Maryland: *Approved* 2016 weighted avg. hikes: 20.0% overall (Updated)

Maryland was one of the first states to release their list of requested 2016 rate hikes, and caused quite a stir at the time due to the largest player in the state, CareFirst, asking for a whopping 30% rate hike. At the time, I didn't have much to go on in terms of hard enrollment numbers, but it looked like the weighted average request would be somewhat lower, perhaps around 22-23%.

Today, the Maryland Dept. of Insurance has released the final, approved rate changes, and while 5 of the 8 companies on the individual exchange saw reductions in their rate change (2 others were approved as is, and one, Kaiser Health Plan was actually increased from 4.8% to 10%), it's still difficult to lock down a fully weighted average due to some crucial enrollment data missing.

I was able to track down the "covered lives" data for 5 of the eight companies.

However, that still leaves the other three: Kaiser Foundation Health Plan, UnitedHealthcare of Mid-Atlantic and All Savers (which is actually a subsidiary of UHC, but lists separately). All three of these companies requested much lower rate changes (+4.8%, -0.5% and -3.2% respectively), and even with Kaiser being increased to a 10% hike still should lower the overall statewide average significantly...assuming the three have a significant combined market share.

Now, I do know that Kaiser and UHC had 17,791 and 3,157 enrollees respectively on the exchange as of February, and that the UHC number includes All Savers, which helps a little...but I have no clue what their off-exchange numbers are.

If there wasn't a single off-exchange enrollee for Kaiser/UHC off-exchange, the weighted average would have dropped from 25.3% requested to 20.0% approved:

As it happens, the MD Insurance Dept. link also helps determine the total individual market size:

These new rates announced today affect only a small percentage of Marylanders. Approximately 4.2% of Marylanders are in the small group market and 3.9% are in the individual market. More than 90% of Marylanders are covered by health insurance plans offered through large employers or employers who self-insure; “grandfathered” plans purchased before March 2010; or federal plans, such as Medicare, Tricare and federal employee plans.

Maryland's current population is roughly 5,976,000 people. 3.9% of that is about 233,000 people, a small number of whom are still in "grandfathered" policies which aren't impacted here. The number in the table is a bit higher (242K), but there's a lot of churn so it sounds pretty close to the mark. I'm a bit surprised as Maryland's 2014 individual market size was estimated at 280,000 by the Kaiser Family Foundation. In addition, I'd be very surprised if there aren't any off-exchange enrollments for Kaiser or UHC. It seems to me there should be roughly 40,000 more people enrolled off-exchange via these companies.

If so, then it would actually look more like this:

...bringing the total weighted average down to somewhere between 16.7% - 18.6%, with a mid-range of around 17.4%

UPDATE: OK, never mind. This Baltimore Sun article makes it pretty clear that the total individual market really is just 233K or so this year:

Health care advocates criticized the CareFirst increases because they far exceeded those of other insurers and Carefirst dominates the market. It holds 94 percent of the individual market and 66 percent of the small business market.

If you add up CareFirst BlueChoice (68%), CareFirst of Maryland (10.9%) and Group Hospitalization & Medical Services (10.9%...GHMS is part of CareFirst as well), you get about 90%, which lines up pretty closely.

In other words, it sounds like the actual weighted average really is more like 20% after all.