My state, rates, and ACA

What goes on with rate planning? When rates are raised — as health insurance rates inevitably are — there rises a chorus along the lines of “THANKS, OBAMA.”

In May 2016, lawmakers in Missouri unanimously passed SB 865, and (–outgoing–) Governor Nixon signed it in early July. The new law calls for numerous changes in the state’s health care systems, including added transparency for health insurance rates.

Missouri is currently one of four states without an effective rate review process for ACA-compliant plans (there were five until April 2016, when Alabama implemented an effective rate review process). State regulators do not take an active role in reviewing proposed rates, and the Missouri Department of Insurance does not currently have access to the rate filings at all. The federal government (specifically, CCIIO – the Center for Consumer Information and Insurance Oversight) conducts the rate review process forMissouri, and rates are published on’s rate review page.

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and, from the same source:

“The federal government can determine whether proposed rates in the state are justified, but they cannot prevent insurers from implementing unjustified rates.”

Also, this:

“According to’s rate review tool, final rate changes for 2016 in Missouri’s exchange were as follows:

  • All Savers (UnitedHealthcare): 9.9 percent average increase
  • Blue Cross Blue Shield of Kansas City: average rate increases range from 8 percent to 12 percent
  • Cigna: decrease of 2.01 percent.
  • Coventry: average rate increases range from 20 percent to 30 percent (modified somewhat during the rate review process)
  • Healthy Alliance Life: 9.77 percent (MSP) and 9.98 percent
  • Humana: 14.81 percent (PPOx)

According to Milliman data, the total number of participating carriers – six – is unchanged from 2015 (although it’s an increase from 2014, when there were only four participating insurers).”

And 2017?

The four carriers that offer plans through the Missouri exchange had the following average rate increases for 2017:

  • Blue Cross Blue Shield of Kansas City (Blue KC): 40.7 percent (increase would have been even higher, but hospitals agreed to lower payments in 2017 as part of their contract negotiations)
  • Cigna: 9.1 percent
  • Healthy Alliance Life (Anthem BCBS): 20.13 percent
  • Humana: 34.9 percent

Way to go, (non profit) Blue KC. (CEO Dannette Wilson earned $1.4 million in 2015, base pay !$600,000 and ~$800,000 in bonuses and other pay, a raise of 19% from the previous year).


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