Rates for regulated 2023 health, dental and small-group insurance plans were announced last week, following in-depth reviews by independent actuaries and the Office of Value Based Health Care Delivery.
While premiums are rising steeply nationwide, the extension of consumer-friendly subsidies through the Inflation Reduction Act, coupled with Delaware’s strong 2022 enrollment and 2023 Health Insurance Marketplace expansion, will limit consumer impact locally, insurance commissioner Trinidad Navarro said.
“This year, Delaware consumers have more carriers and plans to choose from than ever before, so they can find an affordable plan that meets their needs. We remain optimistic that this increased competition will lead to lower rates and higher care quality over time,” Mr. Navarro said.
“Delawareans are facing rising costs in nearly every area of life and making difficult sacrifices to afford necessities — but let me be clear, no matter the financial cost, we cannot afford to sacrifice our health. We will continue to work to ensure that coverage is affordable and accessible to all residents.”
Two new health insurers will be joining the marketplace for 2023. Before tax credits and subsidies, base rates for 21-year-old non-tobacco users range from $315-$505 across nine Aetna CVS Health plan options and from $283-$402 with AmeriHealth Caritas, across four plan options.
Returning Affordable Care Act issuer Highmark Blue Cross Blue Shield of Delaware will be increasing rates 5.5% on average, with base rates for 17 plan options ranging from $249-$618, including a catastrophic plan option. In the last few years, Highmark’s average rates have risen roughly 10%, despite this needed increase.
Plans on the marketplace are spread among metal-level categories — bronze, silver, gold, platinum and catastrophic. The plans are based on how enrollees choose to split the costs of care with their insurance companies.
Mr. Navarro said in a statement that he urges residents to be informed and shop for the best plan for both their needs and their budget.
Thirty plans are available to Delawareans for the 2023 plan year, and local navigators are available to assist in choosing the right one. Open enrollment takes place Nov. 1-Jan. 15, 2023.
Insurers are requesting increases nationally due to inflation, increasing costs of care and rising drug prices, Mr. Navarro’s office said. In Delaware, both state and federal legislation contributed to the long-awaited carrier expansion and final rates.
“It’s no coincidence that Delaware was able to expand the number of carrier options on the Health Insurance Marketplace in the same year that laws limiting hospital price growth to appropriate, inflation-conscious levels became enforceable,” Mr. Navarro said.
“The hospital price growth law, for the first time in our state’s history, gave insurers leverage to negotiate lower costs for consumers while still ensuring that hardworking healthcare providers receive their fair share. We’re grateful to have worked with legislators and the Primary Care Reform Collaborative to put cost containment guardrails in place to curtail rising consumer expenses, encourage carrier expansion, and ensure the effectiveness of every dollar spent.”
With little financial limitations around hospital costs, private insurance plans pay the price, which is, on average, 224% more than Medicare plans, according to the RAND Corp.
During the rate-filing process, questions also remained about the expiration of American Rescue Plan Act subsidies, which the department lobbied Delaware’s congressional delegation to extend. These subsidies lowered consumer costs significantly and contributed to the state’s largest-ever Affordable Care Act enrollment, a year-over-year increase of 26.8%.
Had these benefits expired, healthy consumers who were influenced to acquire coverage through the enhanced discounts may have left the marketplace, shrinking the risk pool and unbalancing rates. On Aug. 16, President Joe Biden signed the Inflation Reduction Act into law, extending subsidies into 2025.
Aside from potential enrollment increases due to the carrier expansion, future participation growth may come from Medicaid unwinding and income-eligibility reviews. National efforts are underway to ensure smooth, affordable transitions to marketplace coverage for those eligible.
Delta Dental will reduce both Affordable Care Act and non-marketplace rates by an average of 4%, and Dominion Dental will increase Affordable Care Act premiums by 2.2%. Metropolitan Life Insurance Co.’s small-group non-marketplace dental plan rates will remain at their current levels.
Returning off-market small-group plans from Highmark will increase an average 2.4%, Optimum Choice plans will rise by 2.7%, and United Healthcare small-group rates will increase by 2.8%. Aetna Health’s small-group plans will increase 7.6%, and Aetna Life rates will increase 5.1%, after an initial increase request of 8.8% was reduced. Aetna Health’s nine off-marketplace individual plan rates will remain at their current levels.