Premiums on ACA exchange plans are holding steady

November 2, 2020
Peter Wehrwein
Peter Wehrwein

Open enrollment has started and the median premium increase is 1.1%, according to the Kaiser Family Foundation.

The open enrollment period for the ACA exchanges started yesterday and premiums are, for the most part, holding steady.

According to the Kaiser Family Foundation, half of the rate changes of coverage sold on Healthcare.gov or the 15 state-run exchanges fall between a 3.5% decrease and 4.6% increase. The median rate change is a 1.1%, according to the Kaiser’s number.

Some insurers are edging rates up because they are anticipating costs associated with the COVID-19, COVID-19 TESTING, a rebound of the utilization of medical services that people put off in 2020, and an increase in ]illness because of forgone preventive services, according to the foundation's report.

Others, though, see a continuation of diminished demand for medical services because of the COVID-19 pandemic, social distancing and a continuance of the reluctance to seek in-person care.

Put them together and it's a wash.

“Most premium changes on the ACA marketplaces will be modest heading into 2021, even with the uncertainty surrounding the pandemic,” says the Kaiser report, which was published on Oct 19. Insurers selling in the individual market have remained profitable and medical-loss ratios have been low because of low utilization so large premium hikes would have been hard to justify, says the Kaiser report.

Still, there are some outliers. In Alabama, Bright Health Insurance is bumping up its premium by 25.6%.

Wellmark Health Plan of Iowa is an outlier in the the direction; it's slashing its ACA premium by 42%.

Kaiser report is based on rate filings at state-level insurance departments as of October 15.

The open enrollment ends on December 15 in the 36 states that are using Healthcare.gov. The closing dates varies in the 14 states, plus Washington, D.C., that have their own state-run exchanges.

In 2020, about 11. 4 million Americans are covered by plans that were purchased either through the federal government’s exchange, Healthcare.gov, or through one of the state-run exchanges, according to an official tally issued by CMS in April. That is roughly the same number who were covered through exchange plans in 2019. The average monthly premium was $595 although after ACA subsidies were applied, the average net premium was $89.