Originally posted 8/21/23; updated 11/08/23

The bad news for Wyoming residents who earn too much to qualify for any federal ACA subsidies is that the state has the second highest unsubsidized premiums in the country after West Virginia. The good news is that, thanks to the Inflation Reduction Act, there are far more residents who do qualify for federal subsidies, which chop those premiums down to no more than 8.5% of their income.

The other good news for them is that for 2024, average premiums across the two insurance carriers which participate on the ACA exchange pretty much cancel each other out, with Blue Cross Blue Shield of Wyoming dropping their average premiums by 7% even as the Montana Health Co-Op seeks to raise theirs by 7.6%. Unfortunately, once again, I've been unable to get ahold of enrollment data for each carrier so this is an unweighted average only; if, say, 90% of enrollees are in Montana Co-Op plans, the weighted average would obviously be more like a 6% increase or whatever.

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

Pretty straightforward in the Mount Rushmore state. Three carriers on the individual market; around 48,000 enrollees total; requested rate changes ranging from a slight drop to a 5.9% increase. The weighted average across all three is +2.5%. No one new seems to be entering the market and none of the current ones are pulling out.

For the small group market, there are six carriers (again, no one new, no one dropping). The requested rate increases for these range from 2.5% to 10.3%, with a weighted average increase of 5.2% statewide.

Update 11/08/23: No changes to any of the preliminary filings on either market.

Originally posted 8/10/23; updated 11/07/23

Nebraska doesn't even bother listing indy/small group plan rate filings on their own insurance department website...the link goes directly to the federal Rate Review database. The problem with this is that very few filings here are unredacted, which means it's difficult to acquire the policy enrollees for many carriers needed to run a weighted average.

Nebraska has 4 carriers on the individual market for 2024: BCBS, Medica, NE Total Care and Oscar Health. The unweighted average rate increase being requested is around 2.9%.

I also don't have the enrollment for any of the 4 Small Group market carriers. It also looks like Aetna is pulling out of the NE sm. group market, but it might just be that the federal database doesn't have them listed yet  The unweighted average rate change being requested there is a 7.9% increase.

UPDATE 11/07/23: No changes were made to the preliminary rate filings for the individual market; for the small group market, Blue Cross Blue Shield had their requested increase shaved down by about 1.7 points.

Originally posted 8/14/23; updated 11/07/23

This one is particularly frustrating. In addition to the filings being listed at the federal Rate Review website, every individual & small group market carrier also has their filings listed via the SERFF database and via New Mexico's own internal, searchable rate filing database...and yet I still can't run a weighted average rate change for either market because almost none of the filings at any of these three databases includes the actual enrollment data (Presbyterian on the individual market is the exception).

As a result, I have to once again settle for unweighted averages, which come to +5.6% on the individual market and +7.7% for small group plans.

UPDATED 11/07/23: In the end there were only slight tweaks made to a few carrier requests in either market.

Last week I reported that at least 593,000 of the "Medicaid Unwinding" population (Americans who had their Medicaid or CHIP coverage terminated since the end of the COVID public health emergency's "Continuous Coverage" provision ended at the end of March) had shifted over to an ACA exchange plan as of the end of July (plus another 88K who enrolled in BHP plans).

As I noted at the time, perhaps 11% or so of the Unwinding population might move to ACA exchange policies instead when the dust settles on the ongoing unwinding process (12% or so if you include BHP enrollees).

Today, Amy Lotven of Inside Health Policy reports some additional data which indirectly supports this:

Originally posted 8/09/23; updated 11/07/23

Louisiana's rate filing database is frustrating, because it's both highly-detailed and confusing at the same time.

They break out the filings not between Individual and small group markets or on- vs. off-exchange policies, but between rate increases over and under 10%. Normally that would be fine, but they also have multiple listings within each market for several carriers; HMO Louisiana, in fact, has 11 entries, each for a different product line, making it tedious and difficult to piece together the weighted average rate change and current enrollment for the carrier as a whole.

Not that any of that matters this year, as they don't appear to have posted any of the ACA-compliant individual market filings there anyway. I had to rely entirely on the federal Rate Review site, and the filings there still don't include enrollment data for most carriers, so the averages below are all unweighted only:

  • Individual Market: Around 1.7% higher
  • Small Group Market: 9.4% higher

It's worth noting, however that Humana is, once again, dropping out of the states' small group market, while Vantage Health Plan appears to be pulling out of both the individual and small group markets in Louisiana.

UPDATE 11/07/23: In the end, every requested rate change was approved as is in both markets.

Originally posted 8/16/23; updated 11/07/23

Unfortunately, South Carolina is another state where they don't make unredacted rate filings available, either on the state insurance dept website, the federal Rate Review website or the SERFF database.

As a result, I'm limited to unweighted averages for both the individual and small group markets:

  • Individual Market: +3.7%
  • Small Group Market: +8.9%

UPDATED 11/07/23: A couple of interesting modifications were made in the individual market by state regulators: Blue Cross Blue Shield had their rate hikes cut from 6% to 2.7%; BlueCHoice was cut from 2.1% to essentially flat; Cigna will see a 17.8% average increase instead of their requested 10.5% hike; Molina drops from +6.4% to +4.6%; and Select Health, which had planned on reducing premiums by 4.6 points will instead see an average 1.3% increase. Huh.

Originally posted 8/10/23; updated 11/07/23

The good news about the Montana Insurance Dept. is that once the final, approved annual rate changes for the individual and small group markets are released, they're pretty good about posting them in a clear, transparent manner.

The bad news is that they only do so for the final rates, not the preliminary/requested rate filings.

For that, I have to yet again rely on an unweighted average of the rate filings from the federal Rate Review website.

Montana only has three carriers on the indy market and four on the small group market. Of these, Montana Health Co-Op is providing their actual enrollment numbers for both, although one is in a roundabout way. For their individual market filing they state that:

Originally posted 8/10/23; updated 11/07/23

Unfortunately, Mississippi is another state which provides zero useful rate filing data for my purposes (preliminary or final) prior to the Open Enrollment Period launching. The only data I have is from the federal Rate Review website, and even the filing forms there are heavily redacted, so all I can put together are unweighted averages for the 2024 calendar year.

It's worth noting that one of the three UnitedHealthcare divisions appears to be dropping out of Mississippi's small group market, as is Humana (which seems to be pulling out of a lot of small group markets nationally).

With that in mind, unsubsidized individual market enrollees are looking for unweighted average increases of around 2.3%, while small group carriers are hoping to increase rates by around 4.5% (again, unweighted).

UPDATE 11/07/23: In the end, there were virtually no changes made to the final/approved rate changes for either market.

via the Centers for Medicare & Medicaid Services (CMS):

In July 2023, 91,521,722 individuals were enrolled in Medicaid and CHIP.

  • In July 2023, 91,521,722 individuals were enrolled in Medicaid and CHIP.
    • 84,504,888 individuals were enrolled in Medicaid in July 2023, a decrease of 1,106,693 individuals (1.3%) from June 2023.
    • 7,016,834 individuals were enrolled in CHIP in July 2023, an increase of 17,565 individuals (0.3%) from June 2023.
  • As of July 2023, enrollment in Medicaid and CHIP has decreased by 2,396,487 individuals since March
    2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
    • Medicaid enrollment has decreased by 2,284,727 individuals (2.6%).
    • CHIP enrollment has decreased by 111,760 individuals (1.6%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 23,043,140 individuals (32.5%) to 93,918,209.
    • Medicaid enrollment increased by 22,709,822 individuals (35.4%).
    • CHIP enrollment increased by 333,318 individuals (4.9%).