2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

UPDATE: Delaware: Approved 2019 ACA rates: 3% HIGHER, would likely be ~7% LOWER w/out #ACASabotage

Huh. This is very odd. Delaware has only a single insurance carrier, Highmark, participating in the individual market next year. They requested an average 2019 rate increase of 13%.

Not only was 13% the amount on the filing form itself, it's also the average increase requested according to the summary at RateReview.HealthCare.Gov:

And yet, a press release from the Delaware Insurance Commissioner yesterday announcing the final, approved rates for Highmark states the following:

Final ACA Individual Rate Increase 3% / Highmark to Rebate Over $5 Million to Small Groups

Dover, DE – Insurance Commissioner Trinidad Navarro announced the 2019 Affordable Care Act (“ACA”) rates today. While Highmark Blue Cross Blue Shield of Delaware (Highmark BCBSD) proposed a rate increase of 5.7% for its 2019 individual Marketplace business, the Department of Insurance (“Department”) ultimately approved a 3% rate increase.

Huh. OK...they're claiming that Highmark only asked for 5.7% in the first place, not 13%. I'm...not sure what to make of that. The only thing I can think of is that they revised their proposed request at a later point, but if they did, I can't find the revised version.

UPDATE 10/02/18: OK, Louise Norris just informed me that Delaware is "working on" restricting short-term plans to no more than 3 months per year and making them nonrenewable, which likely explains at least some of the discrepancy between the 13% and 5.7% figures. That still seems like a pretty big gap, however.

In any event, this is still good news for Delaware residents--instead of 13% or even 5.7% hikes, they'll be looking at just 3%.

There's also some more good news for small group enrollees in Delaware, thanks to the ACA's MLR rule:

...Because our regulatory work doesn’t end with a rate filing approval, I also wanted to mention that Highmark will be rebating a total of $5,050,952.00 to their small group market members as a result of their administrative fees exceeding the mandated MLR (Medical Loss Ratio) rules. The rebates will be paid out by September 30, 2018.”

There's a bit more good news here as well: This year, Delaware was one of a handful of states which "broad loaded" lost CSR revenue, which increased premiums by an equal amount on all metal levels on & off the ACA market. For 2019, Delaware is wisely jumping on board the Silver Loading train, which will maximize benefits for subsidized enrollees while protecting many unsubsidized enrollees from having to pay the CSR load:

The 2019 ACA rates are silver loaded. Silver-plan premiums are the benchmark in calculating tax credits used to subsidize lower-income enrollees’ premiums. Therefore, silver-loading generally results in greater federal subsidies to help curb expenses. Because of the increased federal subsidies received, silver-loading may result in reduced gold plan premiums and free or very low-cost bronze plans for some members.

Because this year’s filing may result in lower costs for many consumers, the Department urges consumers to examine their rates and reapply for coverage through the Marketplace.

Presently, 20,000 Delawareans have health insurance through the Affordable Care Act and will be affected by increasing rates.

Please note that the proposed rate increase will not apply to Delawareans on Medicare, Medicaid, or those with group or individual policies outside of the Marketplace.

This suggests that not only will Delaware be Silver Loading, they'll actually be going the full Silver Switcharoo route, which is even better news!

In fact, the only downside here is that 2019 premiums would likely be around 10% lower without the GOP repeal of the individual mandate, which means they'd be looking at around a 7% decrease instead of a 3% increase without the sabotage factor. That's still an extra $900 per unsubsidized enrollee for the year.