What happens when the insurers who flooded exchanges and garnered the bulk of the membership increase their rates?
WellPoint Blue companies and independent Blue Cross Blue Shield insurers captured the most public exchange members across states in the first open enrollment period -- greater than 50 percent in states like Connecticut, Maryland and Michigan -- according an analysis by Avalere Health.
WellPoint leads enrollment in California, Colorado, Connecticut, Indiana, and Virginia, and independent Blue insurers lead in Washington D.C., Florida, Maryland, Michigan, Rhode Island, Vermont and Washington, while cooperative plans have the largest memberships in Maine and New York.
Now, according to the research and consulting firm, in 9 of 15 states analyzed, insurers with the highest exchange enrollments -- most of them Blues -- are seeking rate increases of over 9 percent.
In part, that strategy is based on uncertainty with new members and their health needs, since 2015 rates were filed "when exchange plans had little experience with their new members," said Caroline Pearson, vice president at Avalere, in the report.
It also means, though, that insurers new to exchanges or expanding in them -- like UnitedHealthcare, for one -- could "shake things up" by offering lower premiums, as Avalere's CEO Dan Mendelson put it.
By and large, insurers that garnered the most members in exchanges last year are increasing their rates, at least in the 15 states Avalere analyzed.
(Source: Avalere Health)
In Florida, Blue Cross is increasing rates by more than 15 percent. In California, Connecticut, Indiana and Virginia, WellPoint is increasing rates by between 5 and 10 percent. Likewise Blue Cross and Blue Shield of Michigan, CareFirst Blue Cross and Maine Community Health Options. The one exception is WellPoint in Colorado, which is reducing rates 5 percent.
(Source: Avalere Health)
Along with rate increases at insurers with high membership, other factors are bound to make more complexity all but certain for both health plans and consumers in this upcoming open enrollment, according to Robert Laszewski is president of Health Policy and Strategy Associates.
State and federal regulators are promising the auto-renewal process be smooth for consumers; they can either default into their existing plans or re-enroll to see if they'll get a better deal with a plan with lower premiums.
That process, combined with premium changes, could create exchange website problems and sow consumer confusion, as Laszewski wrote recently: "Five to ten million people all trying to get through exchange websites between November 15 and December 15? Add however many people are going to sign-up for the first time this November to all of those existing participants re-enrolling for January 1, who will all be hitting the still fragile Healthcare.gov and state exchanges during that four week period."