I got so far behind on my annual rate filing project that some of the states have started issuing their APPROVED changes before I got around to analyzing the REQUESTED rate changes. Ah, well...
LINSEY DAVIS: This is now your third time running for president. you [Trump] have long vowed to repeal and replace the Affordable Care Act, also known as Obamacare. You have failed to accomplish that. You now say you're going to keep Obamacare. Quote, unless we can do something much better. Last month you said, quote, we're working on it. So tonight, nine years after you first started running, do you have a plan and can you tell us what it is?
Oklahoma is another state where I have no access to the actual enrollment data--all I have to go by are the average requested rate changes for each carrier on the individual and small group markets. As a result, the averages for each market are unweighted.
For individual market plans, that unweighted average is a slight decrease of 0.7%, though the carriers range from as low as a 12% drop to as high as a 10% increase.
It's worth noting that BlueLincs HMO, which was only added to the OK individual market last year, is already being removed from it. In fact, as shown below, it looks like BlueLincs was a special line of policies offered at the point of a regulatory gun; apparently Blue Cross was required to create it as an option for group coverage members who move off of employer coverage. However, that regulation was apparently changed shortly thereafter, and no one ever actually enrolled in a BlueLinc plan anyway, so that's that.
For the small group market, average requested rate hikes range from as little as 4.0% to as much as a 15.2. The unweighted average is 8.3%
1 in 7 U.S. residents covered through Affordable Care Act health insurance marketplaces over the last decade, with all-time high enrollment under Biden-Harris Administration
WASHINGTON – Today, the U.S. Department of the Treasury released new data showing that nearly 50 million Americans, or 1 in 7 U.S. residents, have been covered through the Affordable Care Act marketplaces since January 2014. Under the Biden-Harris Administration, which has lowered the cost of marketplace coverage by expanding the premium tax credit, the number of Americans covered through the marketplaces has significantly increased, reaching an all-time high of 20.8 million following open enrollment for 2024—18.2 million Americans have enrolled for the first time since January 2021.
As a result, I've been able to put together a weighted average requested rate increase for the individual market, which comes in at +3.9%.
For the small group market, I have to go with an unweighted average of +12.0%. It's also worth noting that it looks like one of Aetna's divisions is pulling out of the OH small group market, as are two fof the 4 (!) UnitedHealthcare divisions and possibly AultCare, although I'm not sure about that one.
North Dakota only has 3 carriers participating in their individual health insurance market and four in their small group market, since it appears that Health Partners will be pulling out of the latter next year.
For the indy market, the weighted average premium increase being requested is a painful 16.7%, although this may be off slightly due to Medica's enrollment number being a rough estimate (last year's total ND market was only 45,000 people; I'm assuming Medica only has around 2,000 enrollees this year).
For the small group market, I only have the unweighted average rate hikes, which come in at 10.8%.
New Jersey individual & small group market carriers are asking for unweighted average rate increases of 7.3% and 4.5% respectively for 2025. However, the unweighted averages don't tell the whole story--the carriers are asking for rate hikes ranging from as low as 3.8% to as high as 16.2% on the individual market, and from as low as an 18.8% reduction to a 12.3% increase for small group plans.
As is the case with far too many states these days, most of the rate filing memorandums are heavily redacted in New Jersey, making it nearly impossible to get ahold of the actual enrollment numbers, which means I have no way of running a weighted average on either market.
I should note that the 433,000 estimate for New Jersey's total individual market is based on the assumption that 90% of it is via the ACA exchange, with only 10% being enrolled off-exchange.
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 2025: BCBS, Medica, NE Total Care and Oscar Health. The unweighted average rate increase being requested is around 4.0%.
For the 4 Small Group market carriers, I do have enrollment data for two of them, but without knowing the other two this isn't terribly useful. The unweighted average rate change being requested there is a 9.3% increase.
The good news is that this year at least, the SERFF database has both the average rate changes as well as the 2024 effectuated enrollment for all carriers on both the individual and small group markets. There's one curiousity, however: For the small group market, UnitedHealthcare shows up in the SERFF database but doesn't appear on the federal Rate Review website.
This doesn't really move the needle much either way, however, since UHC only reports having 250 enrollees anyway.
In any event, individual market carriers are requesting average 8.3% rate increases, while small group carriers are asking for similar 8.6% hikes.
Not a whole lot stands out to me other than SSM Health Insurance apparently dropping out of the states indy market and a new carrier, Bankers Reserve Life Insurance, newly joining it.
At the same time, the Missouri small group market appears to be losing two carriers (or three depending on your POV): Aetna Health, Aetna Life and Cigna Health & Life are all missing from the 2025 filing summaries as well as the federal Rate Review database.
In any event, the MO individual market is looking at average premium reductions of 1.7% if approved as is, while small group plans are likely to increase by about 7.9% overall.
As always, these are subject to state regulatory review and approval.
