Texas: *Final* avg. unsubsidized 2024 #ACA rate changes: +4.2% (semi-weighted; updated)

Originally posted 8/17/23; updated 11/08/23

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.

I was only able to acquire hard enrollment data for six of the remaining carriers. There's another six where the rate filings include the number of policyholders but not the actual number of covered lives; for those, I'm using an average 1.6x multiplier (assuming around 1.6 covered lives per policy). I could be way off on that, of course.

This leaves five more carriers on the individual market. I'm estimating the total Texas individual market at roughly 2.74 million people (on-exchange enrollment is 2.28 million); if so, then if I break out the balance evenly across the five remaining carriers, I get a semi-weighted average requested rate increase of 4.4%.

On the one hand, there's a lot of assumptions here. On the other, it's not that far off from the unweighted average increase of 5.3%...and in the absence of any more data, this is the best I can do.

For the Texas small group market, the unweighted average rate hike being asked for is 7.8%

UPDATE 9/01/23: I was contacted by someone at Ascension Insurance who wanted to clarify that Ascension Personalized Care is not leaving the Texas individual market after all--it turns out they're actually being underwritten by US Health & Life Insurance Co, which is what they're listed under. I've removed Ascension from the table below entirely to avoid any confusion for current Ascension enrollees.

It also turns out that the ~31,400 effectuated policy number I had on the US Health & Life filing is actually the number of enrollees, so I've updated the table accordingly. This shaves a smidge off the semi-weighted average, although with the final rate changes coming soon and the semi-weighted nature of the estimate this is pretty much a rounding error in the scheme of things.

UPDATE 11/08/23: In the end, only a few of the preliminary rate changes were modified.