2021 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:

  • 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nationally, and that premiums would have dropped around 5.4% on average if not for the ACA's individual mandate being repealed & short-term & association plans being expanded.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 five 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 2021 ACA-compliant individual (and sometimes small group) markets. Scroll down for individual state entry links.

For 2021, the biggest new factor is, of course, the impact of the COVID-19 pandemic on both 2020 and 2021 medical claims expenses. I've added a new column which attempts to separate that out, though not every carrier does so, while some simply refer to the impact of COVID-19 in a fairly vague way.

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In August, the Nevada Insurance Dept. issued their preliminary 2021 rate filings for the individual and small group markets. Unfortunately, while the filing summaries were easy to find, the actual enrollment numbers weren't. As a result, I only had the department's press release to go on for the weighted overall average on the individual market, and I had to go with an unweighted average for the small group market.

Fortunately, now that the NV Insurance Dept. has issued the approved 2021 rates, they've also added more detailed summaries for both markets, meaning I have effectuated enrollments for every carrier. This allows me to run a proper weighted average rate change across both:

Back in June, Maryland's Insurance Dept. posted the preliminary 2021 rate requests for the individual and small group markets. At the time, carriers were seeking an average 4.8% premium reduction on the individual market and a 5.1% average increase for the small group market.

Recently, state regulators posted the approved rate changes for each, and the final 2021 rates have been reduced from the original requests:

Governor Hogan Announces Third Consecutive Year of Lower Individual Health Insurance Premiums

In early August, the Kentucky Insurance Dept. posted preliminary 2021 rate filings for the individual and small group markets. At the time, the carriers were requesting average increases of 11.6% on the individual market (unusually high this year) and 9.7% for the small group market.

More recently, they posted the approved 2021 rate changes, and the individual market hikes have been cut by more than half, to just a 5.0% increas on average.

Small Group plans have also been shaved down slightly, from a 9.7% average increase to 8.8%.

Normally by early October I have the preliminary rate filings analyzed & posted for nearly every state and the approved rate changes for at least half of them. This year I'm lagging way behind for several reasons, some personal, some professional.

Having said that, I'm trying to play catch-up this week. Case in point, today I'm posting Iowa's preliminary individual and small group market filings for 2021.

Wellmark is dropping their premiums by a jaw-dropping 42% next year, which would normally be a huge story except that they only have around 3,000 Iowans enrolled to begin with (which may explain the massive rate drop, of course). Oscar Insurance appears to be expanding into the Iowa individual market, while Medica continues to hold nearly 95% of the market and is only raising premiums by around 2.5%. Overall, 2021 rates are essentially flat on averae.

The small group market is much the same...there's a bunch of carriers which only have a few dozen enrollees statewide, and four which hold over 90% of the market share (realistically more like 2-3 carriers depending on how you define UnitedHealthcare and Wellmark subsidiaries).

The Delaware Insurance Dept. has posted the approved 2021 individual market rates and it's about as unexciting as you can imagine: There's a single carrier in the state (Highmark BCBS), which asked for a 0.5% average premium reduction and was approved for...a 1.0% average premium reduction. Unsubsidized Delaware enrollees will average around $80 in savings per year.

In early August, the Arkansas Insurance Dept. posted the preliminary 2021 rate filings for the individual & small group market. At the time, the carriers were requesting average increases of 7.0% for ACA indy market plans and a slight drop of 0.3% for the small group market.

The approved rate filings have now been published, and the increases have been cut in half on the individual market to just 3.4%, while the small group market is slightly lower still (-0.4%) due to a revision in the estimated number of current enrollees:

2021 Minnesota health insurance rates continue to show stability for another year; expanded consumer choice across the state

ST. PAUL, Minn.—The Minnesota Department of Commerce announced final 2021 Minnesota health insurance rates today, which will remain stable across the state. For the 2021 plan year, 80 counties have three or more health insurance companies offering plans on the exchange, compared to just 31 counties with three or more in 2020. Ninety-seven percent of Minnesotans buying health insurance through MNsure will have an average of 30 different qualified health plans and three or more carriers to choose from.

Five health insurance companies are partnering with MNsure for the 2021 plan year: BluePlus, HealthPartners, Medica, UCare, and newly added Quartz, a Madison-based insurer offering plans in some southeastern Minnesota counties. Quartz will be offering 14 qualified health plans on the exchange. Additionally, dental plans will be available from Delta Dental and Dentegra.

New Insurance Carrier Joins Idaho Exchange, Record Number of Plans Available in 2021

  • Preview plans and prices beginning Oct. 1 at YourHealthIdaho.org

BOISE, Idaho – Your Health Idaho, the state health insurance exchange, announced today that Idahoans will have a record number of medical and dental plans and a new insurance carrier to choose from in 2021.

Regence, which currently sells small group and individual plans off-exchange in Idaho, will offer medical coverage through Your Health Idaho for the first time in 2021. The addition of Regence brings the total number of insurance carriers on the Idaho exchange to seven.

“We are pleased to welcome Regence to Your Health Idaho,” said Pat Kelly, Your Health Idaho Executive Director. “Adding another regional insurance carrier means even more choice for Idahoans and continued local control for the Idaho marketplace.” 

Beginning Oct. 1, Idahoans can preview the 136 medical and 13 dental plans that will be available in 2021 online at www.YourHealthIdaho.org. 

I'm not sure what's going on with Bright Health Care in Nebraska. They entered the state's ACA market in 2020, but for whatever reason they aren't showing up in the HealthCare.Gov Rate Review database. The only carrier listed for the state's individual market is Medica, and the SERFF database for Nebraska doesn't bring up either one.

Even more curious, when I ran a search to make sure that Bright hadn't simply jumped in and then out again the following year, I found this article:

Bright Health Plan announced today its 2021 expansion plan. It will expand access to its Medicare Advantage, individual and family-plan products in select areas, and to add fully-insured small business plans to its available products in certain markets.