees in 2020. There's a total of 17 items on the list, a few of which I actually don't understand well enough to comment on, but let's take a look at the rest! 2/
Read 64 tweets
⚠️ THREAD: When the dust settles on the 2019 Open Enrollment Period, total enrollments will likely be ~11.4M on exchange, plus perhaps 3M off-exchange. Of the 14.4M total, around 13M (90%) will actually pay their premiums. 1/
Of those 13M people, around 4.2 million will be unsubsidized & have to pay full price...and that full price will average around $49/month higher in 2019 than it would have been if Trump & the GOP hadn't repealed the individual mandate & opened the floodgates on #ShortAssPlans. 2/
This is the case even in states where 2019 premiums are *dropping* in 2019 (or staying flat)...they would have gone down *even more* without those changes. Many of the carriers have stated this specifically in rate filings, w/many including actuarial data to support it. 3/
Read 24 tweets
THREAD: For those who still don’t understand how important the #ACA #TexasFoldEm case is (along #StopKavanaugh), here’s a simple timeline of the ACA’s 3-Legged Stool:
1/ Here’s how the #ACA’s 3-Legged Stool was *supposed* to work when the law was passed. The blue leg includes the patient protections. The red leg is the part everyone hated but which served an important purpose. The green leg is the financial help for people to pay for it.
2/ This is what it ACTUALLY ended up looking like: There were two main problems. The financial assistance was cut off at 400% FPL income (& wasn’t generous enough), and the mandate penalty wasn’t strong enough to be fully effective. Both were EASILY fixable.
Read 13 tweets
⚠️⚠️ THREAD: Trump/GOP #ACASabotage is costing #ACA enrollees even more than you thought. Here’s why (warning: graphs ahead!)
1/ Every year during the off season, I spend countless hours digging into hundreds of wonky insurance carrier rate filing forms to analyze the weighted average rate increases for the following year.
2/ I then compile a table which breaks these averages out on a state-by-state basis, and I have a pretty damned good track record of accuracy, if I say so myself.
Read 35 tweets

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