2024 Rate Changes

The good news about New Hampshire's health insurance market is that they're the only state without its own ACA exchange which produces publicly-accessible monthly reports on individual on-exchange market enrollment. The bad news is that they don't seem to publish the actual rate filings in an easy-to-read format, which means I'm left with the federal rate review website, which sometimes posts average rate requests which don't match up with the actual filings...but it's gonna have to do here. 

With these two data sources in hand, New Hampshire's individual market carriers are asking for a weighted average increase of 3.1%. It's important to note that Anthem Health Plans and Matthew Thornton Health Plan are listed as separate carriers on the federal Rate Review website (with separate average rate requests), but on the state's monthly report, they're merged into a single listing.

Nevada used to be a state where the annual individual & small group rate filings were fairly transparent. They have a pretty easy-to-use searchable filing database which clearly lists the carriers, market, maximum & minimum rate changes and even includes the SERFF Tracking numbers for every filing.

Unfortunately, this year at least, most of that proves useless for my purposes. The average rate changes are posted, but the enrollment data is still hidden from public view--entering the SERFF Tracking Numbers still brings up nothing in the SERFF database, and the actuarial memos posted at RateReview.HealthCare.Gov are mostly redacted. As a result, I'm only able to enter enrollment data for one of the nine carriers on the Nevada individual market, and none on the small group market.

Interestingly, the one I have enrollment data for (Aetna Health of Utah) also has a curious discrepancy: The filing itself lists the average requested rate increase as being 6.97%, but on the RR.HC.gov site it only shows up as 1.36%. The other eight carriers all match up (or are within a tenth of a percentage point, anyway).

Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has 10 different carriers participating in the individual market.

One thing which sets Massachusetts (along with Vermont) apart from every other state is that their Individual and Small Group risk pools are merged for premium setting purposes.

Normally you would think this would make my job easier, since I only have to run one set of analysis instead of two...but until recently, it was surprisingly difficult to get ahold of exact enrollment data for each carrier on the merged Massachusetts market (and even more difficult to break out how many are enrolled in each market since they're merged...not that that's relevant to the actual rate changes).

Originally posted 8/09/23; updated 11/03/23

Kentucky is yet another state where the actuarial memos are heavily redacted, making it difficult to acquire information such as the number of enrollees...which in turn makes it impossible to run a weighted average requested rate change for the individual or small group markets.

There are four carriers offering policies on the KY individual market (Anthem, CareSource, Molina and WellCare), with an unweighted average rate change request of 4.1%. Molina has provided an unredacted actuarial memo which includes their enrollment...but it's only 505 people, while KY's total indy market is likely closer to 75,000 or so including the off-exchange market.

Originally published on 7/11/23

via the Indiana Dept. of Insurance:

INDIANA 2024 ACA FILINGS

The companies listed below have submitted ACA-compliant rate filings for Plan Year 2024. Information about the filings may be found at the IDOI SERFF Filing Access or Healthcare.gov Rate Review.

The IDOI will finalize its review of the 2024 ACA compliant filings both on and off the federal Marketplace by August 17, 2023. The Centers for Medicare and Medicaid Services (CMS) will issue the ultimate approval for the Marketplace plans sold in Indiana. CMS will issue its approval on or before September 20, 2023.

General Note:

The Missouri Insurance Dept. has posted their preliminary 2024 single risk pool filings for the individual and small group markets.

Not a whole lot stands out to me other than Cigna apparently dropping out of the states indy market and Humana pulling out of the small group market. Otherwise, neither market has rate changes which seem terribly surprising--they come to a weighted average increase of 4.3% for individual market plans and 6.6% for the small group market.

As always, these are subject to state regulatory review and approval.

Via the Colorado Department of Regulatory Agencies (I accidentally deleted the original blog post so I'm recreating it using the graphics below).

The most noteworthy developments below are that in addition to Friday, Oscar and Bright Health Plans all leaving the Colorado market (as documented/reported on several times earlier this year), it looks like Anthem is reducing its offerings on the individual market, while Aetna and Humana both appear to be dropping out of the states small group market.

Update: Correction, apparently I misread that about Anthem; they have the same total number of plans available after all...not sure how I messed that up; apologies. Their Rocky Mountain division is offering off-exchange policies only, abut aren't listed on CO DARA's summary for whatever reason.

In any event, the weighted average increase being requested is 9.8% on the individual market and 10.6% for the small group market.

via the Idaho Dept. of Insurance:

Each year, the Idaho Department of Insurance posts rate changes of individual and small group health insurance products so consumers can review and provide comments on the proposed increases.  Insurance companies submit proposed rates for the upcoming calendar year to the Department, along with descriptions and justifications for why the rates are reasonable and not excessive.  

The Department of Insurance is seeking public input for rate changes of individual and small group health insurance products to improve insurer accountability and transparency.  By following the links below, the public can access a summary of the increase amounts and the carrier justifications for the rates.  Please submit any comments to the Department for consideration.

Preliminary Rates - 2024

Please choose one of the categories to proceed:

Georgia's health department doesn't publish their annual rate filings publicly, but they don't hide them either; I was able to acquire pretty much everything via a simple FOIA request. Huge kudos to the GA OCI folks!

Unfortunately, it looks like less than half of Georgia's small group market carriers have submitted their filings (alternately, it's conceivable that the other have have pulled out of the G small group market, though I highly doubt that). Only four of the eleven carriers offering policies in 2023 have filings included in the package sent to me by GA OCI. Not sure what that's about.

In any event, Georgia's individual market has grown dramatically over the past year (813,000 people vs. 660,000 a year ago), but the requested 2024 rate filings are pretty ugly, ranging from a somewhat reasonable 6.4% to as high as 27.7% for Cigna (ouch). The weighted average overall is just over 15% even.

via the Minnesota Commerce Dept:

Individual Market PROPOSED Average Rate Changes

The summary table below provides an overview of the proposed average rate changes from 2023 in the individual health insurance market, as reported by the insurers. 

These rate changes do not reflect the impact of federal premium tax credits that are available to eligible Minnesotans who purchase their coverage through MNsure.

It is important to note these are the initial rates proposed by the insurers and filed with the Departments. Rates are subject to review and approval by the Departments and the final approved rates may vary from these proposed rates for many reasons. 

Additionally, the actual rate change a consumer will experience in 2024 can vary from the average – with factors such as specific plan, geographic rating area, age, and federal premium tax credits playing a major role. 

Small Group Market Proposed Average Rate Changes

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