If the pie chart above looks familiar, that’s because I’ve posted different versions of it in the past. The first time was a couple of months ago, when the chart represented the requested average unsubsidized individual market health insurance policy premium increases for 2018. The second time was a few weeks ago, when I had updated it to represent the approved rate increases across about 20 states.
This time, it includes 30 states, representing roughly 54% of the total U.S. population. The detailed methodology and all individual state calculations can be found here (scroll to the bottom for individual state links).
Here’s a summary view. Overall, around 60% of the 2018 rate increases are tied directly to either the threat to Cost Sharing Reduction (CSR) reimbursements or concern over enforcement of the Individual Mandate penalty...both of which are being caused specifically and deliberately by the Trump Administration in both cases (and by the GOP Congress to a lesser extent):
What’s remarkable is how consistent things have stayed throughout the entire process. Yes, the national average has jumped up and down a bit, and the proportion of it which can be tied to the CSR and/or mandate enforcement issues varies from state to state, but in general the total has hovered in the same 30-35% range for quite awhile and the CSR portion seems to consistently make up around 40-50% of that.
Here’s the state-by-state breakout of the 30 states which have released approved rate increases for next year so far:
As you can see, the averages range widely:
At the low end: 26.5% and 5.3% REDUCTIONS in average premiums in Alaska and Minnesota respectively (both instituted reinsurance programs, although the Centers for Medicare & Medicaid pulled a fast one on Minnesota by effectively stealing the money from their Basic Health Plan program).
At the high end: Jaw-dropping 50%+ rate increases in Georgia and Virginia.
IT’S VITALLY IMPORTANT TO REMEMBER THAT THESE ARE UNSUBSIDIZED RATE INCREASES. Roughly 9 million people on ACA exchange policies receive tax credits which should also change to match these rate changes...so if you receive subsidies and your policy increases $200/month, your tax credits should also increase by around the same amount.
The problem, as always, is that the tax credits cut off for anyone earning more than 400% of the Federal Poverty Level (roughly $48,000/year for an individual or $97,000/year for a family of four). Anyone earning between 400% — 600% FPL are the ones who are in for some major pain this fall...except in states which utilize the Silver Switcharoo Gambit, which currently appears to include:
- California
- Connecticut
- Florida
- Georgia (at least 1 carrier)
- Hawaii (?)
- Idaho (sort of)
- Minnesota
- Nevada
- South Carolina
...and possibly other states as well (I’m still trying to figure out some of them).
Notice that some of the states in the table above have the “partial” sabotage number bold-faced, while others have the “full” sabotage number in bold; that represents which rate increase scenario the state insurance regulators have decided the carriers should price their policies at. Some states haven’t decided yet (or haven’t made it clear).
As I keep stressing, even if Trump’s HHS Dept. wasn’t sabotaging the Open Enrollment Period (killing advertising for HC.gov, slashing outreach, cutting the enrollment period in half, etc etc), things would still be crazy-weird thanks to the CSR/mandate mess...so even if you don’t think you’ll qualify for financial assistance (or think you’re gonna be worse off whether you do or not), make sure to ACTIVELY shop around instead of simply letting yourself be automatically re-enrolled.
If you’d like to help help my efforts on these and other healthcare policy issues, I could always use whatever support you're able to provide, either as a one-time thing or on an ongoing monthly basis.