2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

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nationally, and that premiums would have dropped around 5.4% on average if not for the ACA's individual mandate being repealed & short-term & association plans being expanded.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.

In early August, the Nevada Dept. of Insurance posted the state's preliminary 2020 individual market rate changes. The data was a bit incomplete and confusing, but the bottom line is that average unsubsidized 2020 premiums were only expected to increase about 1.0%.

Today they posted the final/approved rate changes, and unlike most states, the overall weighted average will be slightly higher than the original numbers...although only by a hair:

Nevada Division of Insurance reveals approved 2020 Health Insurance Rates

Carson City, NV – The Division of Insurance (‘Division”) has posted the approved 2020 health insurance rates for all plans in the Individual Health Insurance Market at healthrates.doi.nv.gov and encourages consumers to review this information before the Open Enrollment Period begins.

Not much to see here...in August, the Idaho Insurance Dept. posted their preliminary 2020 average rate changes for the individual & small group markets; they averaged 7.0% and 4.0% increases respectively. Today they've posted the final/approved rates, and the indy numbers have been whittled down ever so slightly:

Back in July, I noted that the Minnesota Commerce Department announced the preliminary 2020 rate changes for carriers on the individual and small group markets. At the time, the weighted average increases were roughly 1.6% and 5.5% respectively, although the enrollment estimates for each carrier were estimates only.

Today, the MN Commerce Dept. announced the approved rates for 2020, and in both markets, they shaved average premiums down a couple of points. Here's the actual Commerce Dept. press release:

Commerce releases 2020 health insurance rates for Minnesota

Minnesota’s individual and small group health insurance market rates for 2020 reflect stabilized markets, according to information released today by the Minnesota Department of Commerce in advance of the open enrollment period beginning November 1.

The Arkansas Insurance Dept. just posted their approved 2020 individual and small group market premium rate change requests. For the most part it's pretty straightforward: Individual market premiums are increasing about 2.3% statewide, while small group plans are going up 6.2% overall. This is virtually unchanged from their preliminary rate requests in July, although a single small group carrier had their request reduced from +2% to -0.1%, lowering the overall weighted average by a mere 0.2 points:

Regular readers may have noticed that this is my first blog entry in several days, which is unusual for me. I admit I've been mesmerized by the dramatic Trump/Ukraine/Impeachment saga which has exploded over the past few days.

I'm back in gear today, however, and I'm starting things off with my latest freelance piece over at healthinsurance.org. It's basically a summary explainer of where things stand re. 2020 ACA individual market premiums. As anyone who follows this site knows, the answer this year is basically...FLAT, at least nationally.

The irony of this, of course, is that the 800 pound gorilla in the room is the pending #TexasFoldEm lawsuit decision by the 5th U.S. Court of Appeals, which could potentially tear down the entire Affordable Care Act...and their decision in the case is expected to be released any time over the next five weeks...just ahead of the 2020 Open Enrollment Period.

Back in mid-June, the DC Health Benefit Exchange Authority posted the preliminary, requested average unsubsidized 2020 premium changes for the Individual and Small Group markets:

Overall individual rates increased an average of 9.0 percent and small group rates increased an average of 10.5 percent. In the individual market, CareFirst proposed an average increase of 7.7 percent for HMO plans, and 15.6 percent for PPO plans. Kaiser proposed an average increase of 5.0 percent. For small group plans, CareFirst filed average rate increases of 13.5 percent for HMO plans and 18.5 percent for the PPO plans. Kaiser small group rates proposed an average increase of 3.0 percent. Aetna filed for an average increase of 16.1 percent for HMO plans and 5.0 percent for PPO plans. Finally, United proposed an average increase of 13.0 percent and 7.4 percent for its two HMOs and 11.2 percent for its PPO plans.

This is what it looked like at the time:

Back in May, Maryland was the very first state to publicly release their preliminary 2020 individual and small group market rate change requests. For 2019, thanks to several laws passed by the state legislature and signed by Gov. Hogan, including a robust ACA Section 1332 reinsurance waiver program, instead of increasing by another 30%, premiums dropped by 13.4% this year.

For 2020, the preliminary rates looked pretty good: Average rates were expected to drop by around 3% or so.

Well, today the Maryland Insurance Department announced the approved rates for 2020...and it's even better than that:

Last month I noted that North Dakota had posted their requested 2020 premium rate change requests, including two different filings: One assuming the states' ACA Section 1332 Reinsurance Waiver didn't get approved, the other assuming it did. It was pretty unlikely that their waiver would be denied, however, so the general assumption was that they'd be looking at a significant rate reduction, especially compared with the rate increase if the waiver didn't go through.

At the time, I didn't have access to the actual enrollment figures for the three carriers on North Dakota's individual market, so I had to go with an unweighted average rate change, and came up with a drop of 7.9%.

Since then, however, the state regulators have reviewed and approved the 2020 premium changes, and thanks to Louise Norris, I don't even have to dig up the enrollment data:

Average rates dropping by nearly 6% in 2020 (without reinsurance, they’d have increased by nearly 15%)

In mid-July, the Connecticut Insurance Dept. reported that average requested premium rates for 2020 averaged around a 7.8% increase on the Individual market and 12.0% on the Small Group market.

This weekend, they reported the approved 2020 rate changes for both markets...and have cut down the rate hikes significantly for most carriers (while raising them a bit on a few others):

Insurance Commissioner Issues Decisions For 2020 Health Insurance Rates

Insurance Commissioner Andrew N. Mais today announced the Department has made final decisions on health insurance rate filings for the 2020 coverage year. As a result of these decisions, Connecticut consumers are projected to save approximately $54 million.

Back in early June, the Washington State Insurance Commissioner announced that preliminary rate filings for the ACA individual market in 2020 were averaging just 1.0% higher than this year. My own analysis brought the weighted average in at 1.4%, but whatever. The Small Group market requests also came in at an average increase of 6.7%.

A couple of days ago, the WA Insurance Dept. posted a press release with the final/approved rates for 2020, and they've managed to knock average premiums on the Individual market down by about 4 more points:

Kreidler approves record low average rate decrease of -3.27% for Exchange plans

Eight health insurers approved to sell in next year's Exchange marketplace

The Kentucky Insurance Dept. just announced their approved rate changes for unsubsidized ACA-compliant individual and small group market enrollees. They only shaved a little bit off of the proposed rates from late June, but every bit helps:

DOI Completes Review of Individual and Small-Group Health Insurance Rate Filings

The Kentucky Department of Insurance (DOI) announced today that it has completed its review of the individual and small-group insurance rates filed in the Kentucky market.  The rates will be used to calculate insurance premiums for the 2020 benefit year. 

I noted last month that Rhode Island was the latest state to put in for an ACA Section 1332 reinsurance program waiver:

Governor Raimondo’s proposed FY 2020 budget called for the creation of the Health Insurance Market Integrity Fund, which would make available reinsurance payments to health plans to reduce the burden of high cost claims on individual market premiums. According to insurer filings, the enactment of the Health Insurance Market Integrity Fund would reduce the individual market premium requests from 6.6% to -0.4% for BCBSRI and from 5.4% to 1.7% for NHPRI. These insurers’ pricing assumptions are subject to review and verification by OHIC. Table 1 shows the requested individual market rate increases with and without reinsurance.

Back in June I noted that Maine's Bureau of Professional & Financial Regulation released their preliminary 2020 rate filings for the Individual and Small Group markets. At the time, the three carriers on their Indy market were requesting average rate increases of around 4.7% next year.

In July I reported that the carriers themselves sliced their unsubsidized 2020 rates down of their own volition, to a 1.6% decrease on average.

Last week, after a public comment meeting, it looks like the Maine Insurance Dept. went ahead and approved the lower, revised rates for all three individual market carriers.

Last month I posted the average requested unsubsidized premium rate changes for the 2020 Individual Market in Ohio. At the time, the state was looking at a weighted average reduction of 7.0% from 2019 rates.

Since then, the Ohio Dept. of Insurance has reviewed and approved the rates for 2020, and while they don't provide much detail on individual carriers, overall it looks like they reduced rates slightly more (average reduction of 7.7%). The wording below is almost identical to what it was last month, except for the highlighted text:

Last month I reported on Tennessee's preliminary 2020 premium rate filings. At the time, the weighted average rate change for ACA Individual Market policies was a 1.1% reduction over this year.

Today, the Tennessee Insurance Dept. officially approved the rate changes exactly as is, without making any changes one way or the other:

TDCI Approves Carriers’ 2020 Rates on the Federally Facilitated Marketplace
More Choices, Rate Decrease Highlight Rating Filing Season

The Tennessee Department of Commerce and Insurance (TDCI) announces the approval of insurance rates requested by the five carriers offering coverage on the Federally Facilitated Marketplace (FFM) in 2020.

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