North Dakota only has 3 carriers participating in their individual health insurance market and four in their small group market, since it appears that Health Partners will be pulling out of the latter next year.
For the indy market, the weighted average premium increase being requested is a painful 16.7%, although this may be off slightly due to Medica's enrollment number being a rough estimate (last year's total ND market was only 45,000 people; I'm assuming Medica only has around 2,000 enrollees this year).
For the small group market, I only have the unweighted average rate hikes, which come in at 10.8%.
BISMARCK, N.D. – Insurance Commissioner Jon Godfread has approved the rates for individual and small group health insurance plans compliant with the Affordable Care Act (ACA).
Individual and small-group health insurance plans that are ACA-compliant are purchased through the Healthcare.gov exchange or licensed agents. Three statewide insurance carriers operate on the individual market, available via Healthcare.gov and through insurance agents. Five major carriers exist in the small group market, primarily purchased by employers of small businesses.
“We’re releasing these rates to give consumers who purchase their health insurance on the individual or small group markets an idea of what’s to come for 2024,” said Godfread. “The changes in rates this year are on par with previous years, with no big jumps or decreases in rates. When purchasing health insurance, or any insurance policy, shop around and look at different coverage options and find one that best fits your and your family's needs.”
CMS Approves Added Benefits to Essential Health Benefits (EHB) Benchmark Plans in North Dakota and Virginia
September 6: CMS approved added benefits to the Essential Health Benefits (EHB) benchmark plans for North Dakota and Virginia for the 2025 plan year. The Affordable Care Act requires non-grandfathered health plans in the individual and small group markets to cover essential health benefits (EHB), which include items and services in ten benefit categories. For plan year 2020 and after, the Final 2019 HHS Notice of Benefits and Payment Parameters provides states with greater flexibility by establishing new standards for states to update their EHB-benchmark plans, and for tailoring them to fit the health care needs of their states.
Here's the best summaries I could find of the additional benefits for each state:
Not much to report about the 2024 individual and small group market rate filings. I could only find current enrollment numbers for two of the three indy market carriers and for three of the five small group market carriers. However, based on last year's total enrollment, I'm estimating ND's total indy market at being roughly 50,000 people, which means I was able to make an educated guess at how many are enrolled in Sanford Health Plan policies.
Based on this, I have a (mostly) weighted requested average rate increase of 4.4% for individual market plans and an unweighted average of 6.5% for small group market plans.
January 11, 2023: CMS marked another important maternal health milestone by approving Medicaid and Children’s Health Insurance Program (CHIP) postpartum coverage expansions in Alabama and a Medicaid postpartum coverage expansion in North Dakota through the American Rescue Plan (ARP). Nationally, more than 439,000 people across 28 states and the District of Columbia now have access to Medicaid and CHIP coverage for a full 12 months following pregnancy — up from just 60 days before the ARP. Postpartum coverage extensions form one of the cornerstones of CMS’ Maternity Care Action Plan — part of the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis. Click here and here to learn more about Alabama’s approvals, and here to learn more about North Dakota’s approval.
The headline above is actually a bit questionable; I'm not 100% sure whether the second rate filings are final/approved or not. They're lower than the "requested" rates listed on the federal Rate Review website, and the filing forms say these are "approved," but there hasn't been a formal press release issued either so it's hard to be sure.
In any event, the weighted average unsubsidized rate increase for 2023 looks like it's 4.4% on the individual market (down from the earlier 5.9% requested hikes), while the small group market carriers are requesting average increases of 4.1%.
There are 9 states where I've been unable to track down the actual enrollment data for individual market carriers. North Dakota is among them.
The unweighted average rate increase for 2022 is 6.0% for the ND individual market and 5.3% for the small group market, which consists of the same three carriers (UnitedHealthcare was a fourth participant in ND's small group market in 2021, but they aren't listed in the federal Rate Review database as of this writing, so I'm assuming they're pulling out).
I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.
For the various enrollment data, I'm using data from Medicaid.gov's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In most states I've been able to get more recent enrollment data from state websites and other sources. Unfortunately, I've been unable to do so for North Dakota, so the data below is still six months out of date.
Total Medicaid enrollment in North Dakota stayed fairly steady from 2016 - early 2020...but after the COVID pandemic hit, it jumped significantly, with non-ACA enrollment increasing 21.4%, ACA expansion going up 18.3% and total enrollment increasing by 20.7% overall.
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.
NOTE: This is an updated version of a post from a couple of months ago. Since then, there's been a MASSIVELY important development: The passage of the American Rescue Plan, which includes a dramatic upgrade in ACA subsidies for not only the millions of people already receiving them, but for millions more who didn't previously qualify for financial assistance.
Much has been written by myself and others (especially the Kaiser Family Foundation) about the fact that millions of uninsured Americans are eligible for ZERO PREMIUM Bronze ACA healthcare policies.
I say "Zero Premium" instead of "Free" because there's still deductibles and co-pays involved, although all ACA plans also include a long list of free preventative services from physicals and blood screenings to mammograms and immunizations with no deductible or co-pay involved.
