DE Cites Delayed Care in 2022 Affordable Care Act Premium Boost

Highmark Blue Cross Blue Shield of Delaware is raising its 2022 Affordable Care Act premium, the state’s health insurance commissioner announced.

“Stability in the individual health insurance market is so critical as we continue to battle COVID-19 and healthcare shortages. Rates remain more than 15 percent lower than they were just a few years ago, and with the American Rescue Plan, they’re more affordable than ever before,” said Trinidad Navarro, insurance commissioner for the state of Delaware. “Coupled with the safety net of the SEP, the past year has been positive for insurance access.”

Highmark Blue Cross Blue Shield of Delaware is the state’s only Affordable Care Act health insurer for plan year 2022. It offers 12 health plans on the Affordable Care Act marketplace for individuals and families.

The base rate will be on average three percent higher than the 2021 rates. Although the rate is still lower in the context of Delaware rates historically for the past few years, it comes on the heels of two years of rate decreases. However, it is lower than the insurance commissioner’s initial projections of a four percent rate increase for 2022.

Delaware announced that nearly a quarter of new and returning Affordable Care Act marketplace enrollees in the state (23 percent) had access to a health plan that had a premium of $10 or less per month.

Still, the announcement signaled that overall insurance rates are increasing. The press release noted that this is a nationwide trend, not restricted to The First State, and attributed this to expected increases in healthcare utilization due to delayed care during the coronavirus pandemic.

Expanded access to healthcare coverage includes not only making coverage more affordable but potentially extending open enrollment periods and coverage opportunities as well.

Rates are rising in the small state, but many Delawareans will not feel the difference in their own finances. Nearly 5,400 Delawareans applied for Affordable Care Act coverage during the special enrollment period, more than twice the number of enrollees as the same period in 2020 and three times the normal enrollment levels for this timeframe.

The state also saw a surge in enrollment during open enrollment, receiving a five percent enrollment boost during the 2021 open enrollment period.

As a result of these factors, 30,000 people in a state with a population of around 974,000 have coverage through the Affordable Care Act marketplace.

“The SEP’s success has led to proposals at the federal level for permanent open enrollment expansion as well as monthly enrollment opportunities,” the press release shared.

Costs have been dropping on the Affordable Care Act marketplaces due to the American Rescue Plan Act which instituted significant, temporary subsidies for enrollees. These subsidies will stay in place through the end of 2022.

However, the press release is right to point to rising insurance rates as a nationwide trend. Not all of the states have filed their rates yet, but of those who have filed on the individual health insurance marketplace, the median proposed rate change for 2022 is 3.8 percent, according to a Peterson-Kaiser Family Foundation (KFF) Health System Tracker brief.

The brief also noted that most states that had filed at the time did not expect coronavirus-related healthcare spending to significantly influence their rates. Telehealth utilization, the No Surprises Act, and the American Rescue Plan Act subsidies were other factors that payers named as having an influence on their rate-setting decisions.

Employers have projected that healthcare spending on chronic disease management and mental health will spike in 2022, but that the overall medical cost trend will decline slightly next year from the projected 2021 trend.