• Wed. Nov 16th, 2022

Individuals could see a 15% rate increase for ACA insurance

ByElla E. Kidwell

Jul 1, 2022

Health insurance rates in the state’s Affordable Care Act market could increase nearly 15% for individuals in the 2023 plan year, the state announced Friday.

According to the American Academy of Actuaries, a variety of factors are driving rate increases in Maine and across the country, including COVID-19, the expiration of American Rescue Plan Act tax credits, inflation and shortages of health personnel.

Maine health insurance companies filed their proposed rate increases earlier this week. The proposed rate increases will likely change before the July 20 deadline for revisions, according to the state’s Office of Insurance.

“The increases in demand in the individual market appear to be the result of several factors, including increased healthcare utilization over the past year as more people resumed scheduled medical procedures,” said Timothy Schott, Acting State Superintendent of Insurance. statement. “The Bureau’s actuarial staff will review justifications for rate changes and may object to them or request additional information from insurers.”

Individuals face a proposed weighted increase of 14.7%, while those in the small group market could see their rates increase by 3.4%, according to the insurance office.

The bureau said in a press release that individual and small group rates were increasing across the country, with respective increases of 11% and 10% in Maryland, 18.7% and 16.5% in New York and 11% and 14.6% in Vermont.

More than 88% of registrants in the Maine marketplace purchase coverage through CoverME.gov, the state’s health insurance marketplace.

The bureau said more than 80% of CoverME.gov consumers are eligible for advance premium tax credits to make premiums more affordable by limiting the maximum eligible consumer contribution to a percentage of their income.

Maine has sought approval from the federal Centers for Medicare and Medicaid Services to include the small group market in the Maine Guaranteed Access Reinsurance Association program, which helped lower personal rates in 2019 by providing reinsurance for services at high cost, according to the office.

The state also committed an additional $8.6 million in federal reinsurance, resulting from ARPA’s increase in premium tax credits, to the reinsurance program in 2023, the bureau said.


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