Hawaii only has two health insurance carriers serving the individual market, Hawaii Medical Service Assocation and Kaiser Foundation Health Plan. Both of them have submitted their proposed premium rate filings for 2024; HMSA is asking for a dramatic 12.2% rate hike while Kaiser Foundation is seeking a more modest 3% increase.
Our requested rates include only the amounts needed to cover the expected health care benefits of our members, the cost of administering their benefits, expected Affordable Care Act (ACA) fees, a small charge to help manage the risk of offering benefits to this population, and a small margin that will allow us to continue replenishing HMSA’s reserves.
I've grown to absolutely love the way Hawaii state legislation summarizes the situation being addressed by the bill in question; they don't hold any punches in explaining why the bill is necessary:
The legislature finds that obstacles to access to health care based solely on immigration status prevent many low-income immigrants and immigrants' families from obtaining affordable health care coverage through medicaid, the Children's Health Insurance Program (CHIP), and health insurance exchanges established under part II of the Patient Protection and Affordable Care Act.
The first section of the legislative text is about as frank and clear as I've ever seen:
The legislature finds that Hawaii has long been a leader in advancing reproductive rights and advocating for access to affordable and comprehensive sexual and reproductive health care without discrimination. However, gaps in coverage and care still exist, and Hawaii benefits and protections have been threatened for years by a hostile federal administration that has attempted to restrict and repeal the federal Patient Protection and Affordable Care Act and limit access to sexual and reproductive health care. The Trump administration made it increasingly difficult for insurers to cover abortion care and assembled a Supreme Court that restricted abortion access and that may eliminate the Patient Protection and Affordable Care Act in the near future.
An estimated additional 34,000 people are now eligible for essential care for a full year after pregnancy, thanks to the American Rescue Plan and the Biden-Harris Administration’s efforts to strengthen maternal health coverage.
Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy in Hawaii, Maryland, and Ohio. As a result, up to an additional 34,000 people annually – including 2,000 in Hawaii; 11,000 in Maryland; and 21,000 in Ohio – will now be eligible for Medicaid or Title XXI-funded Medicaid expansion CHIP coverage for a full year after pregnancy. With today’s approval, in combination with previously approved state extensions, an estimated 318,000 Americans annually in 21 states and D.C. are eligible for 12 months of postpartum coverage. If all states adopted this option, as many as 720,000 people across the United States annually would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.
Hawaii only has two health insurance carriers serving the individual market, Hawaii Medical Service Assocation and Kaiser Foundation Health Plan. Both of them have submitted their proposed premium rate filings for 2023, and unlike most states so far this year, their initial requests are quite reasonable: Just a 2% average hike apiece.
Unfortunately, things are much spottier for Hawaii's small group market: I can only find the rate change & current enrollment filings for one of the 5 carriers offering small business plans, at 5.7%. This doesn't mean much without the data from the other carriers, however:
UPDATE 10/19/22: Both of Hawaii's individual market carrier filings have been approved as is, so that's a 2% average rate increase. On the small group market there's still some missing data but I was able to fill in some fields for both the preliminary and final rate filings:
As I note there, the overall weighted average looks like it'll be roughly +3.5% nationally.
Normally I write up a separate entry for both the preliminary and approved rate changes in each individual state, but it seems like overkill to create 14 separate entries at once. Besides, in many of these states there's been few if any changes between the preliminary and approved rate changes.
Every year, I spend months 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 change 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.
Usually I begin this process in late April or early May, but this year I've been swamped with other spring/summer projects: My state-by-state Medicaid Enrollment project and my state/county-level COVID-19 vaccination rate project.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Delaware, Hawaii and Rhode Island only have 3, 6 and 5 counties respectively, so it seemed a little silly to run separate graphs for each one (I was already pushing it by giving Connecticut (8 counties) its own entry). So...I've merged all three onto one graph.
It also seemed a bit disingenous to try and come to any conclusions about a trendline with these three states in particular, so I didn't bother (not that there's much to make of that anyway...every county in these states is running between 40 - 65% vaccinated, and within 30-55% Trump support...except for tiny Kalawao, Hawaii, which only has 86 residents (none of whom appear to have been vaccinated yet, according to the CDC?), which I didn't bother listing at all.
Anyway, I'm including them mostly for completeness sake.
2020 Presidential Election results via DE, HI & RI Secretary of State's office (thru Wikipedia)
Hawaii only has two carriers participating in the Individual health insurance market. For 2020, they're reducing unsubsidized premiums by 1.7%.
COVID-19 isn't listed as a factor at all by either of the carriers, nor by any of the small group carriers in Hawaii either...which makes total sense since Hawaii has the lowest rate of COVID-19 infection in the country.
The small group carriers are requesting a weighted average reduction of 2% as well, although one of the four doesn't have their actual rate change or current enrollment available yet, so this could change.