Massachusetts: *Final* unsubsidized avg. 2024 #ACA rate changes: +3.2% (fully weighted, merged market)

Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has 10 different carriers participating in the individual market.

One thing which sets Massachusetts (along with Vermont) apart from every other state is that their Individual and Small Group risk pools are merged for premium setting purposes.

Normally you would think this would make my job easier, since I only have to run one set of analysis instead of two...but until recently, it was surprisingly difficult to get ahold of exact enrollment data for each carrier on the merged Massachusetts market (and even more difficult to break out how many are enrolled in each market since they're merged...not that that's relevant to the actual rate changes).

Fortunately, for 2024 at least, there's a fully-detailed breakout of all of this, including the filings, public narrative/justifications, actuarial memos and so on...and even a breakout of how many enrollees are in the individual vs. small group market policies!

It's possible that this detailed breakout has been available all along and I just didn't find it until now, but regardless, it makes my data nerd heart sing to see it!

I've broken the data out into the three tables below. The list of carriers and requested rate changes are the same for all three, but the first only includes individual market enrollees, the second only includes small group market enrollees, and the third is the combined, fully weighted average (which is the key number to use for my purposes).

Overall, Massachusetts has around 266,000 indy market enrollees and another 111,000 residents in small group plans. The combined, weighted average rate increase the carriers are seeking is just 3.7%, which is pretty nominal compared to many other states this year.

It's also worth noting that ~225,000 Bay Staters signed up for exchange-based individual market plans during Open Enrollment last fall. Assuming a ~10% net attrition by March 2023, that means MA's off-exchange indy market is around 63,000 people.

UPDATE 9/6/23: Massachusetts has posted their final/approved rate filing summary. The changes are pretty nominal overall, reducing the weighted average rate hikes from a combined 3.6% to 3.2%. There's one other interesting change, however--the effectuated policy enrollment for Health New England has been cut by around 55%, from ~30K to 13.5K for whatever reason.

It's also worth noting that the filing summary is in Excel spreadsheet format and actually breaks out the portion of every carrier's rate changes into component drivers/reasons; I've replicated the table below the general rate filing table: