The Affordable Care Act (ACA) requires that every state have an exchange where consumers can buy individual health insurance policies. In Ohio, the federal government runs the health insurance exchange. Ohioans who do not have health insurance through their employer, Medicare or Medicaid may be eligible to purchase coverage through the exchange. Open enrollment for coverage next year (2019) begins November 1, 2018. Below is preliminary data based on the filings submissions of insurers in Ohio. Once filings are approved in late summer/early fall, final information will be posted.
Ohio’s Health Insurance Market (2018–2019)
In 2018, 8 companies sold health insurance products on the exchange in Ohio and 42 counties had just one insurer with an additional 20 counties having only two.
Unfortunately, while the SERFF database shows 2019 listings for most of the 11 carriers which offer ACA policies in Texas this year, it only actually has the filings posted for 3 of them so far: CHRISTUS, Sendero and FirstCare Health Plans (aka SHA, LLC). Even then, those three carriers hold a pretty small share of the market, totalling just 65,000 enrollees. That means I only have actual 2019 rate data for about 5% of the ACA market available so far.
Like last year, there's only three carriers participating in Indiana's individual market: CareSource and Celtic (aka Ambetter) will again be available both on and off the ACA exchange, while Anthem will only be offering a single Catastrophic plan on the off-exchange market in just five counties:
The overall average rate increase for 2019 Indiana individual marketplace plans is 5.1%. CareSource and Celtic (MHS/Ambetter) have filed to participate in the 2019 Indiana Individual Marketplace. The Department of Insurance anticipates that all 92 counties in Indiana will be covered by one or more insurance company. CareSource plans to cover 79 counties. Celtic (MHS/Ambetter) plans to increase its coverage from 43 counties in 2018 to all 92 counties in 2019.
Anthem has filed to offer a 2019 Off-Marketplace plan in Indiana. This plan is a catastrophic plan and is offered only in Benton, Jasper, Newton, Warren and White Counties.
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
Well this is a nice surprise! Yesterday the Minnesota ACA exchange, MNsure, issued a press release a day ahead of the public posting of requested 2019 individual market insurance rate changes, advising people of the various ways they have to keep their premiums down via ACA tax credits, shopping around and so forth. I was immediately concerned that they might know something I didn't...perhaps they were expecting a batch of double-digit rate hikes as has happened in so many other states the past few years?
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.
Private insurance companies set premium prices, and the Minnesota Department of Commerce regulates those companies. Final, approved 2019 premium rates will be available by October 2, and the 2019 open enrollment period begins on November 1. Minnesotans shopping for health insurance through the individual market may be able to reduce premium costs in three ways:
1. See if you are eligible for tax credits only available through MNsure
Rate filings were due in New Mexico by June 10, 2018, for insurers that wish to offer individual market plans in 2019. Insurers that offer on-exchange coverage have been instructed by the New Mexico Office of the Superintendent of Insurance (NMOSI) to add the cost of cost-sharing reductions (CSR) only to on-exchange silver plans and the identical versions of those plans offered off-exchange (different silver plans offered only off-exchange will not have the cost of CSR added to their premiums).
The past two days have brought a flurry of 2019 premium rate change filings, with Washington, New York, Maine, DC and Pennsylvania putting their preliminary cards on the table. These join 5 other states which had already posted their early numbers, so I now have 10 compiled.
Now that I have a solid amount of state data to work with, I figured I should write up a tutorial to explain my methodology. This has become especially important the past two years since there's some new factors to consider.
Health Insurance Plan Rates Stabilize, Offer More Choice for Consumers Despite Federal Government Sabotage
Harrisburg, PA – Insurance Commissioner Jessica Altman today announced that health insurance rates in Pennsylvania have moderated significantly, counter to the national trend, after Wolf Administration efforts to combat the effects of sabotage on health insurance markets by the federal government and specifically the Trump Administration to dismantle the Affordable Care Act (ACA). Importantly, the filings indicate that rate increases in Pennsylvania will be significantly more modest in 2019 than other states and many consumers will see more choices in their local markets as a result of Pennsylvania's efforts to increase competition.
One important twist: A few months back I remember reading that Maine, like several other states, was considering establishing some type of reinsurance program along the lines of successful programs in Alaska, Minnesota and Oregon. I also remember reading that the Maine version was unusual--it would actually involve reestablishing an old, discontinued state program which was still on the books but had been mothballed for years. However, I never got around to doing a write-up about it.
Members of local advocacy group Charlottesville For Reasonable Health Insurance had provided testimony at the Virginia General Assembly and organized an email campaign, helping to ensure passage of the bill through the legislative session. Introduced by Sen. Creigh Deeds and effective July 1 2018, SB672 will allow self-employed people to take advantage of the much more affordable health plans in the small group business marketplace, without having to hire employees.
...Charlottesville and surrounding counties (Albemarle, Green, Fluvanna) have by far the most expensive healthcare premiums in the nation in 2018. Rates more than tripled for consumers buying coverage on the ACA Individual Exchange, making comprehensive insurance unaffordable for people who do not qualify for subsidy assistance. A typical family of four is being charged $3000 per month for high deductible plans.
OLYMPIA, Wash. – Eleven health insurers filed 74 health plans for Washington state’s 2019 individual and family health insurance market, with an average proposed rate increase of 19.08 percent. There are no bare counties, although 14 counties will have only one insurer selling through Washington’s Exchange, Washington Healthplanfinder.