Blumberg said it's important to keep that context in mind as 2015 premium rates trickle out ahead of the open-enrollment period that starts on Nov. 15. Some states have already released their 2015 premiums, but many proposed rates are still being scrutinized by regulators.
“This is not just some new thing that's been introduced by the Affordable Care Act,” Blumberg said, referencing premium volatility.
In nine states, for employers with fewer than 10 workers, rates increased by double digits in at least half of the years between 2000 and 2013. Similarly, firms with 10 to 24 employees, and five states plus the District of Columbia saw double-digit increases in at least half the years analyzed. And for employers with 25 to 99 workers, seven states also saw hikes of at least 10% in at least half the years studied.
The smallest increase came for companies with fewer than 10 workers in Michigan, which saw premiums grow by an average of just 3.4% over the 14-year period. Firms with less than 10 workers in Indiana saw the steepest hike over that timeframe, with premiums increasing by an average of 8.6%.
Blumberg indicated that the data almost certainly understates the level of volatility in the small-group market because it's spread across an entire state. Individual employers likely saw even more dramatic changes in their premiums.
The Urban Institute researchers analyzed data from the Medical Expenditure Panel Survey-Insurance Component. That information is collected by HHS' Agency for Healthcare Research and Quality through questionnaires filled out by public- and private-sector employers.
Premiums could become a political talking point as Election Day approaches. Sharp increases will likely be held up by opponents of the Patient Protection and Affordable Care Act as evidence that reform is making healthcare more expensive for consumers. Blumberg said she expects there to be volatility in the system at least until 2017 because of all the changes driven by the law.
“All of these actors—the insurers, the employers, the individuals—need to figure things out and get to a new equilibrium,” Blumberg said. “If anything, I would expect to see bigger fluctuations in the first few years.”
Follow Paul Demko on Twitter: @MHpdemko