In Delaware, insurance rates under the Affordable Care Act marketplace (sometimes known as Obama Care) will increase as two new providers sign on.
The story is different for employer group plans that have seen skyrocketing premiums.
The ACA provides health insurance for professionals and businesspeople without group policies as well as those between jobs or at employers that do not offer coverage.
The marketplace differs from what some call “junk insurance” plans that provide minimal coverage.
“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,” said Insurance Commissioner Trinidad Navarro. “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.”
Highmark had been the only carrier in the ACA market.
Two new health insurers will be joining the Marketplace in 2023. Before tax credits and subsidies, base rates for 21-year-old non-tobacco users range from $315 to $505 across nine Aetna CVS Health plan options, and from $283 to $402 with AmeriHealth Caritas across four plan options. Returning ACA 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 to $618 including a catastrophic plan option. In the last few years, Highmark’s average rates have decreased roughly 10% despite the upcoming increase.
Delaware came up with a reinsurance prograqm that put downward pressure on premiums, even with only one carrier in the market.
Plans on the marketplace are spread among bronze, silver, gold, platinum, and catastrophic categories.
A total of 30 plans are available to Delawareans for the 2023 plan year, and local navigators are available to assist in choosing the right plan. Open Enrollment takes place Nov. 1 through Jan. 15.
“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,” said Commissioner Navarro. “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 few financial limitations around hospital prices, private insurance plans pay the price – on average 224% more than Medicare plans, according to RAND Corporation.
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 ACA 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 affecting rates. On August 16, President 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 ACA and non-marketplace rates by an average of 4%, and Dominion Dental will increase ACA premiums by 2.2%. Metropolitan Life Ins. Co.’s small group non-marketplace dental plan rates will remain at their current level.
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 9 off-marketplace individual plan rates will remain at their current level.
About ACA Plans
All ACA-compliant health plans offer essential health benefits, including coverage of pre-existing conditions, prescriptions, emergency services and hospitalization, mental and behavioral health coverage, outpatient care and telehealth, lab services, and more.
Open enrollment for 2023 Health Insurance Marketplace plans begins Nov. 1. Residents may qualify to enroll or change plans based on special circumstances, such as income qualification, loss of health coverage, becoming a parent, or other qualifying factors throughout the year.