2017 Rate Request Early Look: North Dakota

North Dakota's total individual market was 49,000 people in 2014. Assuming a 25% increase since then, it should be roughly 61,000 today, some portion of which is composed of transitional/grandfathered enrollees. I'm going to assume (based on hard numbers from a few other states) that GF/TR enrollees make up perhaps 10% of the total, or 6,100. They enrolled 21,604 people in exchange plans this year, of whom 20,536 were still enrolled as of the end of March. Last year, Blue Cross Blue Shield of ND held roughly 29,000 enrollees total, with Medica making up another 4,800 or so.

All of the above numbers are important when attempting to estimate the weighted average rate hikes requested by ND carriers, because of the 3 operating on the individual market (BCBS, Medica and Sanford), only one of them, Medica, has provided their actual 2016 enrollment tally (7,329).

Without any other data available, I have to make a guesstimate based on the partial info that I do have. Last year BCBS had roughly 6x as many indy enrollees as Medica; assuming this ratio is roughly the same for 2016, that suggests around 44,000 BCBS enrollees. Subtract out the estimated GF/TR enrollees (different risk pool) and that leaves perhaps 4,600 for Sanford.

Again, I realize I'm making a lot of big assumptions here, but it's the best I have to go on for the moment; if anyone can provide me with better numbers for BCBS or Sanford, please do so and I'll adjust accordingly.

Assuming I am reasonably close on the ratios, here's what things look like in ND:

The key here is that Blue Cross Blue Shield of North Dakota, by far the largest player on the independent market, is only asking for a 1.8% average rate hike next year...astonishingly low in a year where so many major carriers (including many of their fellow Blues) are jacking rates up dramatically. Even if BCBS has the exact same 29K that they had last year at this time, the statewide average would only be about 1 percentage point higher, so it looks like North Dakota is joining Rhode Island, Wyoming, Vermont, New Jersey and the District of Columbia in the "Under 10%" club next year.