8 public exchange states see ‘reassuring’ premium increases

8 public exchange states see ‘reassuring’ premium increases

0127ppacaap-crop-600x3381-crop-600x338In the eight states that have announced their 2016 proposed rates for purchasing coverage on the public health care exchanges, the average increase for a silver plan is 5.8%.

The numbers vary greatly by state, from a 12% increase in Oregon to a 5.3% decrease in Michigan, according to an analysis by health advisory company Avalere Health. In 2015, more than two-thirds (68%) of exchange enrollees picked a silver plan.

The proposed change for states that posted rates for an average sliver plan are:


  • Connecticut: +4%
  • District of Columbia: +7.8%
  • Maryland: +8.5%
  • Michigan: -5.3%
  • Oregon: +12%
  • Virginia: +11%
  • Vermont: +6.2%
  • Washington: +4%

For the lowest-cost silver plan, the average increase was 4.5%, with changes of +6.9% Conn., +2.1% D.C., +3.2% Md., -7.6% Mich., +5.7% Ore., +6.1% Va., +10% Vt., +8.6% Wash.

“For the subset of states that posted rates, the overall increases look pretty modest … in the plans with the most enrollment, which are the lowest-cost silver plans,” says Katherine Hempstead, a director at the Robert Wood Johnson Foundation.  “While it is too soon to say how generalizable that will be to the rest of the states, that is reassuring, since that increase is in the ballpark of the overall increase in health care spending since last year.”

Earlier this month, insurers who proposed rate hikes of more than 10% were required to post those increases as a result of transparency requirements. “[They] had to provide a justification; that is why those have been so widely reported,” says Elizabeth Carpenter, a director at Avalere. “The thing to remember about the exchange market is enrollment is really concentrated in these low-cost silver plans.”

In those filings, which are subject to review by the Centers for Medicare and Medicaid Services, several insurers reported seeking double-digit increases, including rate hikes of between 49% and 65% by Blue Cross Blue Shield of New Mexico.

2015 premiums

Looking at these numbers analyzed by Avalere, the lowest cost plans tended to have the smallest increases, “which makes sense since carriers were probably most incentivized to stay low with those plans, and also because perhaps those plans had the most members so there may have been more stability in the data,” Hempstead explains.

Hempstead cautions all that is known so far is the more than 10% increases and rates in these eight states, “which are not necessarily representative, since they are all current or former state-based exchanges,” she says. “So they both show us a different part of the elephant. What we can see so far is not too alarming, but I still want to see the whole elephant.”