The Indy market is about as simple as it gets since there's only a single carrier offering ACA policies either on- or off-exchange (Highmark BCBS). They're actually cutting premiums on average slightly next year, by half a percent. They state in their summary that "Covid19 is expected to increase claim costs in 2021"...but that's all they have to say about it. The full actuarial memo includes an extensive section about the COVID-19 impact factor...but the numbers/percentages are all redacted:
But that's not all! In addition to the actual 2018 MLR rebates, I've gone one step further and have taken an early crack at trying to figure out what 2019 MLR rebates might end up looking like next year (for the Individual Market only). In order to do this, I had to make several very large assumptions:
I wrote last month that Highmark BCBS, the sole individual market carrier operating in Delaware, has requested a 5.8% average premium reduction for 2020. In the press release from the state insurance department they noted:
It is important to note, that the proposed rate decrease is unrelated to Delaware’s intended submission of a 1332 Waiver to establish a reinsurance program. If the application process is successful, the actuarial consultant’s projections are correct, and the State of Delaware secures adequate funding, the waiver program may decrease rates by an additional 20%.
Dover, DE -- Highmark Blue Cross Blue Shield of Delaware (Highmark BCBS) has submitted its required annual rate filing to the Delaware Department of Insurance. After years of substantial increases, Delaware’s Marketplace has stabilized and premiums have decreased. Highmark BCBS, the only insurer continuing to offer insurance coverage in Delaware’s individual market, has proposed a 5.8% decrease for 2020. The proposed 2020 rate decrease will affect over 20,000 Delawareans.
The decrease comes after last year’s 3% rate increase and the Department’s decision to silver load. By applying the rate increase to silver level plans only, a practice known as ‘silver-loading,’ Delaware’s Marketplace received more federal subsidies, helping to assist in stabilizing the market and lowering premiums.
Legislation calls for reinsurance program to aid people with extremely high health insurance premiums
Lawmakers have introduced legislation this week that would create a reinsurance program to help lower the cost of premiums for Delawareans who do not get insurance through their employers.
House Bill 176, which has no Republican co-sponsors, would stabilize the individual health insurance market and help Delawareans struggling with extremely highhealthcare costs to get relief, a release from House Democrats stated.
Delaware is pretty cut & dried: There's only one carrier, Highmark, offering ACA policies in the state. They're requesting a 13.0% average rate increase for 2019, and yes, they call out both the individual mandate being repealed and #ShortAssPlans being expanded by Trump and the GOP.
Unfortunately, they've redacted the specific percentages caused by those factors. The Urban Institute pegs it at 19.9%, but I err on the side of caution and only assume 2/3 of that amount, or right around...13%. If accurate, that means Highmark BCBSD would be keeping rates pretty much flat next year if those changes hadn't been made.
Highmark Blue Cross Blue Shield's 2018 Affordable Care Act marketplace prices will rise by 25 percent, less than it had requested.
The insurer had asked the Department of Insurance for a 33.6 percent increase in June, one month after Aetna announced it would pull out of Delaware's marketplace. The withdrawal will end its coverage of 11,854 Delawareans and make Highmark the only insurance provider in the Delaware marketplace.
...Right now, about 27,000 Delawareans have health insurance through the marketplace. The rate increases will not affect Medicare, Medicaid or coverage by private and government employers.
...Highmark's rate request was based on the uncertain future of Obamacare, especially whether the federal government would or would not enforce the mandate that makes uninsured people either opt in or pay a tax penalty, or continue to make the cost sharing reduction payments, which helps reduce prices for low-income Americans.
Calculating the average requested rate hike in Delaware is easier than most states. This year they officially have 5 carriers participating in the individual market (3 on exchange, 2 off)...but one of those is "Freedom Life" which is a phantom carrier; another is Golden Rule which only has about 120 enrollees; and two of the others are divisions of Aetna, which is dropping out of Delaware's indy market next year altogether. That leaves just Highmark BCBS, unless Golden Rule has surprised me by enrolling a significant number of people off-exchange this year.
