2017 Rate Changes

Hoo, boy. Here comes the pain.

Last year, the Texas ACA-compliant individual market carriers requested an average rate hike of around 16%, although it was a pretty fuzzy guesstimate since I couldn't track down the average rate hikes for about 25% of the market other than knowing that whatever it was, it was under 10%.

This year, the good news is that CMS has started posting all rate change requests whether over or under 10%, making it easier to fill in some of the data. The bad news is that 3 of the 19 carriers offering individual policies next year redacted any data giving a clue as to what their current enrollment numbers are: CHRISTUS, Community First and Oscar Insurance.

The other 16 carriers did provide those numbers pretty clearly (except for Sendero, which only gave a projection of "member months" which I had to divide by 12 to get a rough enrollment estimate).

Last year, the insurance carriers in Pennsylvania asked for a weighted average 15.6% rate increase for individual market policies...but in the end state regulators knocked these down by over 1/5th to around 12% overall.

This year the picture is uglier, as expected. While four of the filings are for rate hikes of under 10%, this is misleading because one of them appears to be brand new while the other 3 have a combined enrollment of...7 people. Not 7,000, not 700...seven.

The rest of the filings range from 16% to a whopping 48% increase request from Highmark Health Insurance for over 20,000 enrollees. Ouch.

Overall, the weighted state-wide average requested rate hike on the individual exchange is 23.6%.

The good news about estimating the DC exchange rate hike requests is that the DC Dept. of Insurance, Securities & Banking is pretty transparent about posting this info, and they keep it simple. It's simpler still because like Vermont, DC requires that all individual and small group policies be sold on the exchange, so there's no off-exchange data to track down.

The bad news is that it's a little bit too simple: Only two carriers (CareFrist and Kaiser) offer policies via the individual exchange, and only CareFirst is offering PPOs:

Having said that, I'm not sure what to make of this part of the official press release:

Last year, Indiana was one of only two states to see virtually flat year over year premium increases on the ACA-compliant individual market, with rates going up a mere 0.7% on average. This year, unfortunately, that won't be the case...although at least one carrier, Celtic, is reducing their average rates by over 5%.

The good news is that I was able to track down the average rate change for all 6 carriers offering individual plans in Indiana (UnitedHealthcare is dropping out of the market, and I'm not sure what's going on with Aetna and Coordinated Care Corporation, both of which do have listings in Indiana's SERFF database for 2017...but neither of which has any actual filings listed. I presume these are placeholders for them to potentially enter the state market, which would be a good thing (and which Aetna has already indicated they might be doing next year). In addition, Golden Rule says that they'll be offering ACA-compliant policies starting next year as well (mainly for their current "transitional" enrollees).

The bad news is that while I've hunted down the current enrollment numbers for 5 of the 6 renewing carriers, one of them, MDwise, is frustratingly unknown, making it tricky to calculate a weighted average rate hike. Actually, I only have hard numbers for 4 carriers; for Celtic I had to cheat a bit by using their projected enrollment for next year. At 197,000 member months, that's an average of around 16,400 enrollees both on & off the exchange.

Without MDwise included, the average of the other 5 carriers comes in at 19.25%. However, MDwise is only (only is relative, I realize) requesting an 11.5% average hike, so any additional enrollees from them would bring that average down somewhat. The problem is figuring out how many current enrollees MDwise has:

Amidst all the hand-wringing over how much healthcare premium rates are expected to go up next year, there's one factor which I haven't really mentioned before. I've probably made a passing reference to it here and there, but I don't think I've focused on it prior to this entry.

Old people, generally speaking, require more medical care than young people. This isn't an absolute, of course; there are 60-year olds who can kick a 30-year old's ass, and while younger people tend to be healthier than the elderly, they also tend towards more risky behavior, be it reckless driving, bungie jumping or whatever. Still, the fact remains that there's a reason why insurance carriers lust after so-called "Young Invincibles" so much: They tend to be relatively low-risk and inexpensive to treat when something does come up.

This year only 3 insurance carriers are offering policies on the individual market in Rhode Island: Blue Cross Blue Shield, Neighborhood Health Plan and UnitedHealthcare. The bad news is that United is pulling out of RI, although they only hold about 4% of the on-exchange market anyway. The rest of the on-exchange market is split almost evenly between BCBS and Neighborhood.

Both Neighborhood Health Plan and BCBS have submitted their filings, and there's some great (and surprising, for this year) news:

Carriers file two average rate increase amounts with OHIC: the EHB base rate increase and the weighted average rate increase. These two percentages reflect different calculations.

A source who doesn't wish to be named attended the annual meeting of the Wisconsin Common Ground Co-Op the other day (Common Ground is one of the 11 Co-Ops which survived last year's Risk Corridor Massacre), and forwarded a few tidbits of info:

  • CG is closely watching the class action lawsuit filed by the now-defunct Oregon Co-Op against the federal government over the lost risk corridor payments, as CG would benefit from a win in the case.
  • CG is open to considering outside investment funding now that CMS is allowing the Co-Ops to pursue it, but isn't scrambling to seek it out just yet. They did note that Wisconsin has a law applying to the Co-Op which requires that all board members use it for their own insurance (which makes total sense, actually). Since any outside investor would likely be on the board, they'd also have to utilize CG coverage.
  • CG is requesting 12.5% weighted average rate hikes for 2017, which is actually at the lower end of the spectrum nationally so far this year. They're also adding a new Silver plan.
  • I was also provided with an image of their overall financials for 2015 (see below). They didn't have much to say about this year since it's only May but seemed comfortable with how things are proceeding so far, and said their MLR (medical loss ratio) is "dropping" although from what to what I have no idea.

Just last week I ran the rate filing numbers for Maine and came up with an overall weighted 20.6% average hike request. Today I've learned three things:

Here's what it looks like with the revisions...the overall average barely changes at all, but it's still a more complete picture:

Unlike most states, New Mexico uses their own, in-house rate review database.

The good news is that it's easy to use, and lists all of the carrier rate hike requests in a clearcut manner...except, oddly, for CHRISTUS, which I'm pretty sure is being offered this year.

The bad news is that it doesn't include any of the actual market share/enrollment numbers, making it impossible to come up with a weighted average. Some of these are available via redacted filings over at the federal RateReview.Healthcare.Gov site, but not all of them. I have New Mexico Health Connections estimated at 48,000 based on this report, but I have no idea how many CHRISTUS or Presbyterian enrollees there are.

The RateReview site lists CHRISTUS as ranging from 9.4 - 15.2%, but without market share numbers I can't even come up with a proper rate hike request, so I've split the difference for now at 12.3%.

Thanks to Zachery Tracer (as well as Dan Goldberg & Cynthia Cox) for the heads up...

Well, now...this is about as cut & dry as it gets! They don't display the actual enrollment numbers for each carrier, but that's OK because the only real reason I need it in the first place is to weight the increases by market share...which the New York Dept. of Financial Services has helpfully already done!

And there you have it: A weighted average requested rate increase of 17.3% across the entire state's ACA-compliant individual market. Remember that NY never allowed transitional plans anyway, and there are likely only a handful of grandfathered plans left on the individual market, so this should cover well over 90% of the market.

They also included the Small Group market, which I take note of when available but don't really track nearly as closely as the indy market: