Consumers, who can generally begin signing up for plans on Nov. 1, are unlikely to notice much of a difference because of increased federal subsidies, but small employers are likely to bear the brunt of higher rates because they do not receive similar government assistance, according to health-insurance experts.
According to a Kaiser Family Foundation review of 72 proposals from insurers in 13 states, insurers on the ACA marketplaces are proposing 10% increases in median monthly premiums. Some insurers are requesting rate increases of up to 20%.
The proposed increases differ greatly between insurers and markets. Furthermore, state regulators do not always approve the full amount requested by insurers.
Rates are typically proposed by insurers to state regulators, who have varying timelines for reviewing and approving them. In early October, the federal government is expected to certify ACA plans.
According to actuaries and insurance-company regulatory filings, the increases reflect factors such as higher prices for medical services, which hospitals and other healthcare providers are seeking in order to cover their own rising labor and other costs.
"It's both labor and supplies." "Everything is getting more expensive," said Debbie Ashford, chief actuary for health solutions at Aon PLC's North American unit, a health consultant and insurance broker.
Many consumers will not pay more because Congress extended expanded premium financial assistance through 2025 as part of the August Inflation Reduction Act.
The law preserved a 2021 subsidy expansion that allowed individuals to be eligible for subsidies for the first time if they earned more than four times the federal poverty level, or about $54,000 for an individual and $110,000 for a family of four. Individuals earning more than four times the poverty line were previously barred from receiving subsidies under the ACA.
According to Cheryl Fish-Parcham, director of private coverage at Families USA, a consumer health-advocacy organization, the increased subsidies mean that the majority of the 13.8 million people enrolled in an exchange plan will see what they pay out of pocket toward their premiums remain constant. According to her, many people will be protected from premium increases.
According to the Biden administration, the additional assistance means that approximately 13 million people covered by the ACA will save $800 per year compared to what they would have had to spend without the extended subsidies. According to the Health and Human Services Department, the average monthly premium after subsidies in 2022 will be $133.
"Small businesses will bear the brunt of the damage," said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, because they lack the bargaining power that larger corporations have when negotiating with health insurers.
Bob Jennings, CEO of 3D Color, a Cincinnati-based manufacturer of prototypes for consumer goods brands with 21 employees, predicted 14% to 23% rate increases in 2023.
Mr. Jennings, on the other hand, stated that he did not want to stop providing benefits in such a competitive labor market. Instead, he claimed, the company passed on a 3% premium increase to employees while agreeing to cover any out-of-pocket expenses that exceeded the out-of-pocket maximum.
3D's health-insurance plan expired in August, so the company recently renewed its coverage for the coming year. According to Gary Claxton, senior vice president at the Kaiser Family Foundation, most smaller businesses have health plans that renew at the end of the year, but some have plans that begin at any time. Companies with open enrollments in the fall, he said, would start hearing soon, if not already, so they could decide what to do.
According to federal data, insurers selling small group plans to employers with 50 or fewer employees in Minnesota have requested rate increases ranging from 2% to 15% for 2023.
Rate increases for the small group market in Florida have ranged from about 4% to nearly 12%. In New York, insurers are requesting rate increases ranging from 11% to 46% for various plans.
According to Moody's Investors Service, because small businesses are not required by the ACA to provide health insurance, rising rates increase the risk that some will drop coverage.
The Biden administration is preparing for open enrollment by awarding $98.9 million in grants to navigators who assist people in signing up for health insurance through the Affordable Care Act.
According to health-insurance experts, if the administration ends the pandemic public-health emergency in 2023, enrollment in ACA plans could skyrocket. During the declaration, the process of determining whether current enrollees are still eligible for Medicaid was halted. Millions of people are expected to lose Medicaid coverage once eligibility checks resume.
The current public health emergency is set to end on October 13, and the Health and Human Services Department has stated that it will provide states with 60 days' notice before calling it off. So far, some state officials have stated that they have received no notification.