Health Insurance: Premiums and Increases

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The increased cost of health insurance is a central fact in any discussion of health policy and health delivery.

In 2018 the average annual premium for employer-based family coverage rose 5{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} to $19,616 for single coverage, premiums rose 3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} to $6,896. Covered workers contributed 18{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} of the cost for single coverage and 29{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} of the cost for family coverage, on average, with considerable variation across firms.

By comparison, annual premiums for 2017 reached $18,764, up 3 percent from 2015 for an average family coverage with workers on average paying $5,714 towards the cost of their coverage, according to the Kaiser Employer Survey, October 2018 and 2017, applying to employer-based insurance.

For those Americans who are fully covered, these cost realities affect employers, both large and small, plus the “pocket-book impact” on ordinary families. For those buying insurance on an exchange or private market plan for 2018, the average increase with subsidies was $201. The 2019 policy premiums are now final and have more moderate averages increases, with some rate decreases. View 2019 rate filings below.

2019 Heath Insurance Premiums – Reports and resources

  • How ACA Marketplace Premiums Are Changing by County in 2019: Many low-income consumers who are eligible for federal financial help under the ACA can get a bronze-level plan and pay nothing out-of-pocket in premiums in more than 2,000 counties next year, depending on their annual income, according to a new analysis. But such plans can come with higher deductibles and out-of-pocket maximums. (View Issue Brief with interactive state maps. | Kaiser Family Foundation, 11/20/2018.
  • Health Exchanges: 2019 Average Monthly Premiums for Second-Lowest Cost Silver Plan and Lowest Cost Plan for States Using the Platform, 2016-2019.  The tables linked below indicate the average monthly premiums for the second-lowest cost silver plan (SLCSP) and lowest cost plan (LCP) across all 39 states using the using the platform, as well as state-level average SLCSP and LCP premiums. The premiums displayed are for a 27-year old single nonsmoker.
    ♦ State by state premiums- updated Oct 11, 2018 – posted by CMS. 
  • Updated Navigator Resource Guide  (Updated: November 2018): The Navigator Guide provides information on recent policy changes, a list of enrollment tools for consumers and assisters, and answers to hundreds of FAQs, ranging from questions about eligibility for marketplace subsidies to post-enrollment issues. The guide is a useful resource throughout the open enrollment season. You can access it online via the Georgetown University site.
  • Health Insurance Marketplace Calculator Updated for 2019: Health Insurance Marketplace Calculator, posted by Kaiser Family Foundation (KFF), now includes local data on the 2019 health plans being sold through the Affordable Care Act (ACA) marketplaces during the 2019 open enrollment period. With the tool, consumers around the nation can generate estimates of their health insurance premiums and what financial help may be available — based on household income, family size, ages of family members, and zip code — for ACA marketplace plans sold in their local area. The calculator also helps consumers determine whether they could be eligible for Medicaid.
         • A Spanish-language version of the calculator is also available. 
         • KFF also offers a searchable collection of more than 300 Frequently Asked Questions  about open enrollment, the marketplaces and the ACA. 
  • Search ACA-Compliant Products
  • Search Transitional Student Plans


    New December Report: Americans with Employer Health Coverage Face Growing Cost Burdens 
    U.S. workers and their families, especially those living in the South, are spending a bigger share of their income on health care, a new Commonwealth Fund study finds. Average employee premium contributions for single and family plans consumed nearly 7 percent of U.S. median income in 2017, up from 5 percent in 2008. In Louisiana, premium contributions represented 10.2 percent of median income. For Americans whose incomes fall in the midrange of the income distribution, total spending on employer plan premiums and potential out-of-pocket costs to meet deductibles amounted to 11.7 percent of income last year, up from 7.8 percent a decade earlier. 
    Full report by The Commonwealth Fund, 21 pp, PDF.


    Recent from HHS/CMS:

    Final 2017 Benefit Year Risk Adjustment Summary Report and accompanying issuer transfer reports. “CMS is announcing risk adjustment payments and charges for the 2017 benefit year as calculated under the HHS-operated risk adjustment methodology.” Full Report released by CMS | News Release Summary,  July 7, 2018.
    Summary Report on Permanent Risk Adjustment Transfers For the 2017 Benefit Year. Full report, for actuaries and state fiscal analysts, (36 pp, PDF) July 9, 2018 
    Analysis: “The Trump administration said July 7 that it was suspending a program that pays billions of dollars to insurers to stabilize health insurance markets under the Affordable Care Act, a freeze that could increase uncertainty in the markets and drive up premiums this fall. Many insurers that enroll large numbers of unhealthy people depend on the “risk adjustment” payments, which are intended to reduce the incentives for insurers to seek out healthy consumers and shun those with chronic illnesses and other pre-existing conditions.

    2018 Health Insurance Premiums – updated resources

    The information below generally applies to health insurance policies available for sale as of Nov. 1, 2017, that took effect for coverage Jan. 1, 2018 through Dec. 31, 2018.  Note that “average” prices listed may not reveal lowest costs or highest costs, so the effect on an individual or family often requires a closer look at individual plans.  The federal HHS-sponsored web site is intended to make this precise list-price information available to policymakers and the general public. Subsidies for those with annual income up to 400 percent of federal poverty can be calculated by those who are prepared to enter their confidential financial information.  

    Table : Monthly Silver Premiums and Financial Assistance for a 40 Year Old Non-Smoker Making $30,000 / Year

    California* Los Angeles $258 $289 12{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $51 $88 71{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Colorado Denver $313 $352 12{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $106 $150 42{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Connecticut Hartford $369 $417 13{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $162 $216 33{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    DC Washington $298 $324 9{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $91 $122 35{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Delaware Wilmington $423 $631 49{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $216 $430 99{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Georgia Atlanta $286 $308 7{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $79 $106 34{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Idaho Boise $348 $442 27{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $141 $241 70{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Indiana Indianapolis $286 $337 18{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $79 $135 72{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Maine Portland $341 $397 17{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $134 $196 46{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Maryland Baltimore $313 $392 25{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $106 $191 81{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Michigan* Detroit $237 $244 3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $29 $42 44{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Minnesota** Minneapolis $366 $383 5{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $159 $181 14{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    New Mexico Albuquerque $258 $346 34{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $51 $144 183{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    New York*** New York City $456 $504 10{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $249 $303 21{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Oregon Portland $312 $350 12{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $105 $149 42{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Pennsylvania Philadelphia $418 $515 23{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $211 $313 49{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Rhode Island Providence $261 $248 -5{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $54 $47 -13{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Tennessee Nashville $419 $507 21{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $212 $306 44{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Vermont Burlington $492 $491 0{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $285 $289 2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Virginia Richmond $296 $394 33{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $89 $193 117{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Washington Seattle $238 $306 29{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $207 $201 -3{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $31 $105 239{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    NOTES: *The 2018 premiums for MI and CA reflect the assumption that CSR payments will continue. **The 2018 premium for MN assumes no reinsurance. ***Empire has filed to offer on the individual market in New York in 2018 but has not made its rates public.
    SOURCE:  Kaiser Family Foundation analysis of premium data from and insurer rate filings to state regulators

    2017 Plan Year Premiums

    2016 Plan Year Premiums

    This report presents an analysis of changes in the premiums for the lowest- and second-lowest cost silver marketplace plans in major cities in 10 states plus the District of Columbia, where we were able to find complete data on rates for all insurers. It follows a similar approach to our September 2013 and 2014 analyses of Marketplace premiums.  In most of these 11 major cities, the authors find that the costs for the lowest and second-lowest cost silver plans – where the bulk of enrollees tend to migrate – are changing relatively modestly in 2016, although increases are generally bigger than in 2015. The cost of a benchmark silver plan in these cities is on average 4.4{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} higher in 2016 than in 2015.

    Benchmark premium changes in 2016 vary significantly across the cities, ranging from a decrease of 10.1{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} in Seattle, Washington to an increase of 16.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} in Portland, Oregon.

    2015 to 2016: Monthly Benchmark Silver Premiums for a 40 Year Old Non-Smoker Making $30,000 / Year
    State Rating Area
    (Major City)
    2nd Lowest Cost Silver Before Tax Credit 2nd Lowest Cost Silver After Tax Credit
    Connecticut 2 (Hartford) $322 $328 2.0{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $208 $208 0.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    DC 1 (Washington) $242 $248 2.8{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $208 $208 0.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Maine 1 (Portland) $282 $290 2.9{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $208 $208 0.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Maryland 1 (Baltimore) $235 $246 4.6{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $208 $208 0.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Michigan 1 (Detroit) $230 $226 -1.8{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $208 $208 0.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    New Mexico 1 (Albuquerque) $171 $190 11.0{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $171* $190* 11.0{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}*
    New York 4 (New York City) $372 $374 0.5{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $208 $208 0.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Oregon 1 (Portland) $213 $248 16.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $208 $208 0.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Vermont 1 (Burlington) $436 $476 9.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $208 $208 0.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Virginia 7 (Richmond) $260 $288 10.8{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $208 $208 0.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Washington 1 (Seattle) $254 $228 -10.1{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} $208 $208 0.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    Average {5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05} change from 2015     4.4{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}     1.2{5667a53774e7bc9e4190cccc01624aae270829869c681dac1da167613dca7d05}
    SOURCE: Kaiser Family Foundation analysis of 2016 insurer rate filings to state regulators.- Table 1
    NOTES: Rates are not yet final and subject to review by the state. Oregon rates reflect preliminary changes from the state. *Unsubsidized Albuquerque premiums are so low that a 40 year old making $30,000 per year would not qualify for a premium tax credit in 2016


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