Most Insurers Participating in the Marketplaces Don’t Expect COVID to Affect Their 2022 Costs

After a tumultuous year of unpredictable COVID-19 changes to utilization and spending, a review of early rate filings for individual market insurers participating in the Affordable Care Act Marketplace finds that most are expecting a return to normal in 2022 without the pandemic playing a large role.

The review of insurers’ preliminary rate filings in 13 states and the District of Columbia reveals that most expect health utilization patterns to return to their pre-pandemic levels and generally aren’t expecting any additional costs or savings related to COVID-19 in their 2022 rates. Of the 75 insurer filings submitted in these states, 16 predict that COVID-19 will have an impact in 2022, generally pushing rates up by less than a 1 percentage point.

The pandemic led to a sharp drop in health spending in April 2020, as many providers cancelled elective procedures and patients practiced social distancing and avoided health care facilities. Since then, spending has mostly rebounded, though utilization this year remains somewhat lower than normal.

Other factors that insurers cite as impacting their 2022 rates include continued use of telehealth services in place of in-person visits, and a somewhat healthier marketplace population due to increased tax credits included in the American Rescue Plan Act. Few mentioned any impact from the No Surprises Act, which prohibits most surprise out-of-network bills starting next year.

Although the ACA Marketplaces cover a relatively small share of the privately insured population, the rate filings for this market are quite detailed and publicly accessible, making them a useful source of information on how insurers are thinking about their likely health costs. Insurers largely made similar assumptions about how COVID-19 would affect their group market costs, the analysis finds.

The brief is available on the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.