Health insurance rates on the state’s Affordable Care Act marketplace may increase by nearly 15 percent for individuals in the 2023 plan year, the state announced Friday.
A variety of factors are driving rate increases in Maine and across the country, including COVID-19, the expiration of tax credits in the American Rescue Plan Act, inflation, and health care workforce shortages, according to the American Academy of Actuaries.
Health insurance carriers in Maine 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 Bureau of Insurance.
“The requested increases in the individual market appear to be the result of several factors, including increased health care utilization in the past year, since more people have resumed scheduled medical procedures,” Timothy Schott, the state’s acting insurance superintendent, said in a written statement. “The Bureau’s actuarial staff will review the justifications for the rate changes and may object or request additional information from the insurers.”
Individuals face a proposed weighted increase of 14.7 percent, while those in the small group market may see their rates increase by 3.4 percent, according to the insurance bureau.
The bureau said in a news release that individual and small group rates are rising across the country, with respective increases of 11 percent and 10 percent in Maryland, 18.7 percent and 16.5 percent in New York and 11 percent and 14.6 percent in Vermont.
Over 88 percent of individual market enrollees in Maine purchase coverage through CoverME.gov, the state’s health insurance marketplace.
The bureau said over 80 percent of CoverME.gov consumers qualify for advance premium tax credits to make premiums more affordable by limiting the maximum contribution from eligible consumers to a percentage of their income.
Maine has requested 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 reduce rates for individuals in 2019 by providing reinsurance for high-cost services, according to the bureau.
The state has also dedicated an extra $8.6 million in federal reinsurance, that resulted from the ARPA increase in premium tax credits, to the reinsurance program in 2023, the bureau said.
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