(The Center Square) – A review of Affordable Care Act marketplace insurers’ rate filings is providing an early peak at health insurance costs for 2024, with a median premium increase request of 6%.
The analysis from the Kaiser Family Foundation examined early rate filings for hundreds of health insurance companies participating in the ACA marketplace. The analysis also examined the factors driving them.
“For 2024, across 320 insurers participating in the 50 states and D.C., this analysis shows a median proposed premium increase of 6%,” according to the report. “Based on a more detailed analysis of publicly available documents from 58 insurers, growth in health care prices stood out as a key factor driving costs in 2024.
“In addition to inflation, insurers also mention changes in pandemic-related costs and the unwinding of Medicaid continuous coverage, though the latter are having a small, if any, effect on premiums.”
The report notes the rising prices and utilization are not specific to the ACA marketplace, with similar trends observed in small group market filings as well. Most enrolled in the ACA market receive a subsidy and are not expected to face premium increases, which would be covered by taxpayers through increased federal spending.
Nationally, premium changes ranged from a 15% decline to an increase of 100%, though most fall between 2% and 10%. Of the 320 filings examined, there are 41 proposed decreases and 75 proposed increases greater than 10%; 104 proposed increases between 0% and 5%; and 99 requesting increases between 5% and 10%.
“These filings are preliminary and may change during the rate review process,” Kaiser says.
It said the 2024 rates “will be finalized in late summer.”
In North Carolina, the proposed rates for 2024 ranged from a negative 8.2% from UnitedHealthcare of North Carolina to 7.2% from Cigna HealthCare of North Carolina.
Other increases include Ambetter of North Carolina (1%), Aetna Health (2.4%), AmeriHealth Caritas North Carolina (3.5%), Oscar Health Plan of North Carolina (5.6%), and Celtic Insurance Company (6.2%). Other proposed decreases include BlueCross BlueShield of North Carolina (-4%), and CareSource North Carolina (-4.2%).
“As is the case in most years, medical trend – which includes growth in prices paid by insurers for medical services and medications, as well as growth in the utilization of health care – is a key driver of premium growth in 2024,” according to the analysis. “Many insurers expect utilization to grow relative to 2022, but price growth is generally playing a larger role in medical trend than utilization is.”
“Looking ahead to 2024, many insurers are expecting broader economic inflation to flow through to the health system and put upward pressure on premiums,” Kaiser said.
During the pandemic, the federal government prohibited states from disenrolling Medicaid recipients, a provision that ended in April and is expected to result in 3.2 million people removed from the system. Many will shift to the ACA marketplace.
About half of the insurer rate filings do not mention Medicaid disenrollments, and most that did are not adjusting premiums because of the shift, according to the report.
