2020 Rate Changes

Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers jump in and out of the market, their tendency repeatedly revise their requests, and the confusing blizzard of actual filing forms which sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:

  • How many effectuated enrollees they have enrolled in ACA-compliant individual market policies;
  • What their average projected premium rate increase (or decrease) is for those enrollees (assuming 100% of them renew their existing policies, of course); and
  • Ideally, a breakout of the reasons behind those rate changes, since there's usually more than one.
  • In 2015, I projected that the overall average rate increases for 2016 would be roughly 12-13% nationally. It turned out to be around 11.6%.
  • In 2016, I projected that the overall average rate increases for 2017 would be roughly 25% nationally. It turned out to be around 22%, but that only included on-exchange Silver plan enrollees across 44 states (I included all metal levels, both on and off exchange, across all 50 states).
  • In 2017, I projected that the overall average rate increases for 2018 would be around 29% nationally, and that 60% of that would be due specifically to deliberate Trump Administration actions designed to sabotage the ACA markets. It turned out to be around 28% nationally.
  • In 2018, I projected that the overall average rate increases for 2019 would be around 2.8% nationally, and that premiums would have dropped around 5.4% on average if not for the ACA's individual mandate being repealed & short-term & association plans being expanded. Hhealthcare think tank Avalere Health came to almost the exact same estimates on the actual rate changes, while Brookings Institute healthcare analyst Matthew Fiedler concluded that unsubsidized ACA individual market premiums would indeed have dropped by around 4.3% nationally on average in the absence of mandate repeal and expansion of #ShortAssPlans.

In other words, I've had a pretty good track record of accurately projecting average premium increases for the upcoming year for four years in a row. With that in mind, below you'll find a table tracking the state-by-state preliminary and final rate changes for the 2020 ACA-compliant individual (and sometimes small group) markets. Scroll down for individual state entry links.

I wasn't expecting my analysis of Rhode Island's 2020 ACA premium changes to be of any particular interest; it's a small state with only two carriers offering individual market policies, after all, so there's not usually much to it.

When I last checked in on the Ocean State (seriously...that's their official slogan for whatever reason), I had noted that the state Senate had passed a bill (2019-S 0738A) which, if signed into law, would lock in most of the ACA's "Blue Leg" protections, including guaranteed issue, community rating, removal of annual/lifetime coverage caps and so forth.

A week or so ago I reported that Covered California had released their preliminary 2020 ACA individual market premium rate changes, with a record-low 0.8% average increase statewide. They detailed in the report how the combination of reinstating the ACA's individual mandate penalty and using that funding to provide additional financial subsidies to the enrollees lowered the average rate increases from 4.0% to 0.8%, saving unsubsidized enrollees around 3.2 points or $167/year on average.

Today, CoveredCA has posted more details about some of the specifics:

Covered California Releases Regional Data Behind Record-Low 0.8 Percent Rate Change for the Individual Market in 2020

Over a month ago, I posted an analysis of the preliminary 2020 premium rate filings for the ACA Individual Market here in Michigan based on the actual filing forms from each of the 11 carriers participating in the market.

At the time, I concluded that the weighted average change marketwide was a 1.95% reduction in premiums compared to 2019, for around 281,000 Michiganders on the Indy market. This would mean roughly a $10 average premium reduction per unsubsidized enrollee per month, or $116 per year:

This just in via the Colorado Dept. of Insurance:

Polis Administration Projects 18.2% Average Decrease in Premiums for Individual Health Insurance Plans in 2020

Reducing health care costs has been a top priority for Polis.

DENVER (July 16, 2019) – Today, the Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), announced that for the first time ever, Colorado health insurance companies that sell individual plans (for people who do not get their health insurance from an employer or government program) expect to reduce premiums by an average of 18.2 percent (-18.2%) over their 2019 premiums, provided the reinsurance program is approved by the federal government. These are the health insurance plans available on the Connect for Health Insurance Exchange, the state’s health exchange made possible by the Affordable Care Act (ACA).

via Brett Kelman of The Tennessean:

A new set of proposals provide some of the strongest evidence yet that Obamacare -- once on the verge of collapse in Tennessee -- has stabilized.

The state’s largest insurance company, BlueCross BlueShield of Tennessee, plans to reenter the Affordable Care Act marketplace in Nashville, Memphis and surrounding counties next year, providing another option for residents on Obamacare. Additionally, two other insurance companies that already offer Obamacare in these cities, Cigna and Oscar Health, are planning to significantly reduce the cost of their coverage plans.

Although the proposals are not final, it appears Tennesseans will have more options and competitive prices in the coming year, said Kevin Walters, a spokesman for the Department of Commerce and Insurance.

via the Connecticu Insurance Dept:

Health Insurance Rate filings for 2020

The Connecticut Insurance Department has posted the initial proposed health insurance rate filings for the 2020 individual and small group markets. There are 14 filings made by 10 health insurers for plans that currently cover about 242,000 people.

Two carriers – Anthem and ConnectiCare Benefits Inc. (CBI) – have filed rates for both individual and small group plans that will be marketed through Access Health CT, the state-sponsored health insurance exchange.

The 2020 rate proposals for the individual market are on average lower than last year while the small group market is on average slightly higher than last year.

The Minnesota Commerce Dept. just posted their preliminary 2020 Individual and Small Group rate changes. The actual rate changes are pretty straightforward...a mere 1.6% average rate increase on the ACA Individual Market, and a 5.5% increase on the Small Group market.

Unfortunately, the actual effectuated enrollment for each carrier (which I use to calculate the weighted average) was provided in either the MN Commece website post or even in the currently-available raw SERFF rate filing forms, so I had to put together estimates based on last year's market share numbers, modified for 2019 based on the on-exchange portion of the total enrollment for the Indy market (for the small group market I just went with the straight 2018 shares).

OK, it feels a bit surreal to post about California's 2020 ACA premiums--and especially mentioning the fact that they're reinstating the ACA individual mandate penalty at the state level--on the very same day that the entire ACA itself is on the brink of complete oblivion (again), due specifically TO the fact that Congressional Republicans repealed the federal mandate penalty..

And yet, here we are:

California’s Initiatives Will Lead to Hundreds of Thousands Gaining Health Care Coverage With Lower Premiums and New Financial Help

This Just In from the Delaware Insurance Dept...

Dover, DE -- Highmark Blue Cross Blue Shield of Delaware (Highmark BCBS) has submitted its required annual rate filing to the Delaware Department of Insurance. After years of substantial increases, Delaware’s Marketplace has stabilized and premiums have decreased. Highmark BCBS, the only insurer continuing to offer insurance coverage in Delaware’s individual market, has proposed a 5.8% decrease for 2020. The proposed 2020 rate decrease will affect over 20,000 Delawareans.

The decrease comes after last year’s 3% rate increase and the Department’s decision to silver load. By applying the rate increase to silver level plans only, a practice known as ‘silver-loading,’ Delaware’s Marketplace received more federal subsidies, helping to assist in stabilizing the market and lowering premiums.

This Just In from the Indiana Insurance Dept...

INDIANA 2020 ACA FILINGS

The overall average rate increase for 2020 Indiana individual marketplace plans is 9.0%. CareSource and Celtic (MHS/Ambetter) have filed to participate in the 2020 Indiana Individual Marketplace. The Department of Insurance anticipates that all 92 counties in Indiana will be covered by both CareSource and Celtic (MHS/Ambetter).

Anthem has filed to offer a 2020 Off-Marketplace plan in Indiana. This plan is a catastrophic plan and is offered only in Benton, Jasper, Newton, Warren and White Counties.

Filing a rate does not guarantee it will be approved for use on the Marketplace, nor does the filed rate guarantee to be the final rate. Therefore, the Department of Insurance is not able to ascertain the amount of any final rates at this time. The state has until September 24, 2019 to review and submit dispositions to U.S. Department of Health and Human Services.

This Just In from the Montana Insurance Commissioner's office:

2020 Rate Filings and Rate Review

Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Montana State Auditor’s Department of Insurance for review and before plans can be sold to consumers.

What is rate review?

The rate review process, established by the Montana Legislature in 2013, does not give the Commissioner the authority to disapprove rates or prevent them from taking affect. It does give the commissioner the chance to review the factors insurance companies use in setting rates.

If the commissioner finds a rate increase to be excessive or unjustified, the insurer can voluntarily lower the rate increase. If the insurer decides to use the rate anyway, the commissioner will issue a public finding announcing that the rate is unjustified.

What does the department consider?

This Just In from the Kentucky Insurance Commissioner's office:

Proposed Insurance Rates Submitted to DOI for Review

Rates Subject to Review

Frankfort, Ky. (June 25, 2019) – Insurance Carriers have submitted proposed rates to the Department of Insurance (DOI) for Kentucky’s 2020 individual and small group markets. Anthem Health Plans of Kentucky, Inc. (Anthem) filed requests for 13 different plans to be offered on the Exchange with a proposed average rate increase of 12%. CareSource Kentucky Co. requested an average rate decrease of 4.5% for 12 different plans to be offered on the Exchange. This decrease follows the 19.4% rate increase approved last year for the 12 plans it offered. The submitted rates are subject to review by the Department.

Not much of an entry, but still: A month ago, the Oregon Division of Financial Regulation posted the requested 2020 rate changes for the Individual and Small Group health insurance markets: 3.3% on average for the Indy market, 8.7% for the sm. group market.

Today, after reviewing the requests from the insurance carriers, the department has posted their "semi-final" rates. These may still see some additional tweaking before the final, approved rates are locked in, but the odds are that these will be the final rates:

Salem — Oregonians can now see the state’s preliminary rate decisions for 2020 individual and small employer health insurance plans. The Division of Financial Regulation must review and approve any rates before they can be charged to policyholders.

Preliminary rate decisions are for individuals who buy their own coverage rather than getting it through an employer and for small businesses.

The state of Maine's Bureau of Professional & Financial Regulation has released their preliminary 2020 rate filings for the Individual and Small Group markets. Overall, the three carriers participating in their individual market are seeking a weighted average rate increase of 4.7% vs. last year. If approved as is, that would bring the average unsubsidized premium up from $675/month to $707/month, or around $381/year.

It's important to keep in mind why premiums are going up. I've included screenshots of the rate filing memos--Maine Community Health Options, which holds over 50% of the individual marketshare, clarifies that the combination of the individual mandate being repealed and the expansion of #ShortAssPlans are causing an 11% increase. They also note that Maine's recent Medicaid expansion implementation may be a factor, although normally that reduces premiums since lower-income populations tend to be less healthy than higher-income populations, so I'm not sure what to make of that.

Along with Massachusetts and Vermont, the District of Columbia merges their Individual and Small Group markets for purposes of risk pools and risk adjustment. This does not, however, necessarily mean that their Indy and Sm. Group average premium changes are identical. For one thing, there are more carriers which offer small group plans than individual market plans; for another, the market share ratios between the two differ.

A week ago, the DC Dept. of Insurance, Securities and Banking (DISB) issued preliminary 2020 rate filings along with this press release:

Washington, DC – The District of Columbia Department of Insurance, Securities and Banking (DISB) received 181 proposed health insurance plan rates for review from Aetna, CareFirst BlueCross BlueShield, Kaiser Permanente and United Healthcare in advance of open enrollment for plan year 2020 on DC Health Link, the District of Columbia’s health insurance marketplace.

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