2024 Rate Changes

Back in July I posted Missouri's preliminary 2024 rate filing requests from individual & small group market carriers; the weighted average across all 9 carriers on the individual market was 4.3%, while it was 6.6% for the small group carriers.

Yesterday the Missouri Insurance Dept. posted the final/approved filings along with this press release:

Missouri Department of Commerce and Insurance releases health insurance rates for 2024 with more choices for Missourians

  • Missourians should shop around when looking for health insurance coverage on the individual market; most will find they have many choices for plan year 2024

Jefferson City, Mo – The Missouri Department of Commerce and Insurance (DCI) announces the release of final health insurance rates for Missouri’s 2024 individual market. 

Originally posted 8/08/23; updated 11/02/23

A few months ago, the Illinois legislature passed, and IL Gov. Pritzker signed, a new law which made my healthcare wonk heart sing, including:

  • Provides that beginning before or on May 1, 2026, and each May 1 thereafter, the Department of Insurance shall report to the Governor and the General Assembly on health insurance coverage, affordability, and cost trends.
  • Amends the Illinois Insurance Code.
  • Provides that any forms and rates filed for large employer group accident and health insurance shall be automatically deemed approved after 90 days after filing.
  • Provides that beginning plan year 2026, rate increases for all individual and small group accident and health insurance policies must be filed with the Department for approval.
  • Provides that unreasonable rate increases or inadequate rates shall be modified or disapproved.
  • Provides that beginning plan year 2025, the Department shall post all insurers' rate filings and summaries on the Department's website.

Originally posted 8/07/23; updated 11/02/03

Alaska is a sparsely populated state with only two carriers on their individual market and four on their small group market. Alaska's insurance department website is useless when it comes to getting rate filings or enrollment data; I had to use the federal Rate Review site to even get the requested rate changes.

Fortunately, Premera Blue Cross includes a summary which lists their enrollment numbers, and with Moda being the only other carrier on the market, I was able to estimate a weighted average (assuming Moda has around 4,000 enrollees, which seems about right given Alaska's total on-exchange enrollment of roughly 25,500 people during Open Enrollment; effectuated enrollment as of last spring is almost certainly a couple thousand lower overall).

From Premera's summary:

Originally posted 8/09/23; updated 11/02/23

Kansas is yet another state where the actuarial memos are heavily redacted, making it extremely difficult to get ahold of the actual enrollment numbers for the individual or small group markets. Once again, without knowing how many Kansans are enrolled in each carriers insurance policies, I have no way of running a weighted average, and therefore can only provide an unweighted average.

With that in mind, for 2024 Kansas individual market carriers are requesting an unweighted average rate increase of 4.5%. One carrier (US Health & Life) does provide an unredacted summary with enrollment, but they're a tiny part of the market which doesn't help much. The small group market carriers are likewise asking for a 4.7% unweighted average rate hike.

It's worth noting that Cigna appears to be leaving the states individual market, while Humana is leaving the small group market...which I've noticed is happening in several other states that Humana currently offers small group plans in as well.

UPDATE 11/02/23: The final/approved rates have been posted to the Kansas Insurance Dept. website; it looks like everything was approved pretty much as is on the individual market, and there was only one carrier request modified on the small group market (UnitedHealthcare was reduced from a 6.1% increase to 3.9%).

via the New Hampshire Insurance Dept:

New Hampshire Insurance Department Announces the Launch of 2024 Open Enrollment Period for Affordable Care Act Individual Marketplace and Releases 2024 Premium Rates

CONCORD, NH (October 31, 2023) – Today, the New Hampshire Insurance Department (NHID) kicked off the Open Enrollment Period for Granite Staters who are seeking individual health coverage on the Affordable Care Act (ACA) Individual Marketplace. The Open Enrollment Period runs from Tuesday, November 1, 2023, through Sunday, January 15, 2024.

“This is a significant opportunity for Granite Staters who do not have health insurance through their employer, Medicare, or Medicaid to enroll in the Individual Marketplace,” said New Hampshire Insurance Commissioner DJ Bettencourt. “For the fourth consecutive year, the 1332 Waiver has resulted in premiums for the individual market being the lowest in New England, ensuring more individuals have access to the healthcare they need.”

The Ohio Insurance Department does this weird thing where they list all of the carriers offering policies on the individual market and list the weighted average year over year premium change...but they don't list the actual rate increases for each carrier. Fortunately, federal Rate Review site includes the rate changes, and the SERFF database for Ohio includes the actual enrollment numbers for all of the individual market carriers except one.

As a result, I've been able to put together a weighted average requested rate increase for the individual market (I estimated the one missing enrollment number based on the overall Ohio indy market total); it comes in at 7.6%.

For the small group market, I have to go with an unweighted average of +10.8%. It's also worth noting that, once again, Humana appears to be bailing on the entire small group market nationally from what I can tell.

UPDATE 10/31/23: The Ohio Insurance Dept. has posted a summary of the weighted average rate increase for the individual market as being slightly higher than the preliminary requests (+7.8% vs. 7.6%):

Premiums for 2024 are projected to increase compared to 2023 - though individual companies' rates will vary from the average.

Weighted average annual premiums for the individual market for 2024 are projected to be $7,010.20. In 2023 weighted average annual premiums were $6,500.65. - an increase of 7.84%.

The final/approved rates are also now posted at the federal Rate Review website...and they've barely changed at all. Yet the official weighted average is slightly higher than I had estimated earlier.

The same is true of the small group market...only 2 carriers (Medical Mutual and Paramount) had their requested changes modified, and even then it was only by a hair apiece.

Ah, at last, another state which includes both the average requested rate changes for 2024 as well as the number of enrollees each carrier has for both the individual and small group markets in clear, transparent language!

Generally, according to NC Insurance laws, health insurance rates must not be excessive, inadequate, or unfairly discriminatory, and must exhibit a reasonable relationship to the benefits provided in the policy.


Rate Changes

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.

In some cases, the carriers actually resubmit revised filings later on in the summer if there's some material change to their finances, the marketplace or other policies which change their analysis.

I debated how to word the headline for this blog post. On the one hand, the press release itself includes some important information and some genuinely good news re. cost savings for Colorado residents. On the other hand, I couldn't get past how hilariously misleading the headline itself is, so I decided to use the sublede instead.

Via the Colorado Department of Regulatory Agencies:

Gov. Polis and DOI Announce 80% of Health Insurers to Decrease Premium Requests for 2024 and Increases Reinsurance Savings to $411M for Colorado Consumers

  • Nearly 20,000 more Coloradans could reduce deductibles to as low as $100.

DENVER - When it comes to health insurance, the Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), makes sure that insurance companies are complying with the Affordable Care Act (ACA), as well as State law and our specific insurance regulations. Today, Governor Polis and the Division of Insurance announced 80% of health insurers will decrease premium requests for 2024.

Via the Colorado Department of Regulatory Agencies:

The most noteworthy developments below are that in addition to Friday, Oscar and Bright Health Plans all leaving the Colorado market (as documented/reported on several times earlier this year), Aetna and Humana both appear to be dropping out of the states small group market.

In any event, the weighted average increase being requested is 9.2% on the individual market and 8.4% for the small group market.