Alaska has only a single insurance carrier offering ACA-compliant individual market plans, so it should be a piece of cake to calculate their average premium change, since I don't have to calculate the relative market share.
Unfortunately, some carriers submit multiple filings for different lines of business even if they both use the same "Actuarial Memorandum" to justify the incresae...and often times the memo itself is redacted, with the critical data (covered lives, percent increases, dollar amounts, etc.) blocked out, making it kind of useless for my purposes. Such is the case with Premera Blue Cross Blue Shield, the sole ACA market carrier in Alaska. Thanks in large part to the state's successful reinsurance program, they'redropping rates by 7% on most of their policies, and by 10.3% on the rest...but I don't know the relative portion of each, so I can't be sure what the weighted average of the two is. The second listing is for Health Savings Account plans only, so I'm assuming the bulk of their enrollees have the first types of policies, which suggests roughly an 8% overall premium drop.
Last year Alabama had only a single insurance carrier, Blue Cross Blue Shield, offering individual market policies anywhere in the state. For 2018, a new carrier, Bright Health Insurance, jumped into the AL market. For 2019, both companies are lowering rates--BCBSAL is only dropping theirs slightly, but Bright clearly way overshot the mark out of the gate and is lowering their prices by 15.5% overall next year.
Unfortunately, neither of the filings clarifies just how many enrollees either has, so I don't know what the relative market share is; I'm going to assume that BCBS held onto about 90% of the total given their monopoly hold last year and the fact that Bright is a new/unknown player in the market (not to mention the fact that Bright seems to have overpriced their first year). Obviously I'll have to change this if I receive hard numbers to the contrary.
It took me four full months for me to analyse the 2019 ACA rate filings for the first 30 states, but the remaining 20 should come fast & furious starting today, because it looks like they were all finally uploaded to the official RateReview.HealthCare.Gov website earlier this afternoon.
Case in point: Hawaii. There's four carrier listings at RR.HC.gov, but this is misleading; two of them are basically double-listed (Hawaii Medical Service Association separated out their PPOs and HMOs into separate listings, but the filing itself merges both; the same is true of Kaiser Foundation Health Plan, whish has On and Off-Exchange policies listed separately in the database but again merges them into the same filing). In reality, Hawaii only has two carriers on the Individual Market as they have for years.
The Missouri Insurance Dept. has released preliminary 2019 rate filings for the individual and small group markets. Interestingly, in addition to the ACA compliant rate changes, they also posted transitional policy rate changes as well, which is unusual.
Missouri's situation is pretty straightforward: Three existing ACA market carriers are sticking around, and a fourth one is jumping in (Medica). Since Medica is new to the market, they don't have any actual rate changes to speak of. The other three are requesting rate increases of 3.7%, 7.3% and -8.6% respectively; Celtic is dropping rates next year.
Gov. Cuomo just announced that he has directed Supt. Vullo to reject any individual market rate increase that included an increase to compensate for the repeal of the individual mandate
...Assuming that nothing else changes during the rate review process, this makes carriers that didn't associate a % of their rate request with the loss of the mandate big winners...and those who did, not so much.
Sure enough, after watching the half-hour speech by Cuomo, it sure as hell sounded like he was doing exactly that: Instructing the state insurance commissioner to only allow 2019 ACA individual market premiums to increase by around the 12.1% (on average) that they were expecting to go up with the ACA's individual mandate penalty in place instead of the roughly 24% (on average) that they said they'd have to raise them to cancel out the adverse selection impact of the mandate being repealed:
For weeks now, I've been painstakingly analyzing and plugging in the preliminary 2019 rate change data for ACA-compliant individual market as each state submits their filings. As of today, I've compiled data for 18 states (+DC), comprising perhaps 40% of the total ACA individual market, give or take. The table below shows where things stand at the moment.
Those yellow and manilla cells at the bottom are not a typo: To the best of my estimates so far, the insurance carriers across these 19 markets are asking for average 2019 unsubsidized premium rate increases of around 10-11%...however, as far as I can tell, they would be keeping rates FLAT year over year (on average), for the first time since the ACA launched, if not for three sabotage efforts by Donald Trump and Congressional Republicans: Repeal of the ACA's individual mandate, and Trump's removal of restrictions on non-ACA compliant "Short-Term, Limited Duration" and "Association" plans, which I've shorthanded as simply #ShortAssPlans....and in fact would actually be dropping in quite a few states (or, in the case of Minnesota, dropping more than they already are set to with those factors):
UPDATED 6/22/18: Added Indiana and Iowa to the table.
UPDATED 6/25/18: Added Florida, Kentucky, Ohio and Texas* to the table *(Texas only has about 1/3 of the total ACA individual market accounted for, so it could easily change) UPDATED 7/3/18: Added Montana and Georgia to the table UPDATED 7/13/18: Added Tennessee, updated Texas to add BCBSTX UPDATED 7/16/18: Added Colorado UPDATED 7/17/18: Added Nevada UPDATED 7/19/18: Added California UPDATED 7/20/18: Added Connecticut
NOTE: I originally missed two carriers (McLaren and Molina); thanks to Louise Norris for calling attention to my error. The entire post, along with the table, has been updated to reflect the updated numbers including all 11 carriers.
Also note that while the headline originally reflected what the average rate change would be without the CSR load sabotage factor introduced in 2017, I've decided to be consistent with other states and only include 2018 sabotage impact.
My home state of Michigan just posted their preliminary requested rate changes for the 2019 Open Enrollment Period, and unlike most of the other states which have released their early requests so far, Michigan is a pleasant surprise: An overall average requested premium increase of just 1.7%!
Also noteworthy: According to the filings, eight of the carriers are specifically projecting exactly a 5% mandate repeal factor, which is remarkably consistent (usually the projections are all over the place). HAP is slightly lower (4.4%) while Molina is higher (7.2%). Priority Health didn't mention this at all, but it's safe to assume it'd be roughly 5% for them as well.
Kris Haltmeyer, a vice president at the Blue Cross Blue Shield Association, told reporters that the premium increases were in part due to the repeal of ObamaCare’s individual mandate in the Republican tax reform bill in December...“With the repeal of the individual mandate and the failure of Congress to enact stabilization legislation, we are expecting premiums to go up substantially,” Haltmeyer said.
...He said the premium increases are “related to the loss of the mandate and then underlying medical costs.”
“Those two things have the most impact on the rate increases,” he added.
...Oh, and what comes after mandate repeal and underlying medical costs? You guessed it: #ShortAssPlans
OK, this doesn't technically count as an official 2019 Rate Hike analysis since none of it comes from actual carrier rate filings, but Covered California, the largest state-based ACA exchange, just released their proposed 2018-2019 annual budget, and it includes detailed projections regarding expected premium increases and enrollment impact over the next few years due specifically to the GOP's repeal of the ACA's Individual Mandate. Oddly, while they mention short-term plan expansion as another potential threat to enrollment/premiums, they do so passingly, and they don't mention association plans at all:
Since 2014, nearly 5 million people have enrolled in Medi-Cal due to the Affordable Care Act expansion, and more than 3.5 million have been insured for some period of time through Covered California. Together, the gains cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.
