Rate Actions Taken by New York’s Department of Financial Services Will Save New Yorkers $607 Million in 2022

New Yorkers who buy health insurance in the individual market will see premiums go up by an average of 9.7% in 2023. Health plans originally requested an average increase of 18.7%, but this was reduced by almost half through New York’s prior approval process. The table below shows the plan’s requests and the rates that were approved. (You can find our comments on each rate request here.)

Prior approval is an important tool—the reduction will save consumers an estimated $167.1 million. However, for consumers, a 9.7% rate increase is still too high. New York should do more to protect consumers from premium increases outside of the rate review process. For example, Connecticut, Delaware, Massachusetts, Nevada, New Jersey, Oregon, Rhode Island, and Washington State have Health Care Cost Containment task forces or agencies. California created an Office of Health Care Affordability in its most recent state budget.

Are you worried about affording health insurance? Most New Yorkers who buy their own health insurance receive subsidies to help pay their premiums. You can explore your options at the NY State of Health enrollment site. You can also get free help switching plans or enrolling in affordable health insurance through the Navigator program by calling 888-614-5400 or emailing enroll@cssny.org.

2023 Individual Market Rate Changes
PlanRequested IncreaseApproved IncreaseChange
Emblem/HIP34.6%9.0%-11.9%
CDPHP28.4%16.5%-25.6%
NYQHC/Fidelis23.2%12.4%-10.8%
Highmark20.5%12.8%-7.7%
MVP19.2%10.1%-9.1%
Unitedhealthcare16.1%9.2%-6.9%
Oscar14.6%6.5%-8.1%
Excellus14.0%10.0%-4.0%
Healthfirst13.0%8.3%-4.7%
MetroPlus13.0%8.1%-4.9%
Independent Health10.2%6.1%-4.1%
HealthPlus (previously Empire)6.9%0.5%-6.4%
Overall18.7%9.7%-9.0%

New York’s individual market premiums might increase by an eye-popping average 19 percent in 2023, far surpassing the requests coming in from carriers in other states. Washington and Michigan are proposing increases of just 7%, despite having comparable individual markets.

Rate increases mean New Yorkers would spend a greater share of their budget on health care and less on food, transportation and other necessities – right as New York faces yet another surge in COVID cases and the U.S. teeters on a possible recession. New York insurance carriers have not offered adequate justification to support their big requested price hikes.

In our comments, HCFANY breaks down why DFS should curb rate requests to protect patients from another unaffordable increase in health care costs. Find your carrier in the list below to see what we had to say.

The public comment period is still open! Tell the State how higher health care costs would impact you here.

You can also tell DFS Superintendent Adrienne Harris or Deputy Superintendent John Powell to lower rates by sharing the below on social media and tagging @NYDFS:

New Yorkers pay enough for health care. Tell @NYDFS to stop premiums from getting even higher, especially during a pandemic + possible recession: on.ny.gov/3ag1yEn  



[Avg Premium Increase Graphic – Click to Download]
On average, NY health premiums could increase by an eye-popping *19%* in 2023. Similar states are proposing increases of just 7%.

Would you be paying more for one of these plans next year? Tell @NYDFS: on.ny.gov/3ag1yEn  



[All Increases Graphic – Click to Download]

Despite reporting record profits during the pandemic, all of New York’s 12 individual market insurance companies plan to increase premiums in 2023. 

Costs could increase by a whopping 19 percent on average, meaning New Yorkers would spend a greater share of their budget on health care and less on food, transportation and other necessities – right as the U.S. teeters on a possible recession. Exact numbers vary by health plan, with Emblem (Health Insurance Plan of Greater New York) planning the largest increase at 35 percent.

There is still time to tell New York to prevent these unnecessary jumps in health care costs. Tell the State how higher health care costs would impact you by leaving a public comment here by July 1.

The Department of Financial Services released its final 2022 rate decisions today, and once again our prior approval law has resulted in huge savings for New Yorkers. Individual market insurers requested an average premium increase of 11.2% this year. After reviewing their requests, DFS knocked that down to just 3.7%, a 67% decrease! That means consumers will save over $138 million in 2022. Small group plans requested an average rate increase of 14%, which was reduced to 7.6%. That reduction will save small business owners over $468 million in 2022.

In the individual market the biggest reductions were for Healthfirst (from a requested increase of 34.4% to an approved increase of 9.7%) and Highmark Western and Northeastern NY (from a requested increase of 18.1% to an approved increase 6.2%. Three plans will lower their rates in 2022: IHBC by 4.4%, MetroPlus by 3.9%, and Fidelis (by 0.1%). These final rates are an average across all the individual plans offered by each carrier.

“Prior approval” means that insurers submit requests to state regulators explaining what they plan to charge next year. The Department’s job is keeping premiums as low as possible while making sure that plans stay solvent. The rate applications include information on the plans’ costs during the current year (though this year they used 2019 data because 2020 was such an outlier) and assumptions the plans have about costs next year. DFS looks at this data and especially at the assumptions plans make to see if they are in line with other sources. For example, the plans provide an estimate of medical trend. Medical trend is the change in what plans spend on health services for members each year due to changes in prices for those services and how often members receive health care. DFS frequently disallows trend estimates that are too high with no justification. DFS has also capped profit in the past to keep rates down. For example, last year it capped profit at 0.5% for all plans.

Prior approval in New York is a public process and members of the public are able to submit comments on the rate requests. You can read our comments on each plan’s request here. This year, many commenters talked about the financial difficulties they are experiencing because of the pandemic. Others talked about paying higher premiums every year but struggling to find doctors and receive care. Some asked why costs aren’t going down given cheaper ways of providing care like telemedicine or the new customers plans will get in 2022 because of the American Rescue Plan’s higher premium subsidies. You can find your individual market plan and the public’s comments on it at these links: