As I noted a couple of weeks ago, Sword of Damocles dangling over the. head of extending the enhanced premium subsidies temporarily included as part of the American Rescue Plan has been circling the runway in an on-again, off-again pattern for the past month or two.
I know I mangled several metaphors there, but the bottom line is that it's starting to look like Senate Democrats may end up bringing it in for a landing after all. Yesterday, via Benjy Sarlin & Sahil Kapur of NBC News:
Manchin weighs options for extending ACA funding to avert premium hikes
I'm about 1/3(update: make that 2/3) of the way through my Annual Individual & Small Group Market Rate Filing project, having analyzed & crunched the numbers for 18 36 states + DC. This seems like a good time to step back and see where things stand.
So far, I've compiled the preliminary unsubsidized average premium rate filings for both the ACA-compliant individual and small group markes in Akransas, Colorado, Connecticut, Delaware, DC, Georgia, Hawaii, Indiana, Kentucky, Maine, Maryland, Michigan, Minnesota, New York, Oregon, Rhode Island, Tennessee, Vermont and Washington State. It's important to remember that these are preliminary filings only--many of the carriers will have their final 2023 rate changes reduced, although in most cases they tend to be approved as is, and in some cases they're even increased beyond what the carrier originally requested.
It's also important to note that these 18 states + DC only represent around 30% of the total U.S. population...aside from New York, the other big states (California, Florida, Texas, Pennsylvania, etc.) haven't posted their 2023 filings yet.
Georgia's health department doesn't publish their annual rate filings publicly, but they don't hide them either; I was able to acquire pretty much everything via a simple FOIA request which was responded to within an hour of my asking.
There's one significant development apiece in Georgia's individual & small group markets:
INDIVIDUAL: A few years ago, Georgia's GOP Governor, Brian Kemp, put in a request to the Centers for Medicare & Medicaid Services (CMS) for what's known as a Section 1332 State Innovation Waiver. If approved, these waivers allow individual states to modify how the ACA operates in their state as long as they can prove that the changes would a) cover at least as many residents b) at least as comprehensively without c) increasing federal spending in the process.
Arkansas is a problematic state for many reasons, but I have to give their insurance dept. website high praise for posting their annual rate filings in a clear, simple & comprehensive fashion (which is to say, not only do they post the avg. premium changes for each carrier, they also post the number of covered lives for each, which is often difficult for me to dig up). Better yet, they also include direct links to the filing summaries and include the SERFF tracking number for each in case I need to look up more detailed info.
Hawaii only has two health insurance carriers serving the individual market, Hawaii Medical Service Assocation and Kaiser Foundation Health Plan. Both of them have submitted their proposed premium rate filings for 2023, and unlike most states so far this year, their initial requests are quite reasonable: Just a 2% average hike apiece.
Unfortunately, things are much spottier for Hawaii's small group market: I can only find the rate change & current enrollment filings for one of the 5 carriers offering small business plans, at 5.7%. This doesn't mean much without the data from the other carriers, however:
UPDATE 10/19/22: Both of Hawaii's individual market carrier filings have been approved as is, so that's a 2% average rate increase. On the small group market there's still some missing data but I was able to fill in some fields for both the preliminary and final rate filings:
The projected population consists of expected retention of existing policies and new sales. The sources of new entrants include the previously uninsured population, grandfathered and transitional policies voluntarily migrating to ACA-compliant plans, and previously insured populations from other markets or carriers. The morbidity adjustment reflects projected Anthem and market changes in morbidity, including changes driven by economic conditions and from the expiration of the enhanced ACA premium tax credits available under The American Rescue Plan Act (ARP) as of December 31, 2022. Membership projections reflect contraction similar to pre-ARP population in 2021. Exhibit E shows the morbidity factor.
Maine Health Insurers File Proposed Rates for 2023 Plan Year
Health insurance carriers in Maine's Individual and Small Group markets have filed proposed rates with the Maine Bureau of Insurance (the Bureau) for the 2023 plan year. June 27, 2022 was the deadline for the initial filing of plans and rates, but insurers may revise their filings through July 20, 2022.
The bad news is they don't include the number of enrollees for each carrier, and even the SERFF database filings don't include that information...yet. Fortunately, MNsure does provide a carrier breakout of the individual market...but this only includes on-exchange enrollment, which means PreferredOne (which only offers ACA plans off-exchange) isn't listed, nor are any off-exchange enrollees for the other five exchange carriers.
As for the small group market, the most recent hard enrollment data I have for that is from 2021, which means it's likely not terribly accurate anymore (especially since PreferredOne appears to be dropping out of the MN small group market entirely next year). In addition, UnitedHealthcare scrapped all of their sm. group offerings last year and replaced them with new ones, so I have no clue how many enrollees they have at the moment.
