OE7

(sigh) I'm into the home stretch with only a handful of states left to go. Unfortunately, South Carolina is yet another state where the actual enrollment numbers are either missing or redacted, making it impossible to run a properly weighted average...but again, the range between the three carriers offering individual market policies is so narrow that it doesn't make much difference anyway (between -3.72% and +0.17%).

The unweighted average is a 1.9% reduction in unsubsidized premiums statewide.

On the small group market, however, average 2020 premiums are jumping by double digits: 11.1%.

Oklahoma has three carriers on the Individual Market these days. Once again, all three rate filing memos are redacted, but I was able to dig up the number of current policy holders for one of them (CommunityCare HMO).

I've bumped that number up a bit to account for the total number of covered lives to an even 2,000. For the other two carriers, I'm assuming Blue Cross Blue Shield still holds the lion's share of enrollees and that the total on+off-exchange market is around 187,000 people.

If this is all correct, the weighted average rate increase for unsubsidized enrollees is around 1.4% statewide.

Meanwhile, the unweighted average rate hike for the small group market is 6.5%.

Not much to say about Mississippi this year...they still have two carriers on the individual market, and while they do have a whole website/database set up specifically to track and report health insurance premium changes, it's messy and only appears to post the rate filings after they've been approved, which won't be for another couple of months.

As a result, I have no idea what the relative market share is between the two and am assuming they're roughly even. Even if they aren't, the requested rate changes are so close it doesn't make much difference anyway (2.3% and 3.0%). If approved as is, unsubsidized Mississippians can expect to pay about $200 more total next year.

On the small group market, there's five carriers; again, I don't know the market share of any of them, so the unweighted average increase is 6.2% statewide.

Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has ten different carriers participating in the individual market. MA (along with Vermont and the District of Columbia) has merged their Individual and Small Group risk pools for premium setting purposes, so I'm not bothering breaking out the small group market in this case.

Getting a weighted average was a bit tricky. On the one hand, only one or two of the rate filings included actual enrollment data. On the other hand, the Massachusetts Health Connector puts out monthly enrollment reports which do break out the on-exchange numbers by carrier. This allowed me to run a rough breakout of on-exchange MA enrollment. I don't know whether the off-exchange portion has a similar ratio, but I have to assume it does for the moment.

Huh. This is interesting...after a couple dozen states with near-flat or even reduced 2020 premiums, Louisiana is just the third state I've come across where the carriers are seeking double-digit rate increases for next year.

There's actually only 3 carriers offering individual market plans in Louisiana, but there's seven listings because two of the carriers have broken out their submissions into several different product lines. Overall, HMO LA, LA Health Service & Indemnity (Blue Cross Blue Shield of LA) and Vantage Health Plan are requesting average premium increases of 11.7% statewide.

I should note that there's also one odd listing (see second screenshot below), from UnitedHealthcare. It claims to be for off-exchange ACA-compliant individual market plans, but two things about it make no sense:

After several years with four carriers participating in their ACA individual market, the Peach State is gaining not one but two additional carriers this year: CareSource and Oscar are joining Alliant, Ambetter/Centene, Blue Cross Blue Shield and Kaiser. Unlike a lot of the states I've crunched numbers for recently, I was able to acquire hard enrollment numbers for every single Georgia carrier...including both the Individual and Small Group markets, which is a rarity this year!

Statewide, GA's individual market carriers are requesting average unsubsidized 2020 rate hikes of just 2.4%, while the small group carriers are looking for a 12.8% average increase:

(sigh) The good news is that none of the five carrier rate filings for Utah's individual market have been redacted. Hooray! The bad news is taht only one of the five (Molina) included their current enrollment total on the filing at all. Boo!

As a result, I'm only able to run a "mostly" unweighted average...that is, it's an unweighted average of the other four carriers, plus a slight additional tweak based on the tiny number (448 people) enrolled in Molina policies. Utah's total individual market should be around 240,000 people, so that's barely a rounding error. My best guess is that unsubsidized enrollees are looking at roughly a 5.9% average premium drop next year.

For the state's small group market, the unweighted average increase is 2.7%.

West Virginia has three carriers offering policies on the Individual Market: CareSource, Highmark and The Health Plan of WV (aka Optum). I was ble to find the hard enrollment number for CareSource, while both HighMark and Optum are redacted, so I based my enrollment estimates on 83% of last year's (WV's total ACA exchange enrollment dropped 17% this year). Even if that ratio is off, it won't make that much of a difference since the two are pretty close anyway (+5.9% and +6.5% respectively).

Statewide, unsubsidized West Virginians will be seeing roughly a 6.7% average increase...to a whopping $1,000/month on average, one of the highest rates in the country. Of course, WV is also one of the few states which, to my knowledge, is still refusing to Silver Load or Silver Switch their premium increases, which makes it even worse for the few unsubsidized enrollees they have.

Meanwhile, the unweighted average increase on the WV small group market is +11.2%.

Just hours after explaining what a dramatic impact the nearly-flat average 2020 premium changes are going to have on this year's (and next year's) Medical Loss Ratio rebate payments, I've discovered that rates are going to be increasing even less than I thought nationally.

Back in late May, Virginia was one of the first states to post their preliminary 2020 premium rate filings. At the time, the 10 carriers participating in VA's individual market (one of which is new for 2020) were asking for average increases of 2.9% statewide:

I've now analyzed the preliminary average (weighted or, in a few unfortunate cases, unweighted) premium change requests for over 3 dozen states. Of the dozen or so left, the largest states unanalyzed are Georgia, Texas...and Florida.

Florida may be the third largest state, but it has the largest ACA Individual health insurance market. 18% more Floridians enrolled in ACA exchange policies this year than California, in spite of FL's total population being only 54% as large.

Two years ago I noted that for whatever reasons (demographics? state economy?), Florida's Individual market is twice as large as the rest of the country on a per capita basis. Today I found out that FL's indy market is actually larger than their large group market:

(sigh) Kansas is yet another state where the enrollment data for each of the carriers is redacted on the filing forms this year. To run the weighted average, I'm using last year's estimated enrollment numbers for each, which may have shifted around this year.

Assuming things haven't shfited around too much, unsubsidized Kansans will likely be looking at roughly a 3.1% average premium reduction in 2020...which also happens to be the same as the unweighted average change.

Meanwhile, the small group market is looking at an unweighted average increase of 9.7% statewide.

(sigh) As is common this year, the rate filings for Iowa's Individual and Small Group market are heavily redacted, making it impossible to calculate a weighted average premium rate change. On the Indy market, Medica is reducing their unsubsidized 2020 premiums by 11.3%, while Wellmark is raising theirs by around 4.8%.

Seeing how Wellmark only re-entered the ACA-compliant individual market this year, I'm assuming Medica has the lion's share of enrollees...but who knows? Also, Wellmark is offering two different types of policies; I'm assuming that at most the two combine to be similar to Medica's total. If so, that should mean an average premium reduction of around 3.3%.

For the small group market, I just ran an unweighted average of the 12 different companies offering policies, coming up woth an average 5.4% increase.

There is one interesting tidbit in the Wellmark filing, however: They expect 100% of their 2020 enrollees to do so on-exchange, which basically means that their unsubsidized premiums have gone up so much that they don't expect anyone to be willing to pay full price (off-exchange) for them.

Hawaii only has two carriers participating in the Individual health insurance market. For 2020, they're reducing unsubsidized premiums slightly.

The state's small group market has four carriers; unfortunately, only one of the four (Kaiser Foundation Health Plan) has posted their enrollment data; the other three are redacted. The unweighted average increase on the small group market is a mere 0.8%, however.

The good news is that as of August 2nd, the preliminary 2020 ACA premium rate changes are now available for every state at the RateReview.HealthCare.Gov website.

The bad news is that more carriers appear to be redacting their filings, making it more difficult to run weighted averages based on relative market share. In the case of Illinois, all five carriers on the individual market either redacted or not listed in the summary memos at all.

As a result, all I can do is run an unweighted average, which comes to a 1.4% premium increase statewide. My guess is that Blue Cross Blue Shield likely has the bulk of the market, which means the weighted average is likely just about flat.

For the small group market I didn't even bother trying to get the enrollment data; the unweighted average there is a 4.7% increase.

Louise Norris did note a few other details:

The good news is that as of August 2nd, the preliminary 2020 ACA premium rate changes are now available for every state at the RateReview.HealthCare.Gov website.

The bad news is that while it does make it extremely easy to look up the average rate changes being requested for every carrier on the Individual and Small Group markets, they appear to have made it somewhat harder to dig up the other key data I need to run weighted averages...namely, the actual enrollment numbers for each, along with other noteworthy items like special circumstances, breakouts of the reasons for the rate changes and so on.

Every year some rate filing forms are redacted, but it seems to be more prevalent for 2020. I don't know if that's something being done by the carriers or at HC.gov's end, but for whatever reason, it's more difficult for me to run weighted averages this year.

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