2022 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.

Unfortunately, there are about a dozen states where due to the carriers and/or the state insurance departments heavily redacting the rate filing documentation, I've been unable to fill in the actual number of people enrolled by some or all of the insurance carriers within that state's individual market. This means that the average premium rate changes listed (shown in grey) are unweighted averages, not weighted.

This can make a big difference in some cases: Let's say you have 2 carriers in a state, one raising rates by 10% and the other raising them by 1%. The unweighted average increase would be 5.5%. However, what if it turns out that the first carrier has 90% of the market share while the second only has 10%? That would mean a weighted average increase 9.1%. The unweighted average is the best I can do for these states without knowing the market share breakout, however.

As of this writing, I've plugged in the preliminary (requested) 2022 statewide average rate changes for all 50 states plus the District of Columbia, giving a national average increase of 3.9% overall. I've also entered the final (approved) averages for 19 states so far. For those states, the national weighted average increase is a bit higher, 4.8%. This will likely drop as more final averages are entered in the coming weeks hover; the odds are high that once every state is filled in, the final average increase will be slightly lower than the preliminary average.

UPDATE 10/19/21: I've filled in the final/approved averages for Oregon, Indiana, Delaware, Connecticut and Idaho, which collectively whittle the final national average down from 4.8% to...4.6%.

UPDATE 10/21/21: I've managed to get hard enrollment numbers (allowing weighted changes) as well as approved rate changes for North Dakota, Arizona and South Carolina. In addition, Wisconsin's insurance dept. issued their weighted, approved average as well.

With these updates, the preliminary national average increases to 4.1%, while the approved average (across 29 states) is down to 4.2%.

UPDATE x2 10/21/21: OK, I'm on a roll today: I've also managed to get more accurate enrollment data for Alabama as well as confirming AL's approved rate changes, and have also filled in the enrollment data for Iowa carriers (again, confirming approved changes), which allowed me to run the weighted average statewide. None of these changes moves the needle on either preliminary or approved rate changes, however.

UPDATE 10/22/21: Added approved rate changes for Colorado, Michigan & Montana.

UPDATE 10/27/21: Added approved rate changes for Ohio, Tennessee, South Dakota, North Carolina & Arkansas, along with some updates/corrections to enrollment data & carrier participation for a few other states.  Also revised estimated total market enrollment for the 7 states which I don't have hard data available for.

UPDATE 11/02/21: Now that the 2022 Open Enrollment Period has officially launched, the federal Rate Review website has been updated with approved rates for all 50 states + DC, allowing me to fill in the remaining states.

Overall, it looks like the average unsubsidized rate increase is around 3.5% nationally.

(click image for higher-resolution version)

Oregon

(sigh) It's a bit silly for me to write about this now, given that the 2022 Open Enrollment Period ended a few weeks ago, but it's still relevant going forward.

As long-time readers know, I was one of a handful of healthcare wonks who coined the phrase "Silver Loading" to describe a wonky policy pricing strategy which insurance carriers started using back in late 2017 to counteract the Trump Administration's decision to terminate Cost Sharing Reduction subsidy reimbursement payments:

Let's say in 2017 a carrier projected that overall claim expenses in 2018 would increase around 5%. To keep things simple, let's say they offered just 3 plans: One Bronze, one Silver (which happends to also be the "benchmark Silver" used to determine subsidies) and one Gold, priced at an average of $450, $600 and $750/month.

Rate Changes

As I noted last night, thanks to the federal Rate Review website finally being updated to include the final, approved 2022 rates for both the individual and small group markets in all 50 states (+DC), I've been able to fill in the missing data for my annual ACA Rate Change Project.

As I note there, the overall weighted average looks like it'll be roughly +3.5% nationally.

Normally I write up a separate entry for both the preliminary and approved rate changes in each individual state, but it seems like overkill to create 14 separate entries at once. Besides, in many of these states there's been few if any changes between the preliminary and approved rate changes.

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:

North Carolina

The most remarkable thing about North Carolina's 2022 ACA carrier rate filings aren't the rate changes themselves--they range from -15% to +14.6%, nothing shocking--but the sheer explosion in competition coming to both the individual and small group markets.

NC's indy market is going from five carriers to ten in one shot, with Aetna, AmeriHealth, Celtic, Friday and UnitedHealthcare all jumping into the risk pool. On the small group side, there are two new entrants: Bright Health and Friday Health Plans.

In any event, overall, the average preliminary rate increase for unsubsidized enrollees is averaging 8.7%, while small group plans are going up by an average of 9.8%.

Colorado

Back in August, the Colorado Division of Insurance (DOI) announced preliminary 2022 rate filings for the states individual and small group markets. At the time, carriers were requesting a weighted average increase of around 1.3% for indy market ACA plans and 5.4% for small group plans.

This week, Colorado's Polis-Primavera Administration announced approved rate filings for 2022:

Polis-Primavera Administration Announces Reinsurance Program Will Save Coloradans an Average of 24.1% for 2022

Open Enrollment starts Nov. 1.

Iowa

Back in August, I analyzed the preliminary rate filings for the 2022 individual & small group markets in Iowa. At the time, I was unable to run a weighted average due to only having the enrollment data for one of the three individual market carriers (and none of the small group market).

At the time, the unweighted average rate change for the individual market came in at +0.7%, while small group plans averaged out at +0.9%. Unfortunately, this isn't terribly useful since it assumes every carrier has the same market share.

More recently, Iowar regulators have approved the rate filings (with almost no changes at all)...and the SERFF database now includes the Unified Rate Review Templates for every carriers, which allows me to fill in the enrollment of each in both markets. This lets me run the weighted average rate changes.

With that data, individual market plans are going up 6.6% for unsubsidized individual market enrollees and 1.2% for small group plans on average:

South Carolina

A week or so ago, I posted an analysis of the preliminary rate filings for South Carolina's 2022 individual & small group markets.

At the time, I wasn't able to find the actual filing forms and was thus limited to running unweighted averages for both markets, which came to a flat year over year increase in the individua market and a 4.4% reduction in small group plans.

Since then, however, I've managed to find the SERFF database filings for all carriers, and can now run weighted averages for approved rates in both markets.

Overall, they come in at a weighted average increase of 3.1% for the individual market and 2.1% for small group plans. It's also worth noting that I was wrong about UnitedHealthcare dropping out of the small group market--it looks like they're instead replacing all of their current policies with new ones, which means there's technically no actual "rate changes" since the existing offerings are being terminated and thus have nothing to compare against:

Arizona

Back in mid-August I posted my analysis of Arizona's preliminary 2022 rate filings for the 2022 individual & small group health insurance markets. At the time, I wasn't able to get ahold of the actual carrier actuarial memos which include the number of people enrolled in those policies in 2021, which means I wasn't able to run a weighted average rate change for either market.

As a result, I had to go with unweighted averages, which are far less useful since how much a carrier with a huge market share changes their premiums will have a much bigger impact on the statewide average than one with only a handful of enrollees.

Arizona is a case in point: At the time, the unweighted average was a 4.8% reduction on the individual market and a 7.7% increase for small group plans.

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:

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