Oklahoma is another state where I have no access to the actual enrollment data--all I have to go by are the average requested rate changes for each carrier on the individual and small group markets. As a result, the averages for each market are unweighted.
For individual market plans, that unweighted average is a slight decrease of 0.7%, though the carriers range from as low as a 12% drop to as high as a 10% increase.
It's worth noting that BlueLincs HMO, which was only added to the OK individual market last year, is already being removed from it. In fact, as shown below, it looks like BlueLincs was a special line of policies offered at the point of a regulatory gun; apparently Blue Cross was required to create it as an option for group coverage members who move off of employer coverage. However, that regulation was apparently changed shortly thereafter, and no one ever actually enrolled in a BlueLinc plan anyway, so that's that.
For the small group market, average requested rate hikes range from as little as 4.0% to as much as a 15.2. The unweighted average is 8.3%
The good news is that the federal Rate Review database has now posted the preliminary avg. 2025 rate filings for the individual and small group markets for every state. This makes it very easy to plug in the average requested rate changes in 2025 for every carrier participating in both markets.
The bad news is that most of the underlying filing forms are heavily redacted, meaning I can't use the RR database to acquire the other critical data I need in order to run a proper weighted average: The number of people actually enrolled in the policies for each carrier.
This means that in cases where this data isn't available elsewhere (either the state's insurance department website, the SERFF database or otherwise), I'm limited to running an unweighted average. This can make a huge difference...if one carrier is requesting a 10% increase and the other is keeping prices flat, that's a 5.0% unweighted average rate hike...but if the first carrier has 99,000 enrollees and the second only has 1,000, that means the weighted average is actually 9.9%.
First, I want to apologize to all of my regular visitors for the 2-week gap in posting; a combination of personal committments and unjustified distractions resulted in my not posting any updates for a longer-than-acceptable period of time. I hope to try and make up for that over the next week or so.
The Colorado Division of Insurance (DOI) has completed its initial review of the health insurance plans that the companies have filed for 2025. The information below highlights the key information about the number of companies, plans and the premium changes the companies are requesting.
On July 25, 2024, the DOI will hold a virtual stakeholder meeting from 9:30-11:30 a.m. MDT, to share preliminary information regarding health insurance for 2025. This meeting will focus on highlights and trends the DOI has identified in its initial review of the information Colorado health insurers have submitted for 2025. People interested in attending this July 25 stakeholder meeting should register (via Zoom) using the following link - Register for July 25 Stakeholder Meeting(opens in new window).
Through the rest of summer and into the fall, the DOI will continue to review the information the insurance companies have submitted, and expects to release the final, approved plans and premiums in mid-October, ahead of the Nov. 1 start to the annual open enrollment period for the individual market.
Bipartisan Reinsurance program effort continues to save consumers millions in 2025. Colorado Option plans will again have lower premiums than non-option plans.
DENVER - Today, Governor Polis and the Department of Regulatory Agencies’ (DORA) Division of Insurance (DOI), announced health insurance plans and premium savings for Coloradans in 2025 thanks to Colorado’s landmark reinsurance program. Coloradans will save $477 million on premiums and avoid a nearly 23% premium increase, which would occur if reinsurance did not exist.
“Reinsurance savings help make healthcare more affordable for all Coloradans, keeping more of their hard-earned money in their pockets to save or spend. Colorado is leading the nation in saving people money on healthcare and the $477 million Coloradans will save on premiums in 2025 proves that what we are doing in Colorado works,” said Governor Polis.
On average, individual market insurance premiums would be 23% higher in 2025 without Reinsurance and that is simply an average. In many counties in the western half of Colorado, premiums would be more than 40% higher without Reinsurance. In Mesa County, premiums would be 43% higher if Reinsurance wasn’t in place. In total, the DOI estimates that Reinsurance will save $477 million for Coloradans in 2025, which by the end of 2025 will bring the total estimated savings to over $2 billion since it started in 2020.
“Ensuring all Coloradans have access to high-quality and affordable healthcare is foundational for me, both personally and professionally. When we invest in the health and well-being of Coloradoans, we create a stronger, more resilient home for all of us. I am proud of our work to help ensure costs do not hinder our neighbors from getting the coverage they need, and thanks to the Reinsurance Program, Coloradoans will continue to see significant health care premium savings,” said Lt. Governor Primavera and Director of the Office of Saving People Money on Health Care.
Colorado Option
During last year’s open enrollment, 34% of all health insurance plan selections made through Connect for Health Colorado were for Colorado Option plans, an 188% increase in enrollment from the previous year.
For the 2025 plan year, the insurance companies filed 48 Colorado Option individual plans, which are offered at the bronze, silver and gold metal tiers. These Colorado Option individual plans will be available from six insurance companies, and there will be at least one company with a gold, silver and bronze level Colorado Option plan in every county across the state.
Preliminary review of the filings indicates that the average change in premiums for Colorado Option plans in the individual market will only be about a 4% average increase in premiums compared to non-Colorado Option plans, which show a 6% average increase.
I actually have Colorado's overall individual market premiums down as incrasing by 6.5% overall on a weighted statewide basis (at least the preliminary requested rates, anyway).
Small group plans are scheduled to increase by 8.1% overall if approved as is.
TRUTH OR CONSEQUENCES – Gov. Michelle Lujan Grisham today signed into law legislation that builds on the administration’s work to make healthcare more affordable and accessible for every New Mexican.
“Delivering quality healthcare to New Mexico’s population requires a tailored approach that takes into account rural communities, New Mexicans benefiting from Medicaid, and the tens of thousands of public employees in our state,” said Gov. Lujan Grisham. “These are bills that are going to positively impact a vast swath of New Mexicans.”
The governor signed these important healthcare bills during a ceremony at Sierra Vista Hospital in Truth or Consequences.
As an aside, I was a bit confused about the name of the city so I looked it up. Huh.
Emergency rooms not required to perform life-saving abortions, federal appeals court rules
The Biden administration reminded hospitals of their obligation to perform life-saving abortions under the Emergency Medical Treatment and Labor Act after the overturn of Roe v. Wade. Texas sued, arguing it was an overstep that mandated abortions.
Federal regulations do not require emergency rooms to perform life-saving abortions if it would run afoul of state law, a federal appeals court ruled Tuesday.
After the overturn of Roe v. Wade in June 2022, the U.S. Department of Health and Human Services sent hospitals guidance, reminding them of their obligation to offer stabilizing care, including medically necessary abortions, under the Emergency Medical Treatment and Labor Act (EMTALA).
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.
