A look at state ACA participation and 2015 individual market health insurance rate filings

Under the ACA, states have had the opportunity to decide if and how they expand their Medicaid programs and to what extent they have a hand in the administration of health insurance exchanges.

Today, 30 states and the District of Columbia have opted to expand their Medicaid programs, 1 state is discussing the possibility of expansion and 19 are decidedly not expanding at this time. In addition, 16 states and the District of Columbia run their own exchanges. Three – New Mexico, Nevada and Oregon – are considered “federally-supported” state-based exchanges because they rely on the federal government’s IT infrastructure: HealthCare.gov. The remaining states are in the federal marketplace, though some have a “partnership” with the federal government that permits them to administer consumer assistance and outreach functions.

Open enrollment for the second year of the Affordable Care Act’s health coverage expansion began on November 15, 2014, enabling consumers across the country to begin shopping for 2015 health insurance coverage. As of November 25, seventeen states—Colorado, Delaware, Hawaii, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New York, Ohio, Oregon, Rhode Island, South Carolina, South Dakota, Vermont, and Washington—as well as the District of Columbia announced approved rates for both on-exchange and off-exchange health plans in the individual market. In total, HRI has collected data from 50 states and the District of Columbia.

Among the seventeen states and DC with final rate announcements, the average premium (across metal tiers and ages) is about $361, and the average premium increase from 2014 is 3.7%. By contrast, the average premium increase across all reporting states is 5.4%, and the average premium is $389.

Though average rate increases hover in the single-digit range, actual changes and premium prices vary significantly across states. In states with approved rates, average rates range from a 22% decrease to a 35% increase (in Colorado).

Click on individual states in the map to pull up details on state ACA participation and 2015 premium rate filings.

Average Premium Increase1
Limited information available
Data not available

Updated as of August 5, 2015

State has announced all approved rate filings

1 Premium data as of November 25, 2014.
2 Louisiana is only reporting bids from insurers that are requesting rate increases of 10% and higher.
3 California is reporting a 4.2% weighted average premium rate increase for on-exchange plans only.
4 Arkansas reports a 2% average premium rate decrease on its health insurance marketplace, which includes the private option for Medicaid-eligible individuals.
5 Montana's published rates includes individual, on-exchange plans only.
6 New York is reporting a 5.7% average premium rate increase for insurers both on- and off-exchange.
7 Ohio's Department of Insurance published average rate data for the federal exchanges in an article on its website.
8 Minnesota is reporting an average rate increase of 4.5% for the four companies returning to MNsure (on-exchange plans only) in 2015.
9 Nebraska's Department of Insurance reports a sampling of 2015, on-exchange rates.
10 Oregon's Department of Insurance reports average 2015 premiums for a single, 40-year-old non-tobacco user who selects a standard silver plan.
11 State's premium information is available via Healthcare.gov or state-run website for on-exchange plans only.
12 Washington's Department of Insurance reports the average approved premium increase for both on- and off-exchange plans is 1.5%.
13 Hawaii's Department of Insurance is reporting premium data for non-smoker, individual plans available on the Hawaii Health Connector.

Methodology for Premium Analysis

PwC’s Health Research Institute (HRI) prepared an analysis of premium rate filings for the individual health insurance market for 2015, both on- and off-exchange, based on publicly available health insurance rate filings and other data as of November 25, 2015.

The figures shown for each state on the map are simple averages (e.g. average premium rate, overall rate increase) using data reported by insurance carriers in their rate filings. It should be noted that these averages would include the impact from multiple factors, including metal level/plan design, age, and geography, on health insurance plan premiums. Even with the beginning of open enrollment, certain states are only reporting partial information about 2015 rates, and others are only reporting percentages that rates have changed without sharing actual premium data. Unless otherwise noted, this analysis only includes individual health insurance filings containing rate information.