As exchanges ramp up for 2016 open enrollment that begins on November 1, insurance departments have been hard at work over the summer to review and approve rates for the health plans that will be available. Several states have now finalized their individual and small group market rates, with few states approving the rates proposed by insurance companies. Wide variation across states continues to exist as the markets adjust to the changes included in the Affordable Care Act and as regulators ensure the rates accurately reflect the risk pool and will be enough to cover claims. However, even in states where premiums are rising, many individuals receiving subsidies through exchanges will not feel the direct impact of the price shifts.
States with final rates available include the following:
Connecticut: Rate changes across 11 carriers in the individual market ranged from a 1.3 percent decrease (ConnectiCare Benefits, which currently has the most enrollees from the state’s marketplace, called Access Health CT) to a 21.7 percent increase (United HealthCare). Most carriers were required to change their initial filed rates, with the state approving rate increases below those requested for seven carriers.
Maryland: In the small group market, rates went down by an average of 1.8 percent. In the individual market, the approved rates varied from a decrease of more than 3 percent (Cigna Heath and Life Insurance and All Savers Insurance) to an increase of 26 percent (CareFirst of Maryland and Group Hospitalization and Medical Services). United HealthCare of the Mid-Atlantic also reduced their rates this year.
Montana: There are only three carriers in Montana’s individual market, which will be increasing rates an average of 22 to 34 percent. The two carriers in the small group market are increasing their rates 5.6 to 6.8 percent.
New York: Rates remain nearly 50 percent lower since New York State of Health (the state’s exchange) was established. This year, the individual market rates increased an average of 7.1 percent, below the 8 percent average increase in health care costs. Among the 17 carriers participating, the changes ranged from a decrease of over 12 percent (Oxford OHP) to an increase of 14 percent (Health Republic).
Oregon: Oregon was one of the first states to release final rates for 2016, highlighting the importance of actuarial review to ensure premiums can cover the cost of care. The average rate increases in the individual market ranged from 8.3 percent to 37.8 percent.
Rhode Island: As of August 19, the Office of the Health Insurance Commissioner had approved rates for two of the three carriers in Rhode Island’s individual market (Blue Cross Blue Shield of Rhode Island is subject to a separate review process that has not yet concluded), where rates will go up only 2.7 and 5.8 percent.
Vermont: The rates approved for plans offered through Vermont Health Connect, the state’s exchange, increased 2.4 percent (MVP Health Plan) and 5.9 percent (Blue Cross and Blue Shield of Vermont), each representing a reduction from the proposed rates.
Many of the increases can be explained by the reduced availability of federal funds through the reinsurance program next year. Kaiser Family Foundation has been tracking the changes in premiumsfrom 2015 to 2016, comparing the costs from year to year of the lowest- and second-lowest cost silver plans for several major metropolitan areas. As the prices change, so do the tax credits available to consumers, so it is important to underscore returning to the marketplaces to shop for the best price.
