Iowa

Back in August, I analyzed the preliminary rate filings for the 2022 individual & small group markets in Iowa. At the time, I was unable to run a weighted average due to only having the enrollment data for one of the three individual market carriers (and none of the small group market).

At the time, the unweighted average rate change for the individual market came in at +0.7%, while small group plans averaged out at +0.9%. Unfortunately, this isn't terribly useful since it assumes every carrier has the same market share.

More recently, Iowar regulators have approved the rate filings (with almost no changes at all)...and the SERFF database now includes the Unified Rate Review Templates for every carriers, which allows me to fill in the enrollment of each in both markets. This lets me run the weighted average rate changes.

With that data, individual market plans are going up 6.6% for unsubsidized individual market enrollees and 1.2% for small group plans on average:

UnitedHealthcare Logo

As I've griped about many times before, it's confusing as hell trying to keep track of a bunch of insurance carriers which have similar names. For instance, in Kansas, they have both Blue Cross Blue Shield of Kansas and Blue Cross Blue Shield of Kansas City...which are apparently considered separate corporations.

Picking on  Kansas again, one of the carriers offering ACA exchange plans is called Sunflower State Health Plan...but if you look it up, you'll see that "Sunflower Health" is actually owned by Centene Corporation. Which also owns "Ambetter Health." Oh, and they also own "Celtic Insurance" as well.

In fact, Centene Corporation has no fewer than 28 other subsidiaries. Now, in some cases these may not be health insurance carriers, and in others they may simply be "product branding" instead of actual corporate subsidiaries, but it's still confusing as hell.

South Carolina

A week or so ago, I posted an analysis of the preliminary rate filings for South Carolina's 2022 individual & small group markets.

At the time, I wasn't able to find the actual filing forms and was thus limited to running unweighted averages for both markets, which came to a flat year over year increase in the individua market and a 4.4% reduction in small group plans.

Since then, however, I've managed to find the SERFF database filings for all carriers, and can now run weighted averages for approved rates in both markets.

Overall, they come in at a weighted average increase of 3.1% for the individual market and 2.1% for small group plans. It's also worth noting that I was wrong about UnitedHealthcare dropping out of the small group market--it looks like they're instead replacing all of their current policies with new ones, which means there's technically no actual "rate changes" since the existing offerings are being terminated and thus have nothing to compare against:

Arizona

Back in mid-August I posted my analysis of Arizona's preliminary 2022 rate filings for the 2022 individual & small group health insurance markets. At the time, I wasn't able to get ahold of the actual carrier actuarial memos which include the number of people enrolled in those policies in 2021, which means I wasn't able to run a weighted average rate change for either market.

As a result, I had to go with unweighted averages, which are far less useful since how much a carrier with a huge market share changes their premiums will have a much bigger impact on the statewide average than one with only a handful of enrollees.

Arizona is a case in point: At the time, the unweighted average was a 4.8% reduction on the individual market and a 7.7% increase for small group plans.

CBO Logo

Regular readers may have noticed that I haven't checked in on the status of #BidenCare (aka #ACA 2.0) since way back in early August. There's several reasons for this: At first I was swamped with my COVID vaccination/case/death rate project; then, more recently, I had to scramble to get my annual Rate Change project up to date.

Both of these have indeed monopolized my time, but the main reason is simply that President Biden's Build Back Better (BBB) plan (which ACA 2.0 is a part of) has gotten bogged down over the past few months due to infighting and intransigence by a handful of "moderate/centrist" Democrats in the House but especially by two Democratic Senators in particular (Joe Manchin of West Virginia and Kyrsten Sinema of Arizona).

(Needless to say, I'm not even mentioning any Republicans in either the House or Senate, since not a single one of them is willing to support the bill.)

It seemed a bit pointless to write up a lengthy, in-depth analysis of the latest developments on the bill when what does or doesn't have a serious shot at making the final cut kept changing every few days.

COVID-19 Vaccine

Here's the weekly look at the rate of COVID-19 cases & deaths at the county level since the end of June, broken out by partisan lean (i.e, what percent of the vote Donald Trump received in 2020).

The case rate is pretty much the same as it was last week, with new cases running 3x higher per capita in the reddest tenth of the country than the bluest tenth...

COVID-19 Vaccine

Methodology reminders:

  • I go by FULLY vaccinated residents only (defined as 2 doses of the Pfizer or Moderna vaccine or one dose of the Johnson & Johnson vaccine).
  • I base my percentages on the total population, as opposed to adults only or those over 11 years old.
Rate Changes

Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:

Pennsylvania

I can't overstate how much I wish every state was as good as Pennsylvania is at not only making their annual rate filings publicly available on the state insurance dept. website, but doing so in such a clear, simple format, while also including a consistent summary page for every carrier!

As a result of this attention to transparency and detail, I was able to put together my Pennsylvania analysis pretty quickly even though they hae a huge number of carriers on both their individual and small group markets.

Aside from Cigna joining the PA indy market, not too many surprises in the Keystone State this year...approved average indy market premiums are staying nearly flat overall (+0.2%), while small group plans will cost around 4.8% more than last year on average.

Texas

Texas' annual health insurance rate filings are kind of a mixed bag in terms of transparecy. Hardly any of the carriers have Uniform Rate Review Template (URRT) forms or Rate Filing Justification Form Part II available (these are the documents which generally include the actual number of people enrolled in the policies for each market for that insurance carrier), and the Actuarial Memorandum (Part III) is heavily redacted for most of them, making it very difficult to lock in the actual enrollment numbers.

On the other hand, a few of them do offer one or both of the former documents, and in a few cases I was able to get the policyholder figures via the SERFF database. I'm operating on the assumption that each individual market policy has roughly 1.5 covered lives apiece on average.

Unfortunately, without having even that estimate available for half the carriers offering policies in Texas, I can't run a weighted average increase (it comes to +4.9% using what I have available), so I'm left (once again) with an unweighted average of around +1.5% on the individual market and +6.1% for small group policies.

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