Friday, May 16, 2014

Gullible to the Actuaries SWAG

Media outlets and health policy "experts" have been spewing over reports this week about the initial 2015 rate increases that have been submitted in Washington and Virginia. Headlines such as Six Reasons Obamacare Premiums are Going Up Next Year  and Big Obamacare Insurers Signal Big Premium Hikes have been the norm. These articles are coming from the left and the right with very different takes on whether or not Obamacare is increasing premiums. Want to know who is right?

None. Of. Them.

I'm going to let you in on a little secret - initial rate filings mean absolutely nothing. Especially filings for Obamacare compliant rates. Here are five (of many) reasons why we have no idea of what rates will look like.

1. The make up of the market isn't determined. While HHS issued a report on demographics by shopping cart they don't know who has paid, who will quit paying, or how many of the shopping carts were duplicates.

2. Insurance company rate submissions are based on little claims data and a short time frame (experience, trend); so whatever the rates end up they will not be credible. Setting the rates is like predicting the Cleveland Browns will win the Super Bowl in 30 years.

3. States will vary. Insurance markets had different variables for underwriting pre-Obamacare. This will lead to some having lower increases than others. Some states will also have a different make-up of enrollments. A state with a higher population of younger people might have a lower increase than one with an older population. Unhealthy states may see higher increases simply because the underlying risk is greater.

4. Speaking of pre-Obamacare, rates that were set last year assumed that nobody could keep the plan that they liked. By unilaterally changing his own law, President Obama actually distorted his risk pool. People in good plans that are healthy will stay in those plans where allowed. Because of community rating the medically underwritten plans that have good risk will be priced lower than the Obamacare mandated pool that must be equal regardless of health status. Why go into the peed in baby pool when you can stay in the less peed in pool?

5. The blanket figures in these studies use an aggregate number. This tells us little about how the rates will look for different metal tiers. 8% doesn't mean the increase is equal for Bronze, Silver, Gold, and Platinum tiered plans. Bronze plans might be 3% and Gold plans might be 15%. One carrier might also have a larger market share today and decide to eliminate Platinum plans because the risk in these products is very high. By simply eliminating a plan it could have adverse impact on their Gold plans or on their overall market share.

Rate watching is important. But before the MSM start throwing stones at each other remember, because of these and many other reasons actuaries are using SWAG as their calculation method.

In other words they are making a Systematic Wild Ass Guess.
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