2020 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 jump in and out of the market, their tendency repeatedly revise their requests, and the confusing blizzard of actual filing forms which 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:

  • How many effectuated enrollees they have enrolled in ACA-compliant individual market policies;
  • What their average projected premium rate increase (or decrease) is for those enrollees (assuming 100% of them renew their existing policies, of course); and
  • Ideally, a breakout of the reasons behind those rate changes, since there's usually more than one.
  • In 2015, I projected that the overall average rate increases for 2016 would be roughly 12-13% nationally. It turned out to be around 11.6%.
  • In 2016, I projected that the overall average rate increases for 2017 would be roughly 25% nationally. It turned out to be around 22%, but that only included on-exchange Silver plan enrollees across 44 states (I included all metal levels, both on and off exchange, across all 50 states).
  • In 2017, I projected that the overall average rate increases for 2018 would be around 29% nationally, and that 60% of that would be due specifically to deliberate Trump Administration actions designed to sabotage the ACA markets. It turned out to be around 28% nationally.
  • In 2018, I projected that the overall average rate increases for 2019 would be around 2.8% nationally, and that premiums would have dropped around 5.4% on average if not for the ACA's individual mandate being repealed & short-term & association plans being expanded. Hhealthcare think tank Avalere Health came to almost the exact same estimates on the actual rate changes, while Brookings Institute healthcare analyst Matthew Fiedler concluded that unsubsidized ACA individual market premiums would indeed have dropped by around 4.3% nationally on average in the absence of mandate repeal and expansion of #ShortAssPlans.

In other words, I've had a pretty good track record of accurately projecting average premium increases for the upcoming year for four years in a row. With that in mind, below you'll find a table tracking the state-by-state preliminary and final rate changes for the 2020 ACA-compliant individual (and sometimes small group) markets. Scroll down for individual state entry links.

The state of Maine's Bureau of Professional & Financial Regulation has released their preliminary 2020 rate filings for the Individual and Small Group markets. Overall, the three carriers participating in their individual market are seeking a weighted average rate increase of 4.7% vs. last year. If approved as is, that would bring the average unsubsidized premium up from $675/month to $707/month, or around $381/year.

It's important to keep in mind why premiums are going up. I've included screenshots of the rate filing memos--Maine Community Health Options, which holds over 50% of the individual marketshare, clarifies that the combination of the individual mandate being repealed and the expansion of #ShortAssPlans are causing an 11% increase. They also note that Maine's recent Medicaid expansion implementation may be a factor, although normally that reduces premiums since lower-income populations tend to be less healthy than higher-income populations, so I'm not sure what to make of that.

Along with Massachusetts and Vermont, the District of Columbia merges their Individual and Small Group markets for purposes of risk pools and risk adjustment. This does not, however, necessarily mean that their Indy and Sm. Group average premium changes are identical. For one thing, there are more carriers which offer small group plans than individual market plans; for another, the market share ratios between the two differ.

A week ago, the DC Dept. of Insurance, Securities and Banking (DISB) issued preliminary 2020 rate filings along with this press release:

Washington, DC – The District of Columbia Department of Insurance, Securities and Banking (DISB) received 181 proposed health insurance plan rates for review from Aetna, CareFirst BlueCross BlueShield, Kaiser Permanente and United Healthcare in advance of open enrollment for plan year 2020 on DC Health Link, the District of Columbia’s health insurance marketplace.

Last year individual market carriers here in my home state of Michigan only raised premiums 1.7% on average in 2019, with Oscar Insurance Co. being a new addition to the market. For 2020, they're reducing average premiums by about 2.0%. Oscar made very little headway in their debut year, only enrolling 649 people statewide.

On the surface, it looks like Michigan's total ACA-compliant individual market has plummeted by a whopping 18% (281K vs. 344K last year). However, this can be misleading because the enrollment numbers listed each year only include the number of enrollees actually impacted by the rate changes. For instance, if a carrier pulls out of half the state, then a chunk of their current total enrollment won't be listed since enrollees in that half aren't seeing their current premiums change...they'll be losing coverage altogether and will have to switch to a different carrier.

The New Mexico Office of the Superintendent of Insurance website just posted the preliminary 2020 insurance rate filings. Here's the full list, which includes a mish-mash of Individual Market, Large Group and Small Group Market policies, with a Pediatric Dental standalone plan thrown in as well.

It's worth noting that the NM carriers are being very careful to separate out on & off-exchange policies into separate listings even though they're all part of the same risk pool, and they're even separating out off-exchange "Mirrored" policies, which refers to CSR Silver Switching; this is a very good thing.

I've cleaned up the listings and plugged in the weighted average rate increases in the table below this one:

Warning: There's perhaps 100 people on the planet who'll have any interest in this post. Fortunately, most of those 100 people read this site regularly.

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. There are hundreds of insurance carriers nationally, with dozens of forms apiece, some of which follow no hard formatting guidelines, and most of which are revised at least once over the course of the spring, summer and fall before being locked in for the upcoming open enrollment period. It's a pretty imposing task.

This Just In via the Washington State Insurance Commissioner's office...

Thirteen health insurers request record-low increase of less than 1%; Two new insurers join individual market in 2020

June 3, 2019

OLYMPIA, Wash. – Thirteen health insurers filed a record-low average proposed rate increase of 0.96% for the 2020 individual health insurance market. Also, two new insurers — PacificSource Health Plans and Providence Health Plan — are joining Washington’s market next year.

All 39 counties will have at least one insurer selling inside the Exchange, Washington Healthplanfinder.

Thanks to Dan Goldberg for the heads up; this Just In via the New York Dept. of Financial Services:

2020 INDIVIDUAL AND SMALL GROUP REQUESTED RATE ACTIONS

5/31/2019 - Health insurers in New York have submitted their requested rates for 2020, as set forth in the charts below. These are the rates proposed by health insurers, and have not been approved by DFS.

* Indicates the Company offers products on the NY State of Health Marketplace.

The NY DFS website also includes handy links to the actual enrollment numbers for every carrier on both the Individual and Small Group market, allowing me to break out the numbers further:

So far, only 4 states have released their preliminary 2020 ACA-compliant individual market premium rate filings: Maryland, Virginia, Vermont and Oregon.

So what's the deal with the other 46 states (+DC)? Well, here's a handy 2020 Submission Deadline table from SERFF (the System for Electronic Rates & Forms Filing, a database maintained by the National Association of Insurance Commissioners).

However, it's a bit overly cumbersome: It stretches out over 5 full pages, and includes columns for Standalone Dental Plans as well as a bunch of info regarding the Small Group Market. I used to try tracking Small Group rates as well, but that got to be too difficult to keep up with, and I haven't really done much analysis of standalone dental plans at all. Let's face it: About 90% of the drama, controversy and confusion regarding ACA premiums is all about the individual market.

Virginia is traditionally the first state to release their preliminary individual (& small group) market healthcare policy rate changes, but this year the state insurance regulatory body delayed the initial deadline by a couple of weeks. As a result, three other states (Maryland, Vermont and Oregon) beat Virginia to the punch this year.

The extended VA deadline passed last week, however, and so I'm now able to dig up the preliminary 2020 rate filings for the ACA market. It's important to remember as always that these are preliminary requests only; some of them are bound to change at least once between now and late September, when the final rate changes are locked in and the contracts are signed for the 2020 calendar year (and Open Enrollment Period).

Initial filings reveal stabilization as rate review season kicks off

Salem, OR—Oregon consumers can get a first look at requested rates for 2020 individual and small group health insurance plans.

In the individual market, seven companies submitted rate change requests ranging from an average 3.2 percent decrease to an average 13.5 percent increase, for an average of 3.3 percent. In the small group market, nine companies submitted rate change requests ranging from an average 0.3 percent decrease to an average 13.1 percent increase, for an average of 8.7 percent. See the chart for the full list of rate change requests.

“It’s early in the process, but we are encouraged to see carriers providing more options to Oregonians by expanding into both rural and coastal communities, and the market stabilizing in spite of uncertainty at the federal level,” said Insurance Commissioner Andrew Stolfi. “Now it is time to start our open and thorough review process that allows Oregonians to provide input on the filings that affect them.”

Last year, the two insurance carriers offering individual market policies in Vermont, BCBS and MVP, originally requested rate increases averaging 7.5% and 10.9% respectively, or a weighted average of 8.6%. These were eventually whittled down to 5.8% and 6.6% respectively, for a weighted average increase of 6.1% in 2019.

It's important to keep in mind that Vermont is one of only two states (the other is Massachusetts) which merges their Individual and Small Group risk pools into one.

Every year for 4 years running, I've spent the entire spring/summer/early fall 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.

The actual work is difficult due to the ever-changing landscape as carriers jump in and out of the market, their tendency repeatedly revise their requests, and the confusing blizzard of actual filing forms which 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: