Health insurers in New York are asking for rate increases again this year: in the individual market an average of 8.4 percent and in the small group market, an average of 12 percent. UnitedHealthcare of New York asked for the biggest increase in the individual market (27.1 percent), while HealthPlus (Empire) asked for the smallest (2.4 percent).
In New York, insurance premium changes in the individual, small group, and Medicare Advantage markets are subject to prior approval. That means the state has to review their justifications and decide if they are asking for a reasonable change. The data provided to the Department of Financial Services, which regulates health insurance in New York, are available publicly and the public is able to post their own comments. HCFANY submits comments each year assessing whether or not the carriers are asking for reasonable changes. If not, we ask the Department of Financial Services to reject their requests. You can see the letters we wrote last year here. DFS wants to hear from you, too! You can find a guide for submitting your own comments here. The comments are due by June 28 – you can find your insurance company’s application here.
The requests are much smaller this year in the individual market than they were last year. This reflects the success insurers had in 2018. Nationally, this was the most successful year yet for the individual insurance marketplaces created by the Affordable Care Act (ACA). The ACA remains in place despite federal efforts to sabotage the law – and states like New York have worked hard to counteract that sabotage, which creates a more stable environment for insurers.
One sign of this success is that insurance companies owe customers about $800 million in rebates because their medical costs were so much lower than the premiums they collected. The ACA requires them to spend at least 80 percent of their income on medical services – instead, they only spent 70 percent. The average medical loss ratio for the major carriers applying in New York was 85.4 percent, just above the state’s minimum of 82 percent. Four New York carriers failed to meet the state threshold.
Even though the request is smaller than past requests, it is hard for consumers to manage any premium increase. New Yorkers increasingly report that they cannot afford health care, even when they buy insurance. Many New Yorkers get assistance with insurance premiums through the Affordable Care Act and so won’t be affected – but those that don’t get assistance cannot manage another increase. Your voice matters in New York – while the Department’s decisions must be based on the information provided by the insurers, your stories about managing (or not managing) premium increases over the past few years add valuable information to public discussions about health care in New York. New York will only develop good solutions to our affordability crisis by listening to all voices – we need to hear from you!
 Cynthia Cox, Rachel Fehr, and Larry Levitt, “Individual Insurance Market Performance in 2018,” Kaiser Family Foundation, May 7, 2019, https://www.kff.org/private-insurance/issue-brief/individual-insurance-market-performance-in-2018