2021 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 tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms 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nationally, and that premiums would have dropped around 5.4% on average if not for the ACA's individual mandate being repealed & short-term & association plans being expanded.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 five 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 2021 ACA-compliant individual (and sometimes small group) markets. Scroll down for individual state entry links.

For 2021, the biggest new factor is, of course, the impact of the COVID-19 pandemic on both 2020 and 2021 medical claims expenses. I've added a new column which attempts to separate that out, though not every carrier does so, while some simply refer to the impact of COVID-19 in a fairly vague way.

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New York is the fifth state (well, fourth really) to announce their preliminary 2021 health insurance policy premium rate changes for the individual and small group markets (thanks to Michael Capaldo for the heads up):

NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICES

2021 INDIVIDUAL AND SMALL GROUP REQUESTED RATE ACTIONS

6/5/2020

Health insurers in New York have submitted their requested rates for 2021, as set forth in the charts below. These are the rates proposed by health insurers, and have not been approved by DFS.

via the Washington Insurance Commissioner's office:

OLYMPIA, Wash. – Fifteen health insurers filed an average proposed rate decrease of 1.79% for the 2021 individual health insurance market. This includes two new insurers — UnitedHealthcare of Oregon and Community Health Network of Washington — that are joining Washington’s market. 

With 15 insurers in next year’s individual market, all 39 counties will have at least two insurers selling plans inside the exchange, Washington Healthplanfinder. Ten insurers will sell plans outside of the exchange. 

The proposed average rate decrease follows an average premium reduction of 3.25% for 2019 plans. 

The District of Columbia has joined Vermont and Oregon in releasing their preliminary 2021 Individual and Small Group market premium rate filings:

This page contains proposed health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2021.

The District of Columbia Department of Insurance, Securities and Banking (DISB) received 188 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 2021 on DC Health Link, the District of Columbia’s health insurance marketplace.

The four insurance companies filed proposed rates for individuals, families and small businesses for the 2021 plan year. Overall, 188 plans were filed, compared to 181 last year. The number of small group plans increased from 156 to 163, and the number of individual plans remained at 25.

In the middle of a deadly global pandemic which has already killed more than 100,000 Americans and completely disrupted the entire U.S. healthcare system, private insurance carriers still have to go about preparing their annual premium rate change filings for 2021. This is a long, complicated process which begins a good nine months before the new plans and prices are actually enrolled in.

The task of setting 2020 premiums was the first time since the ACA went into effect which was relatively calm for insurance carrier actuaries:

Annnnnd we're off! In the middle of a deadly global pandemic which has already killed more than 85,000 Americans and completely disrupted the entire U.S. healthcare system, private insurance carriers still have to go about preparing their annual premium rate change filings for 2021. This is a long, complicated process which begins a good nine months before the new plans and prices are actually enrolled in.

The task of setting 2020 premiums was the first time since the ACA went into effect which was relatively calm for insurance carrier actuaries. Unlike setting rates for 2014 or 2015, they weren't dealing with a complete overhaul of the entire insurance industry. Unlike 2016-2017, they weren't dealing with the prospect of ACA premiums being crippled for 3/4 of the country (via King v. Burwell) or the fallout of the Risk Corridor Massacre. Unlike 2018, they weren't dealing with how to deal with CSR rembursements being cut off or the entire ACA being repealed by Congress. Unlike 2019, they didn't have the unknown impact of the individual mandate being repealed to consider.

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:

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