Nevada: RATE-HIKE-A-PALOOZA! Six more states added at once!

Protect Our Care is a healthcare advocacy coalition created last December to help fight back against the GOP's attempts to repeal, sabotage and otherwise undermine the Affordable Care Act. This morning they released a report which compiled the approved 2018 individual market rate increases across over two dozen states.

Needless to say, they found that the vast majority of the state insurance regulators and/or carriers themselves are pinning a large chunk (and in some cases, nearly all) of the rate hikes for next year specifically on Trump administration sabotage efforts...primarily uncertainty over CSR payment reimbursements and, to a lesser extent, uncertainty over enforcement of the individual mandate penalty.

Anyone who follows this site knows that this is hardly shocking news; I've been laser-focused on this issue for the past five months or so. I've already compiled and broken out the average rate increases for 22 of the 28 states covered by the Protect Our Care report. The average increases in my spreadsheets differ from some of the numbers in the POC report because I also include the off-exchange ACA-compliant market (which isn't always included in the sources cited by POC's report), and because I make sure to weight the averages by relative carrier enrollment share of the market. For these reasons, the Protect Our Care report normally wouldn't have caught my eye, though obviously it's a good thing for the sabotage issue to get more exposure.

However, POC has also tracked down the approved rate increases for six additional states which I hadn't yet compiled...which makes this exciting to a healthcare data nerd like myself! They've helped me fill in the blanks for Illinois, Indiana, Nevada, Ohio, South Dakota and Utah. So without further ado, here's Nevada:

According to the Washington Examiner article linked to by POC...

Nevada's average Obamacare rate is expected to increase by nearly 37 percent next year.

Nevada is the latest state to finalize its rates for 2018, with some states seeing decreases in some plans and others seeing double-digit increases.

The average increase for rates sold on the exchange will be 36.8 percent above this year's rate, the state said. However, the increase is slightly lower, 31.6 percent, when taking into account plans sold off the exchange on the individual market.

This is what I was referring to above. Four out of the six carriers offering plans on Nevada's individual market are off-exchange only, which means they aren't impacted by the CSR issue. However, these four only appear to make up about 1/3 of that market, with the other two on-exchange carriers holding nearly 2/3 of the market. That means the actual breakout is something like the following:

  • On-Exchange Carriers: 65% of market x 36.8% rate increases = 0.23920
  • Off-Exchange Carriers: 35% of market x 21.9% rate increases = 0.07665
  • Total: 0.31585 = 31.6% overall average rate increase

Nevada's insurance division did not disclose a reason for the price increases.

Insurers on the individual market throughout the country have raised prices because of a combination of factors, including a sicker-than-expected enrollee population and the federal government's failure to guarantee payment of insurer subsidies for 2018.

These two bold-faced sections make it hard to tell whether or not that 31.6% average is with or without the CSR load...but the actual rate filing letters I wrote about last month seem to indicate that these increases assume CSRs will be paid, and thus don't include the load. The Kaiser Family Foundation estimates roughly an extra 10.2 point load for on-exchange plans to cover CSRs, so that would result in roughly a 38.2% overall increase if CSRs aren't paid.