Insurance Commissioner Jessica Altman released the 2021 requested rate filings for health insurance plans under the Affordable Care Act, highlighting that the average rate request would result in an average decrease in premiums in the individual market, allowing consumers greater flexibility and increased access to affordable, comprehensive coverage.
“Overall, Pennsylvania continues to have a healthy and competitive health insurance market and insurers are committed to providing the ACA coverage options Pennsylvanians deserve,” Altman said. “As filed, of Pennsylvania’s 67 counties, no county will lose an on-exchange insurer, and 13 counties will gain at least one new insurer. This marks the third year where Pennsylvania is seeing increased competition and decreasing or moderately increasing premiums, demonstrating that Pennsylvania’s efforts to stabilize and improve affordability in this market have been working.”
Insurers selling in the individual market filed plans requesting an average statewide decrease of 2.6 percent. Insurers that currently sell in Pennsylvania’s small group market filed plans requesting average statewide increases of 2.2 percent.
“Pennsylvania has taken the necessary steps to ensure ACA-compliant health care coverage is accessible, and continues to work towards making it more affordable,” said Altman. “Under Governor Wolf’s leadership, Pennsylvania is now switching to a state-based health insurance exchange later this year and establishing a reinsurance fund that will directly pay some of the health care costs for high-cost individuals.”
These initiatives have driven down premium rates for 2021, according to Altman, and are the reason that premiums are, on average, going down in the individual market. Based on the proposed filings, the reinsurance program’s impact will make premiums 5.3 percent lower than they would be without this program in place, an even greater impact than the 4.6 percent decrease initially projected.
Other factors that are impacting these proposed rates include any anticipated costs related to COVID-19, such as COVID-19 testing and treatment costs, the anticipation of new treatments and vaccines, an increase in mental health and substance abuse treatment needs, telehealth utilization, as well as changes to provider reimbursement rates. The current economic turbulence and its accompanying impact on where people get their health insurance coverage, including a current and anticipated loss of employer coverage, is a factor as well.
The Department has observed thousands of individuals move to employer-sponsored COBRA plans during the COVID crisis. Many of these individuals may be eligible for Medicaid or may otherwise seek to enter the ACA individual market and access subsidies for the 2021 plan year, which will be a more affordable option than COBRA for many.
Rate filings for 2021 health insurance plans were submitted to the Insurance Department on May 19. The Department generally makes proposed rates public in July, but delayed the timeline this year to allow additional time to better understand the projected impact of COVID-19 on health care costs in 2021. Proposed rate changes vary by plan and region and are subject to change as the department conducts its review process. Final approved rates will be made public in the fall.
“Although the final rates are not yet approved and open enrollment is still a few months away, I urge consumers to begin thinking about their health care and insurance needs and encourage consumers to shop around when the state-based exchange platform is public,” said Altman.
Public comment on rate requests and filings will be accepted through Aug. 21, and can be emailed to ra-in-comment@pa.gov.
Details are available here.
