How Repeal of the Individual Mandate and Expansion of Loosely Regulated Plans are Affecting 2019 Premiums
| Table 3: Impact of Individual Mandate Penalty Repeal and Other Legislative and Regulatory Changes on Premiums, by State and Insurer, 2018 and 2019 | ||||
| State | Insurer | Overall 2018-2019 Rate Change |
2018 Rate Impact of Individual Mandate (IM) Uncertainty |
2019 Rate Impact of IM Penalty Repeal (Impact of other legislative and regulatory changes, if noted) |
| AZ | BCBS | 0% | 4% | 10% (IM; STLD) |
| AZ | Bright Health | NA – 2019 entrant | NA – 2019 entrant | 4% (IM; STLD/AHPs; “other legislative uncertainty”) |
| AZ | Health Net | -6% | NA | 2% |
| AZ | Oscar | NA – 2019 entrant | NA – 2019 entrant | 5-10% (IM; “other potential reforms”) |
| CA | Anthem BC | 4% | 0% | 3% (Primarily IM) |
| CA | Blue Shield CA | 10% | 3% | 5% |
| CA | Chinese Community | 7% | NA | 2% |
| CA | Health Net | 8% | 0% | 2% |
| CA | Kaiser | 9% | 0% | 5% |
| CA | L.A. Care | 7% | NA | 5% |
| CA | Molina | 2% | 0% | 6% |
| CA | Oscar | 7% | 0% | 5% |
| CA | Sharp | 10% | NA | 5% |
| CA | Sutter | 15% | 0% | 10% |
| CA | Valley | -1% | 0% | 5% |
| CA | Western Hlth Advntg | 7% | 0% | 5% |
| CO | Bright Health | 7% | 0% | ~6% (5% IM; <1% STLD) |
| CO | Cigna | 8% | NA | 12% (IM; STLD/AHPs) |
| CO | Denver Health | 22% | NA | 5% |
| CO | Friday Health Plans | 7% | 10% | 4% |
| CO | Kaiser | 7% | NA | ~7% (6% IM; 1.3% STLD) |
| CO | Rocky Mountain HMO | 6% | 5% | 10% |
| CT | Anthem Blue Cross | -3% | NA | 5% (IM; STLD/AHPs) |
| CT | ConnectiCare | 6% | 2% | ~1% (0.5% IM; 0.5% STLD) |
| CT | ConnectiCare Ben. | 4% | 2% | ~1% (0.5% IM; 0.5% STLD) |
| CT | ConnectiCare Ins. | 9% | 2% | ~1% (0.5% IM; 0.5% STLD) |
| FL | Molina | -2% | 6% | 8% |
| IL | Health Alliance | 7% | 3% | ~8% (2.5% IM; 5% STLD) |
| IN | CareSource Indiana | 5% | NA | 5% |
| MD | CareFirst Blue Choice | -17% | 0% | 5% |
| MD | CareFirst CFMI | -11% | NA | 0% |
| MD | CareFirst GHMSI | -11% | NA | 0% |
| MD | Kaiser | -7% | NA | 9% (Primarily IM) |
| ME | Anthem | -4% | 0% | 5% (IM; “sustainability of the ACA marketplace”) |
| ME | Community Hlth Opt. | 1% | 13% | ~10% (5% IM; 5% STLD) |
| ME | Harvard Pilgrim | 2% | 14% | 14% |
| MI | Alliance | 0% | NA | 5% (IM; STLD) |
| MI | Blue Care Network | 1% | 5% | 5% |
| MI | BCBS | 4% | 5% | 5% |
| MI | Meridian | 1% | NA | 2% |
| MI | Molina | 2% | 10% | 7% |
| MI | Total Health Care | 8% | NA | 5% (IM; “other market-wide changes”) |
| MN | Group Health | -7% | NA | ~9% (5-8% IM; 1.5-4% STLD/AHPs) |
| MN | Medica | -12% | NA | 3% |
| MN | PreferredOne | -11% | NA | 0% |
| MN | UCare | -10% | NA | 5% |
| MO | Medica | NA – 2019 entrant | NA – 2019 entrant | 3% |
| MT | Montana Health Coop. | 10% | 5% | 16% |
| MT | PacificSource | 6% | NA | 7% |
| NC | BCBS | -4% | NA | 4% |
| NE | Medica | 2% | 0% | 7% (IM; STLD/AHPs) |
| NM | Christus | 4% | 0% | 6% (IM; reduced outreach) |
| NM | HCSC | 0% | NA | 6% |
| NM | Molina | -6% | 0% | 6% |
| NV | Health Plan of Nevada | 0% | NA | 10% |
| NV | Sierra | -2% | NA | 10% |
| OH | AultCare | 9% | NA | ~16% (13% IM; 2% STLD; 0.9% AHPs) |
| OH | CareSource | 17% | NA | 5% |
| OH | Medical Health Ins. Co | 9% | NA | 4% (IM; STLD) |
| OH | Molina | 6% | 6% | 9% |
| OH | Paramount | 2% | NA | 7% (IM; STLD/AHPs) |
| OR | BridgeSpan | 5% | 5% | 8% (IM; STLD/AHPs) |
| OR | Health Net | 10% | 2% | 4% (IM; STLD/AHPs) |
| OR | Kaiser | 9% | 2% | 8% (IM; STLD/AHPs) |
| OR | Moda | 6% | 2% | 4% (IM; STLD/AHPs) |
| OR | PacificSource | -10% | 2% | 5% (IM; STLD/AHPs) |
| OR | Providence | 10% | 5% | 8% (IM; STLD/AHPs) |
| OR | Regence BCBS | 0% | 5% | 8% (IM; STLD/AHPs) |
| PA | Cap. Adv. Assurance | -21% | 6% | 6% |
| PA | Cap. Adv. Insurance | -43% | 6% | 6% |
| PA | First Priority Health | 1% | 6% | 6% |
| PA | First Priority Life | 7% | 6% | 6% |
| PA | Geisinger Health Plan | 0% | 6% | 6% |
| PA | Geisinger Quality Opt. | 8% | 6% | 6% |
| PA | Highmark | 6% | 6% | 6% |
| PA | Highmark Choice | 4% | 6% | 6% |
| PA | Highmark Select Res. | 0% | 6% | 6% |
| PA | Highmark Health Ins | -7% | 6% | 6% |
| PA | Keystone, Central | -7% | 6% | 6% |
| PA | Keystone, East | -2% | 6% | 6% |
| PA | PA Health & Wellness | NA – 2019 entrant | NA – 2019 entrant | 6% |
| PA | QCC | -6% | NA | 6% |
| PA | UPMC Health Cov. | 12% | 6% | 6% |
| PA | UPMC Health Opt. | 2% | 6% | 6% |
| RI | BCBS | 8% | NA | 0% |
| RI | Neighborhood | 9% | NA | 2% |
| SC | BlueChoice | 7% | 6% | NA |
| SC | BCBS | Unknown | 6% | NA |
| SD | Avera | 3% | 5% | 5% |
| SD | Sanford | 10% | NA | 3% |
| TN | BCBS | -15% | 7% | 1% |
| TN | Bright Health | NA – 2019 entrant | NA – 2019 entrant | 4% (IM; STLD/AHPs; “other legislative uncertainty”) |
| TN | Celtic | NA – 2019 entrant | NA – 2019 entrant | 5% |
| TN | Cigna | -13% | 14% (IM; non-compliant) | NA |
| TN | Oscar Insurance | 7% | 0% | 5-10% |
| TX | Christus | 3% | 15% (IM; reduced outreach) | 0% |
| TX | Molina | 7% | 6% | 6% |
| TX | Sendero | 16% | NA | 10% |
| TX | Vista360health | 16% | NA | 2% |
| UT | Molina Healthcare | 23% | 8% | 10% |
| VA | CareFirst BlueChoice | 15% | 3% | 5% (IM; STLD/AHPs) |
| VA | Cigna | 11% | NA | 12% (IM; STLD/AHPs) |
| VA | GHMS | 45% | 0% | 5% (IM; STLD/AHPs) |
| VA | Kaiser | 34% | NA | 8% |
| VA | Optima | -7% | 25% | 15% (IM; STLD/AHPs) |
| VA | Piedmont | 12% | 0% | ~12% (11.4% primarily IM; 0.8% STLD/AHPs) |
| VT | BCBS | 6% | NA | 2% |
| VT | MVP | 7% | NA | 2% |
| WA | Asuris | 6% | 5% | NA |
| WA | BridgeSpan | 0% | 5% | NA |
| WA | Coordinated Care | 14% | 0% | 5% (IM; STLD/AHPs) |
| WA | Health Alliance | 7% | 0% | NA |
| WA | Kaiser, NW | 14% | 8% | NA |
| WA | Kaiser, WA | 19% | 4% | 3% |
| WA | LifeWise | 7% | 6% | NA |
| WA | Molina | 7% | 5% | NA |
| WA | Premera BC | 2% | 4% | NA |
| WA | Regence BCBS | 8% | 5% | NA |
| WA | Regence BS | 3% | 5% | NA |
| WI | Aspirus Arise | Unknown | NA | 4% |
| WI | Group Health | Unknown | 3% | 7% (IM; STLD/AHPs) |
| WI | Molina | -18% | 7% | 11% |
| WI | Network Health Plan | Unknown | NA | 10% (IM; AHPs) |
| WV | CareSource | 13% | NA | 5% |
| Average | 5% | 6% | ||
| NOTES: Rate impacts are rounded to the nearest percent. “IM” refers to the uncertainty about and/or repeal of the individual mandate penalty. “STLD” refers to Short Term Limited Duration plans. “AHPs” refer to Association Health Plans. “NA” means an insurer did not publicly quantify a rate impact, including instances where insurers did not mention the individual mandate, STLD, or AHPs at all; mentioned an impact of these factors but did not explicitly quantify the rate impact; or quantified the rate impact but redacted the amount from public filings. A value of “0%” means the insurer did publicly quantify the impact and specified that it was 0%. Excludes data for DC, Massachusetts, and New Jersey, which have state-enforced individual mandates, and New York, which prohibited insurers from raising rates due to the individual mandate penalty repeal.
SOURCE: Kaiser Family Foundation analysis of insurer rate filings to state regulators and ratereview.healthcare.gov |
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