As regular readers know, every year I pore over hundreds of annual health insurance policy rate filings from carriers participating in the individual and small group markets, attempting to run weighted average rate changes on a state-by-state level. I then compile all 50 states (+DC) into a national weighted average rate change table.
I generally do this twice for every state: First, over the spring and summer, I crunch the numbers for the carriers preliminary rate change requests. These are submitted to the state regulatory authorities (or in a few cases, federal regulators), who run their own actuarial analysis and then either approve the requests as is, lower the requested rates or (in a few cases) even raise rates more than requested, since part of the regulators job is to ensure that the insurance carriers have enough cash flow to actually pay their claims over the upcoming year.
Fourteen health insurers have been approved to sell in Washington's 2024 individual health insurance market. Insurers requested an average increase of 9.11% but 8.94% was approved. How much premium someone pays will depend on the plan they select, the number of people covered, their age, whether or not they smoke and where they live.
West Virginia is yet another state where I'm unable to acquire unredacted actuarial memos and/or filing summaries in order to run weighted average rate changes, so I have to settle for unweighted averages. On the other hand, on the individual market, at least, WV only has three carriers and their requested rate changes for 2024 are in a very narrow range anyway (from flat to a 2.1% increase), so it doesn't matter much.
The good news is that West Virginia's individual market rates are only increasing by around 1% next year, one of the lowest avg. rate increases in the country.
The bad news is that West Virginia already has by far the highest unsubsidized individual market rates in the nation, at nearly $1,200 per month (second highest this year is Wyoming at $965/month).
In any event, small group market carriers are requesting an unweighted average increase of 9.6% overall.
UPDATE 11/08/23: State regulators increased the rate h ikes from 1.1% to 3.0% for CareSource, but otherwise left the other carriers on both markets as is.
As always, the Texas individual and small group markets are pretty messy. For starters, they have up to 20 individual market carriers depending on the year, along with over a dozen small group market carriers some years.
On top of that, as is also the case in some other states, some of the names of the insurance carriers can be confusing as hell. There's the "Insurance company of Scott & White" which seems to have changed its name to "Baylor Scott & White Insurance Co.," which isn't to be confused with "Scott & White Health Plans" and so on.
In addition, this year there seem to be a lot of carriers bailing on the Texas market altogether: Ambetter, Ascension and FirstCare appear to be pulling out of the states individual market, while Aetna (up to four different divisions?) along with Humana are leaving the small group market.
The bad news for Wyoming residents who earn too much to qualify for any federal ACA subsidies is that the state has the second highest unsubsidized premiums in the country after West Virginia. The good news is that, thanks to the Inflation Reduction Act, there are far more residents who do qualify for federal subsidies, which chop those premiums down to no more than 8.5% of their income.
The other good news for them is that for 2024, average premiums across the two insurance carriers which participate on the ACA exchange pretty much cancel each other out, with Blue Cross Blue Shield of Wyoming dropping their average premiums by 7% even as the Montana Health Co-Op seeks to raise theirs by 7.6%. Unfortunately, once again, I've been unable to get ahold of enrollment data for each carrier so this is an unweighted average only; if, say, 90% of enrollees are in Montana Co-Op plans, the weighted average would obviously be more like a 6% increase or whatever.
Pretty straightforward in the Mount Rushmore state. Three carriers on the individual market; around 48,000 enrollees total; requested rate changes ranging from a slight drop to a 5.9% increase. The weighted average across all three is +2.5%. No one new seems to be entering the market and none of the current ones are pulling out.
For the small group market, there are six carriers (again, no one new, no one dropping). The requested rate increases for these range from 2.5% to 10.3%, with a weighted average increase of 5.2% statewide.
Update 11/08/23:No changes to any of the preliminary filings on either market.
Nebraska doesn't even bother listing indy/small group plan rate filings on their own insurance department website...the link goes directly to the federal Rate Review database. The problem with this is that very few filings here are unredacted, which means it's difficult to acquire the policy enrollees for many carriers needed to run a weighted average.
Nebraska has 4 carriers on the individual market for 2024: BCBS, Medica, NE Total Care and Oscar Health. The unweighted average rate increase being requested is around 2.9%.
I also don't have the enrollment for any of the 4 Small Group market carriers. It also looks like Aetna is pulling out of the NE sm. group market, but it might just be that the federal database doesn't have them listed yet The unweighted average rate change being requested there is a 7.9% increase.
UPDATE 11/07/23: No changes were made to the preliminary rate filings for the individual market; for the small group market, Blue Cross Blue Shield had their requested increase shaved down by about 1.7 points.
This one is particularly frustrating. In addition to the filings being listed at the federal Rate Review website, every individual & small group market carrier also has their filings listed via the SERFF databaseand via New Mexico's own internal, searchable rate filing database...and yet I still can't run a weighted average rate change for either market because almost none of the filings at any of these three databases includes the actual enrollment data (Presbyterian on the individual market is the exception).
As a result, I have to once again settle for unweighted averages, which come to +5.6% on the individual market and +7.7% for small group plans.
UPDATED 11/07/23: In the end there were only slight tweaks made to a few carrier requests in either market.
They break out the filings not between Individual and small group markets or on- vs. off-exchange policies, but between rate increases over and under 10%. Normally that would be fine, but they also have multiple listings within each market for several carriers; HMO Louisiana, in fact, has 11 entries, each for a different product line, making it tedious and difficult to piece together the weighted average rate change and current enrollment for the carrier as a whole.
Not that any of that matters this year, as they don't appear to have posted any of the ACA-compliant individual market filings there anyway. I had to rely entirely on the federal Rate Review site, and the filings there still don't include enrollment data for most carriers, so the averages below are all unweighted only:
Individual Market: Around 1.7% higher
Small Group Market: 9.4% higher
It's worth noting, however that Humana is, once again, dropping out of the states' small group market, while Vantage Health Plan appears to be pulling out of both the individual and small group markets in Louisiana.
UPDATE 11/07/23: In the end, every requested rate change was approved as is in both markets.
Unfortunately, South Carolina is another state where they don't make unredacted rate filings available, either on the state insurance dept website, the federal Rate Review websiteor the SERFF database.
As a result, I'm limited to unweighted averages for both the individual and small group markets:
Individual Market: +3.7%
Small Group Market: +8.9%
UPDATED 11/07/23: A couple of interesting modifications were made in the individual market by state regulators: Blue Cross Blue Shield had their rate hikes cut from 6% to 2.7%; BlueCHoice was cut from 2.1% to essentially flat; Cigna will see a 17.8% average increase instead of their requested 10.5% hike; Molina drops from +6.4% to +4.6%; and Select Health, which had planned on reducing premiums by 4.6 points will instead see an average 1.3% increase. Huh.
