The cost of health insurance plans on and off Connecticut’s Affordable Care Act Exchange will rise by as much as 25% next year, according to final numbers released by the state on Friday, heightening concerns about access to health care.
Insurance officials approved the rate changes eight weeks after insurers proposed an average increase of 20.4% for individual plans and 14.8% for small group policies. The department approved an average increase of 12.9% on individual plans and 7.9% on small groups.
The approved changes range from a 6% decrease on some policies to increases of 20% and 25% on others.
Although the state-approved average increase is lower than the rate requested by insurance companies, it still represents a significant cost increase for consumers in the coming year.
“Working on behalf of consumers, the department’s actuaries and professional staff have been able to reduce demands for health insurance rate increases. But the skyrocketing cost of health care that these premiums cover needs to be addressed,” Connecticut Insurance Commissioner Andrew Mais said. “The unit cost of inpatient and outpatient care has increased by around 9% per year. Prescription drug prices have risen again.
“The rates announced today will continue to protect consumers from inflationary prices and unwarranted profits while ensuring Connecticut residents access to a stable and competitive health insurance market. But we need to look at other avenues available to reduce overall costs and keep care, and this insurance, affordable.
ConnectiCare Benefits Inc., which sells on- and off-exchange plans to 75,003 people, asked for an average uplift of 24% for individual policies on the exchange. The insurance department approved an average increase of 15%, with increases ranging from 10% to 23.6%, depending on the plan.
ConnectiCare Benefits also requested an average increase of 22.9% on its small group policies offered through the exchange. The ministry approved 15%, with increases ranging from 13.1% to 18.9%, depending on the plan. The policies cover 3,476 people.
Anthem Health Plans, which sells policies to 27,698 people through the exchange, asked for an average increase of 8.6% on its individual plans. The Department of Insurance approved an average of 6.3%. According to the policy, the rate changes range from a decrease of 3.9% to an increase of 13.6%.
Anthem has sought an average upside of 3.6% on its small group plans. The ministry approved an average cut of 1.4%. The variations range from a decrease of 6% to an increase of 20.2% for policies covering 19,271 people.
ConnectiCare Insurance Company, which offers both on-exchange and over-the-counter plans, requested an average increase of 25.2% for its individual on-exchange policies. The ministry approved a 15% increase. The increases range from 9.1% to 20.3%, depending on the plan. There are 8,782 people registered.
Off-exchange policies range from a 0% increase (small group Aetna Life Insurance) to a 25.1% increase (an individual plan through ConnectiCare Benefits).
ConnectiCare attributed its increases to rising medical and pharmaceutical costs, as well as delayed care due to the pandemic.
Karen Moran, president of ConnectiCare, told a public hearing in August that the company suffered more than $65 million in losses in the individual market over the past year because rate increases had no impact. not track the increased use of medical services and the cost of prescription drugs, among other expenses.
“For an insurance program to be viable, rates must be sufficient to cover the payment of claims and the administrative costs of running the program. Over the past year, the total insurance premiums we have received are far less than the cost of care we have actually funded,” she said. “Previously approved premiums by the insurance department were significantly lower than what we needed to meet members’ needs. … The most important driver of our tariff increase proposal is to restore tariffs to an adequate level.
Cigna, which offers off-exchange small group policies, had asked for an average uplift of 19.6% on its plans. The insurance department approved 12%.
Sarah Souza, director of small groups actuarial at Cigna, said last month that even with the 2023 plan increases, the company’s premiums would be lower than the market average.
“For Silver plans, which are most popular among small employers, we have the lowest plan in six of eight rating zones representing the vast majority of small employer locations,” she said. .
Residents and health care advocates have urged state insurance officials to reject substantial rate increases.
“It’s breathtaking,” Lynne Ide, communications and engagement program manager at Connecticut’s Universal Health Care Foundation, said in July. “Looking at these rate requests, the ranges are off the charts.
“Our big concern right now is, coupled with inflation and the fallout from COVID, these proposed increases are causing problems. Our concern is that people are looking at it and deciding to go without health coverage because they just can’t afford it.
“My jaw hit the ground, obviously,” added Ted Doolittle, the state’s health care advocate. “I am deeply concerned that people will go without coverage because of these high prices. It is the responsibility of insurance companies and providers to explain to the people of the state why this is unavoidable and that there is no alternative.
Open registration for Health Policies 2023 begins November 1.