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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

Methods

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Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.