I've had a pretty long blogging hiatus, and that's in part because I've been working on a longer piece about Texas -- Texas! -- passing a law directing the state department of insurance to take on active rate review in the ACA marketplace and in fact "focus its rate review in a manner that uniformly maximizes the benefits of silver loading."
Mirabilis! The law has been fleshed out in a proposed rule, and in 2023 gold plans in Texas will be priced well below silver plans.
Not to steal my own fire, I'll just point out here as a sidenote and placeholder that Texas, as one of twelve states that has refused to enact the ACA Medicaid expansion,, has strong cause to price silver plans at a platinum level (the proposed rule would price them a bit lower than platinum). Eligibility for premium subsidies in the ACA marketplace begins at 100% FPL in nonexpansion states, as opposed to 138% FPL (the Medicaid eligibility threshold) in expansion states. In Texas, 69% of enrollees have income below 200% FPL -- and so do 89% of all silver plan enrollees. In fact, the average actuarial value obtained by silver plan enrollees in Texas in 2022 is exactly 90% -- i.e., platinum level.
Average Actuarial Value of Silver Plans in Texas
Actuarial value | Number enrolled | Percent of all silver | Fractional AV |
94% | 821,857 | 69.8% | 65.6 |
87% | 223,349 | 19.0% | 16.5 |
73% | 73,010 | 6.2% | 4.5 |
70% | 59,654 | 5.1% | 3.6 |
Average AV |
|
| 90.2% |
The amazing aspect of this tale is not actuarial but political. And that is for another day.
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