Rate Increases

This article in the Des Moines Register seems to be fairly clear, but there's some weird discrepancies which make me wonder, so take this with a grain of salt:

Iowa's chief insurance regulator has approved double-digit premium rate increases affecting thousands of Iowans.

The Iowa Insurance Division said Wednesday that Insurance Commissioner Nick Gerhart has approved increases requested by Wellmark Blue Cross & Blue Shield, Coventry Health Care and Gundersen Health Insurance.

All of the rate increases are for policyholders holding individual health insurance plans. They will go into effect Jan. 1.

For Massachusetts, I'm not bothering with an actual spreadsheet, as this Boston Globe article has summed up the key numbers:

The new rates will affect about 300,000 people who buy health insurance on their own or work for small businesses with 50 or fewer employees and will renew plans in January.

...The rate hikes approved by the state mean that premiums for individuals and small businesses will rise 6.3 percent next year, on average, but the costs for some plans will rise more, and others less. This year, rates for individuals and small employers rose an average of 3.1 percent in January, after increasing 1.9 percent in 2014.

This article from the Idaho Statesman provides the final approved rate changes for 2016 in Idaho, which were mostly left intact:

Blue Cross of Idaho’s rates for individuals buying their own plans will go up an average of 23 percent. Company officials say the increase is needed after Blue Cross lost millions of dollars because current customer premiums are not keeping up with claims paid.

Last year, the company’s average rate increase for individual policies was about 15 percent. That year, the company paid nearly $221.1 million in claims while receiving $188.7 in premiums.

Other average rate changes for 2016, including for plans sold off the Idaho health insurance exchange:

  • Mountain Health COOP: 26 percent
  • SelectHealth: 15 percent
  • Regence BlueShield of Idaho: 10 percent
  • BridgeSpan Health, a sister company of Regence: 7 percent
  • PacificSource Health Plans: -8 percent

State Insurance Director Dean Cameron said he did not find any proposed rate changes to be unreasonable.

I know I'm not supposed to repost entire news stories, but this one is literally 6 sentences, so click on some Alaska Dispatch News links to give them some love, willya?

JUNEAU — The state Division of Insurance has approved average rate increases for next year of nearly 40 percent for the two companies providing individual health insurance plans through the federally run online marketplace.

Division director Lori Wing-Heier says Premera Blue Cross Blue Shield and Moda Health cited the high cost of medical services as one of the factors in requesting rate increases.

She also said Alaska has a relatively small market and very small group of individuals with high-cost claims.

She said the average rate increase approved for Premera was 38.7 percent and 39.6 percent for Moda. She said that applies to individual plans on and off the online marketplace.

Wing-Heier says the cost of health care in Alaska has been a long-standing concern, with no clear answers for addressing it.

Well I'll be damned. Given all the tea leaf/entrail-reading that I've had to do in some states to try and piece together the weighted average rate increases for 2016 (usually due to missing enrollment/market share data for the companies participating), it's a pleasant surprise to see that my own state of Michigan has posted the approved rate hikes without any gobbledygook:

Individual market to increase on average 6.5%, small group 1.0%

FOR IMMEDIATE RELEASE - August 18, 2015

LANSING - Michigan consumers and small businesses will experience lower increases in the cost of their 2016 health insurance plan than those in many other states, according to the Michigan Department of Insurance and Financial Services (DIFS). DIFS reports that the average approved rate changes on a premium weighted basis increased by 6.5 percent for the individual market and 1 percent for the small group market.

When I crunched the numbers for Florida's individual market back at the beginning of August, I had to make certain assumptions based on missing data. Even though I had hard numbers for many of the missing market share/enrollment fields, there were still major gaps, especially on the "companies requesting increases of under 10%" side.

I ended up with three potential scenarios for the requested weighted average increase in the Sunshine State: A best-case scenario of 8.6%, a "most likely" scenario of 10.3% and a worst-case scenario of 12.0%. In the interest of caution, I plugged the "most likely" number (10.3%) into my national average spreadsheet, and assumed it'd be somewhere between that and 12% publicly.

OK, the bad news is that the requested 2016 individual market rate increases in Kansas were somewhere around 28%, with some as high as 38%. This would have looked something like this:

Ouch. The good news (well...relatively good, anyway), is that in the end, the approved rate hikes are considerably less...although still not pretty:

Premiums for Kansas health insurance plans offered in the federal marketplace won’t increase as much as originally proposed, state Insurance Commissioner Ken Selzer said Tuesday.

Kansas Insurance Commissioner Ken Selzer said Tuesday that premiums for health insurance plans offered in the federal marketplace won’t increase as much as originally proposed.

Way back in early June, Washington State reported that the overall average requested individual market rate increases for 2016 came in at 5.4%, which is pretty darned good.

Just now, the state insurance commissioner reported that the approved weighted average increase next year will be even lower: Just 4.2%:

OLYMPIA, Wash. –The Office of the Insurance Commissioner has approved 136 individual health plans from 12 insurers who will offer them to the Exchange, Wahealthplanfinder, for sale in 2016. The Washington Health Benefit Exchange Board is scheduled to certify the approved insurers and their plans at its board meeting later today.  

The companies requested an average rate change of 5.4 percent, but 4.2 percent was approved.

Yes, I'm back. From what I can tell, the major Obamacare/health insurance-related stories while I was out were a) Scott Walker/Marco Rubio finally releasing their proposed "replacement plans" (such as they are) for the ACA, and b) the approved 2016 rate changes for ACA-compliant individual/small group policies across a whole mess of states (technically all 50 states +DC had to be finalized as of 2 days ago, but it'll still take awhile to dig up all of them, since many news stories & reports may leave out off-exchange plans, increases of less than 10% and/or actual market share for weighting purposes).

I'm ignoring the Walker/Rubio story for the moment, mainly because they're both complete jokes, but will write up something about that later. For now, let's dive into the approved 2016 rate change story, starting with Arkansas.

Vermont was one of the earliest states to report their requested rate hikes back in mid-May. Due to Vermont's small size (both in total population as well as insurance providers...there's only two of them even operating on the individual markets), as well as their unique law requiring that all individual policies be purchased through the ACA exchange, they were also one of the easiest to calculate.

In addition, as far as I can tell, in Vermont, both the individual and small group markets are considered part of the same rate pool, although the market share differences between the two still resulted in slightly different weighted averages: 7.8% for the individual market, 8.1% for the small group market. These were slightly revised to 8.0% and 8.3% just prior to the review/approval process.

Yesterday the state regulators announced the final approved rates for both BCBSVT and MVP...and lo and behold, they've shaved off several points in both the individual and small group markets:

IMPORTANT: See this detailed explanation of how I've come up with the following estimated maximum requested weighted average rate increases for this state.

As explained in the first link above, I've still been able to piece together rough estimates of the lowmid-range and maximum possible requested average rate increase for the Arkansas individual market. Note: While the table & methodology for Arkansas are the same as most of the other states I've posted on, there's one important difference here; see below for details:

Again, the full explanation is included here.

IMPORTANT: See this detailed explanation of how I've come up with the following estimated maximum requested weighted average rate increases for this state.

As explained in the first link above, I've still been able to piece together rough estimates of the maximum possible and mid-range requested average rate increase for the Ohio individual market:

Again, the full explanation is included here, but to the best of my knowledge, it looks like the companies with rate increases higher than 10% come in at a weighted 15.5% increase, but only make up about 28% of the total ACA-compliant individual market, with several other companies with requested increases of less than 10% (decreases in some cases) making up the other 72%.

Last week I reported that insurance companies offering individual healthcare policies in New Mexico were asking for some pretty ugly rate hikes (on a percentage basis, anyway), mainly due to Blue Cross Blue Shield of NM (aka "Health Care Services Corp.") putting in for a jaw-dropping 57% hike. This resulted in 30% overall requested increases when weighted by market share.

Then, a few days later, the New Mexico state insurance commissioner announced the approved rate hikes for all 5 (or is it 6? see below...) of the companies in question. For BCBSNM (aka HCSC), they lopped the 57% hike down massively:

IMPORTANT: See this detailed explanation of how I've come up with the following estimated maximum requested weighted average rate increases for this state.

As explained in the first link above, I've still been able to piece together rough estimates of the maximum possible and mid-range requested average rate increase for the Georgia individual market:

Again, the full explanation is included here, but to the best of my knowledge, it looks like the companies with rate increases higher than 10% come in at a weighted 18.3% increase, but only make up about 29% of the total ACA-compliant individual market, with several other companies with requested increases of less than 10% (decreases in some cases) making up the other 71%.

IMPORTANT: See this detailed explanation of how I've come up with the following estimated maximum requested weighted average rate increases for this state.

As explained in the first link above, I've still been able to piece together rough estimates of the maximum possible and mid-range requested average rate increase for the North Carolina individual market:

BCBS of NC had previously requested an already-ugly 25.7% average rate hike, but has now asked to bump that up even more, to 34.6% overall.

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