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June 12, 2015 01:00 AM

Blog: Don't rush to analyze initial ACA premium rates

Bob Herman
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    Two reports out this week show how difficult it is to draw conclusions about the proposed premium rate increases for next year's individual health plans.

    Avalere Health dove into the 2016 insurance rate filings of eight states. It's a small sample size, and the rates applied only to 50-year-old nonsmokers. But the consulting firm found that the premiums for silver-level plans sold on next year's Affordable Care Act exchanges would go up, on average, by 5.8%, ranging anywhere from a 12% rate hike to a 5.3% decrease.

    The premiums for the second-lowest-cost silver plan in the eight states studied would only go up by 1%, Avalere found. That's well below inflation, and those plans are important because they are the benchmarks for determining premium subsidies.

    Conversely, HealthPocket looked at rate filings for 45 states, but only looked at plans offered in the most populous cities for 40-year-old nonsmokers. Still, the consumer research group said the average silver-plan premium would increase 14%, while bronze-plan premiums would go up 9% on average. Silver and bronze plans represented about 89% of selections in the ACA's most recent open enrollment.

    When the federal government listed proposed individual and small-group rate hikes last week, health insurers that pitched extraordinarily high premium increases were front and center. Indeed, many of the proposals would create rate shock for insurance companies' members. But the recent reports from Avalere and HealthPocket show early rate filings cannot be generalized—nor do insurers know much until regulators finalize the figures this fall.

    It could be just as likely that insurance premiums will climb modestly, as they did last year. And with King v. Burwell looming, it's possible the exercise of setting premiums for 2016 could be all for naught.

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