![]() Inflation and utilization trendsĮvery year, insurers are asked to project their health cost “trend,” which is a combination of rising prices paid to hospitals, doctors, and pharmaceutical companies (inflation) and upward or downward expectations for utilization (or, the number of visits, stays, or prescriptions).Īs is the case in most years, health cost trend is a key driver of premium growth in the coming year. Insurers do not always publicly quantify all factors driving their premiums. We also searched for other key words relating to current issues like telemedicine and mental health, but we found most insurers did not reference these subjects in their filings. Across all 72 filings, we systematically tracked key words relating to medical trend, the COVID-19 pandemic, and certain policy changes (the expiration of American Rescue Plan Act subsidies, the implementation of the No Surprises Act, and the Family Glitch administrative fix). In these filings, insurers describe factors they expect will have either an upward or downward impact on their costs for the coming year. ![]() It is also the case that the overall average increase in premiums is often different from the average increase in the benchmark silver plan, which is the basis for calculating subsidies for Marketplace enrollees. Compared to recent years, relatively few insurers are requesting to lower their premiums, with only 4 out of 72 insurers filing negative premium changes, and the remaining 68 insurers requesting premium increases.Īs these rates are preliminary and we do not yet have data for every state, the actual average percent increase in premiums will not be known until early fall. Most premium changes insurers are requesting for 2023 fall between about 5% and 14% percent (the 25 th and 75 th percentile, respectively). ![]() So far, we find that across 72 insurers in 13 states and the District of Columbia, the median proposed premium increase is about 10%. While our analysis focuses on the ACA markets, the main premium drivers we identified (prices and utilization) are systemic and not specific to the ACA markets. The main contributor to premium growth is health cost trend, which reflects rising prices paid to providers and pharmaceutical companies as well as a rebound in utilization. The median proposed premium increase is 10% across these 72 insurers. ![]() We find that insurers in this market are proposing to raise premiums by more than in recent years. In tracking these filings, we are looking at several factors that could drive costs in 2023, including health cost trend (which includes health sector inflation and changes in utilization), the COVID-19 pandemic, and changes in federal policies (including the possible expiration of the American Rescue Plan Act subsidies, the implementation of the No Surprises Act, and the administrative fix to the Family Glitch). (The 13 states reviewed include: Georgia, Indiana, Iowa, Kentucky, Maryland, Michigan, Minnesota, New York, Oregon, Rhode Island, Texas, Vermont, and Washington.) These filings are preliminary and may change during the review process. At the time of this brief, we have compiled data from 72 insurers across 13 states and the District of Columbia. A relatively small share of the population is enrolled in these plans (compared to the number in employer plans), but these filings are generally more detailed and publicly available. In this analysis, we reviewed rate filings from plans participating in the Affordable Care Act (ACA) Marketplaces to track what insurers say will be driving premium growth in the coming year. These filings can provide insight into what factors insurers expect will drive health costs for the coming year, including inflation, the COVID-19 pandemic, and policy changes. Each year, health insurers submit rate filings to state regulators, detailing their expectations for the coming year’s health costs.
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