2023 Rate Changes

Kansas

(sigh) Once again, the Kansas Insurance Dept. is supremely unhelpful when it comes to providing information about individual & small group market health insurance premium rate changes. Not only are the ACA plans not listed in the state's SERFF database or on the department's website, even the actuarial memos available at the federal Rate Review website are heavily redacted.

As a result, I only have the actual enrollment numbers for a handful of carriers, preventing me from being able to calculate a properly weighted average. With enrollment data for three of the six carriers on the individual market, and based on an estimated total individual market enrollment of 110,000 Kansans, the average increase should be around 8.3%, give or take (the unweighted average is 9.8%).

For the small group market, I don't have any hard enrollment data, so can only run the unweighted average increase, which is around 7.2%.

New Mexico

New Mexico's preliminary 2023 individual & small group market rate filings are finally available. It's possible that these are even the approved rates (the filing headers make this a bit confusing, but even if they are, the odds are there will be some final tweaks anyway now that the Inflation Reduction Act has been signed into law, extending the enhanced ARP subsidies for another three years.

The weighted averages themselves are pretty high (11.3% for individual market plans; an unweighted 8.8% for the small group market). Beyond that the most noteworthy item is that True Health NM is dropping out of the New Mexico exchange, leaving nearly 1/3 of the state's individual market enrollees to shop around for a different carrier:

About 38,000 New Mexicans will have to find a new health insurer next year.

Bright Health Group, the owner of True Health New Mexico, announced Thursday that it will no longer offer individual and family plans for the 2023 plan year to members in New Mexico and five other states.

North Dakota

The headline above is actually a bit questionable; I'm not 100% sure whether the second rate filings are final/approved or not. They're lower than the "requested" rates listed on the federal Rate Review website, and the filing forms say these are "approved," but there hasn't been a formal press release issued either so it's hard to be sure.

In any event, the weighted average unsubsidized rate increase for 2023 looks like it's 4.4% on the individual market (down from the earlier 5.9% requested hikes), while the small group market carriers are requesting average increases of 4.1%.

New York

I wasn't expecting New York to be the first state to publicly release their final/approved rate filings, but so be it (in fact, they're just the first state I'm aware of to do so).

Thanks to Michael Capaldo for the heads up on this press release from the NY Dept. of Financial Services:

DFS ANNOUNCES 2023 HEALTH INSURANCE PREMIUM RATES, SAVING NEW YORKERS $799.5 MILLION

Virginia

Virginia has an extremely robust, competitive individual & small group insurance market...and in 2023 it's getting even more competitive, with what appear to be two new carriers joining the individual market (Aetna Health Inc. and Anthem EPO), although Anthem is only offering off-exchange policies (why??) while Bright Health Insurance appears to be dropping out of the individual market (which is a common theme for Bright this year...)

Virginia used to be one of the first states to release their preliminary rate filings for the upcoming year, but for the past year or two it's been among the later ones. I don't know how much of this is due to COVID-related issues or if it's just an internal policy change for some other reason. Regardless, as a result, VA also happens to be the first state to release their annual rate filings since the Inflation Reduction Act (which includes a 3-year extension of the enhanced ACA subsidies) passed both the U.S. House and Senate.

Texas

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.

The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

Texas' annual health insurance rate filings are kind of a mixed bag in terms of transparecy. Hardly any of the carriers have Uniform Rate Review Template (URRT) forms or Rate Filing Justification Form Part II available (these are the documents which generally include the actual number of people enrolled in the policies for each market for that insurance carrier), and the Actuarial Memorandum (Part III) is heavily redacted for most of them, making it very difficult to lock in the actual enrollment numbers.

South Dakota

In South Dakota, there are only 2 carriers offering individual market coverage next year. Avera has around 21,800 enrollees; Sanford has roughly 23,900. The weighted average rate increases requested are around 11.4%.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.3%.

UPDATE 11/01/22Well, it looks like the individual market filings were approved as is. I'm guessing the small group carrier filings were as well, though I don't know that for sure.

Montana

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.

The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

In Montana, there are only 3 carriers offering individual market coverage next year. I have hard enrollment numbers for one of them; for the other two, I'm assuming equal enrollment for each based on a rough assumption of ~52,000 total indy market enrollees statewide.

Assuming this is fairly close, that would put the weighted average rate increases at roughly 8.8%. If not...well, the unweighted average would be 9.3%.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.9%.

Oklahoma

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available. The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

In Oklahoma, there are 7 carriers offering individual market coverage next year (it looks like Bright Health Insurance is dropping out). I have hard enrollment numbers for 4 of them; for the other three, I'm assuming equal enrollment for each based on a rough assumption of ~190,000 total indy market enrollees statewide.

Assuming this is fairly close, that would put the weighted average rate increases at roughly 8.8%. If not...well, the unweighted average would be 9.0% anyway, so this is at least somewhat more accurate.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 8.1%.

Iowa

Here's the preliminary 2023 rate filings for Iowa's individual & small-group markets. Unfortunately, I only have the enrollment data for the two smaller carriers on the individual market (and none for the small group market), but based on my estimate of Iowa's total ACA-compliant individual market, I can make an educated guess as to the weighted average, which should be roughly 2.0%.

Unfortunately I can't do the same for the small group market; for that, the unweighted average rate increase is around 5.1%.

I should also note that Iowa also has 35,400 residents still enrolled in pre-ACA ("transitional" or "grandmothered") medical policies, with nearly all of them being via Wellmark: 

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