Published September 27, 2017|20 min read
While the Affordable Care Act introduced a lot of consumer protections for health insurance shoppers, it doesn’t stop health insurance from being a moving target. What do we mean by that? Health insurance plans change every year – from premium changes to network changes – and health insurance companies are constantly exiting and re-entering the state exchanges.
That’s why we put together this list of the biggest changes coming to your state for the 2017 health insurance open enrollment period: which carriers are coming and going, how costs are going to increase (or decrease), and any new laws that may change how you experience healthcare and health insurance. Many insurers are losing money with their exchange plans, leading directly to carriers both small and large exiting the marketplace completely. For the carriers that are left, expect large premium increases as insurers attempt to make their plans profitable, or at least break even.
Of the three carriers who offered health insurance plans on the Alabama exchange in 2016, only one will remain for 2017: Blue Cross Blue Shield of Alabama, the carrier that already covers the majority of exchange enrollees in Alabama. Humana and UnitedHealthcare, the other two carriers, are officially exiting the marketplace at the end of 2016.
While the lack of choice is concerning, it does make figuring out the year-over-year premium changes easier: Blue Cross Blue Shield of Alabama has filed for premium increases that average 36.1% across all of their plans, down from their original request of 39%.
Alaska is one of the three states left with just one health insurance company on the marketplace in 2017. Premera will be the only option for exchange enrollees in Alaska next year.
Premera proposed a premium increase of 9.8% for 2017 plans, a much lower increase than their previous increases and their original 2017 estimate of up to 42%. As many Alaskans know, health insurance costs are much higher in Alaska than in other states – monthly premiums in Alaska are approximately twice as much as the nationwide average premium. To help curb the increasing rates, Alaska passed a law in July 2016 that set up a reinsurance fund to help insurers pay for high-risk residents.
This bill will stay in effect for two years; during this time, the Alaska legislature is working on a broader plan to help prevent the collapse of the Alaska exchange.
Three carriers will be offering plans on the Arizona marketplace in 2017: Blue Cross Blue Shield of Arizona, Health Net, and Ambetter. However, for the vast majority of counties, the only plans available will be from Blue Cross Blue Shield. Residents of Maricopa and Pima counties will have access to plans from Ambetter; in addition to those plans, Pima county residents will have access to Health Net plans. Blue Cross Blue Shield is only offering Catastrophic plans in Pima county.
While there was some fretting over whether or not Pinal County would have a marketplace plan in 2017, Blue Cross Blue Shield has decided to sell plans in that region.
Across all plans offered in Arizona – both on-exchange and off-exchange – the average premium rate increase for 2017 will be 49%. This number does not take into account people shopping around for new plans, which will likely reduce the overall rate increase.
Arkansas is losing UnitedHealthcare plans at the end of 2016, leaving four options in the Arkansas exchange: Blue Cross Blue Shield, Ambetter, QualChoice, and QCA Health Plan. The average premium increase in Arkansas will be between 4% and 13.6%, depending on your current carrier and whether or not you choose to shop around.
Arkansas is building a state-based exchange for 2017, however, they will still be using Healthcare.gov as the front-end of their state exchange.
In 2017, the average premium increase for a health insurance policy in the state of California will be 13.2%.
New for 2017, enrollees in PPO plans will be required to choose a primary care physician within 60 days of their plan going into effect. While common practice for enrollees in HMO plans, this is new for PPO plans. This does not affect PPO members’ freedom to see a specialist doctor without a referral.
Health insurers will now be required to provide tools that will help consumers view provider specific cost shares and quality information for inpatient, outpatient, ambulatory services, and prescription drugs.
California also enacted several new rules for plans to help primary care physicians track their patients’ overall health, including information sharing protocols between physicians and hospitals.
Colorado’s health insurance premiums will increase by 17.65%, including both on- and off-exchange plans. Both Humana and UnitedHealthcare are exiting the Colorado market, impacting about 20,000 current policyholders. However, a new health insurer, Bright Health, is entering the Colorado marketplace. Bright Health does not currently offer plans in any other state, nor will they in 2017.
Connecticut is losing 50% of their carriers in 2017, leaving residents with only two options: ConnectiCare and Anthem. On average, ConnectiCare premiums will increase 17.4% and Anthem premiums will increase 22.4%.
HealthyCT, the state co-op, will shut down at the end of 2016. This affects approximately 11,000 existing policyholders. UnitedHealthcare is exiting the Connecticut exchange, as it is in many other states, leaving an additional 1,500 existing policyholders without 2017 coverage.
Two companies will offer health insurance plans through the Delaware exchange: Aetna and Blue Cross Blue Shield. Their proposed premium increases for 2017 are approximately 30% (weighted average by market share). It’s likely that the majority of exchange enrollees will not feel the effects of these rate increases, however – 85% of exchange enrollees received a subsidy in 2016.
No insurers are leaving DC Health Link, the health insurance exchange for residents of the District of Columbia. On average, premiums will increase around 7%.
UnitedHealthcare will not provide individual plans on the Florida marketplace in 2017. Additionally, Aetna is leaving the Florida marketplace entirely. After pulling out of the Florida marketplace in 2015, Cigna will be back for the 2017 open enrollment period. Many of Florida’s counties outside of the Miami, Tampa, and Orlando metro areas will only have one or two carriers on the exchange for 2017.
Premiums are expected to increase about 19% on average.
As of April 2016, the practice of balance billing – when healthcare providers charge patients the difference between what they charge and what health insurers reimburse them – is illegal in situations where the hospital or urgent care facility is in-network but the patient does not have the ability to choose a participating provider at the facility. The most common example of this is during a surgery – your surgeon may be in-network, but the anesthesiologist might not be. The hospital would then charge you full price for the anesthesiologist’s services. Because you don’t have a choice of anesthesiologists, hospitals will no longer be able to charge you in this instance (and others like it) in the future.
Three major health insurance carriers, UnitedHealthcare, Cigna, and Aetna, are exiting the Georgia exchange at the end of 2016. Blue Cross Blue Shield of Georgia will be the only carrier offering coverage in every county in Georgia.
Premiums in Georgia are set to increase, on average, around 27%.
For 2017, Hawaii is officially switching over to Healthcare.gov. This is expected to have minimal impact on consumers, as Hawaii has been using Healthcare.gov as their marketplace back-end since 2015. Two carriers will offer plans in 2017: Hawaii Medical Service Association and the Kaiser Foundation. On average, health insurance premiums will increase about 35% in 2017.
Idaho has five carriers offering plans in 2017: Blue Cross of Idaho, BridgeSpan, Mountain Health Co-op, SelectHealth, and Pacific Source. On average, premiums will increase approximately 24%.
Aetna and UnitedHealthcare are leaving the health insurance marketplace in Illinois at the end of 2016. In addition to those exits, Land of Lincoln Health, a health insurance co-op, closed down at the end of September 2016.
The average rate increase for 2017, weighted by the market share of the insurer, will be 43.91%.
In good news, Cigna is joining the Illinois health insurance exchange in the Chicago area.
Land of Lincoln co-op members qualify for a special enrollment period up until the beginning of 2017 open enrollment.
Of the eight carriers who offered health insurance plans on the Indiana exchange last year, only four will offer plans in 2017: Anthem Blue Cross Blue Shield, CareSource Indiana, Celtic, and MDwise. While three insurers are increasing their premiums in 2017 (an average of 18%), Celtic is actually decreasing their premiums by 5.3%.
If you’re an Indiana resident with a marketplace plan from UnitedHealthcare, Southeastern Indiana Health Organization, Physicians Health Plan, and Indiana University Health Plans, you’ll need to shop for new coverage in 2017.
Like other states in the nation, Iowa is losing UnitedHealthcare from their exchange in 2017. Fortunately for Iowans, they’re gaining Wellmark Blue Cross Blue Shield. The average premium increase in Iowa will be about 28% in 2017.
Two Blue Cross Blue Shield entities and Medica are offering health insurance plans on the Kansas exchange in 2017. Medica is new to the exchange; BCBS of Kansas Solutions are increasing their premiums by 47% and BSBS of Kansas City are increasing their premiums by 28%.
Kansas passed a law in April 2016 allowing health insurance carriers to offer EPO plans, with the goal being to create plans with cheaper premiums for Kansas citizens.
Kentucky’s state-run marketplace, Kynect, was dismantled via executive order by newly elected governor Matt Bevin. Starting with the 2017 open enrollment period, Kentucky residents will use Healthcare.gov to sign up for health insurance plans. Because of this transition, you may experience some technical difficulties signing up for health insurance.
Aetna, WellCare, Baptist Health, and UnitedHealthcare are leaving the Kentucky marketplace in 2017. On-exchange plans will be offered by Anthem Health Plans of KY, CareSource, and Humana. The average premium increase for their marketplace plans will be about 24%.
Around 13% of Louisiana’s exchange enrollees will lose their health insurance company next year, as UnitedHealthcare is exiting the marketplace. During the 2017 open enrollment period, they’ll have to pick from plans offered by Blue Cross Blue Shield of Louisiana, HMO Louisiana, Humana, and Vantage Health Plan. On average, premiums in Louisiana are expected to rise around 27%.
Maine has three health insurers offering plans on the exchange in 2017: Anthem, Community Health Options, and Harvard Pilgrim HMOs. (Harvard Pilgrim also offers a PPO plan off-exchange, and Aetna offers off-exchange plans as well.) Premiums for on-exchange plans will rise, on average, about 24%.
The most important thing that Maryland residents need to know about the 2017 open enrollment period is that Maryland Health Connection, the Maryland state exchange, now has an app. The app will allow you to shop for and compare plans, as well as show you your eligibility for premium tax credits.
The five health insurance carriers offering plans on the Maryland exchange are CareFirst BlueChoice, CareFirst Blue Cross Blue Shield, Cigna, Evergreen, and Kaiser Permanente. Premiums across all individual health insurance plans are increasing, on average, 25%.
There are eleven carriers offering plans on the Massachusetts exchange for 2017: Ambetter, Blue Cross Blue Shield of Massachusetts, BCBS HMO Blue, Boston Medical Center HealthNet Plan, Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, Minuteman Health, Neighborhood Health Plan, Tufts HMO, and Tufts Insurance Company.
Premiums will increase about 7.5% for the average person, using a weighted average based on market share.
Two health insurance companies are leaving the Michigan marketplace at the end of 2016: Priority Health Insurance Company (PPO plans) and UnitedHealthcare. Twelve health insurance carriers remain in Michigan, leaving Michigan residents with a wide variety of health insurance plans to choose from. The weighted average premium increase will be 16.59%.
There will be four carriers offering plans on MNsure, Minnesota’s state health insurance exchange, in 2017: Blue Plus, HealthPartners, Medica, and UCare. Premiums are expected to rise significantly: on average, 56.6% across all carriers. This significant increase does mean that subsidies will rise, offsetting some of the increased cost.
All carriers, with the exception of Blue Plus, are limiting their total 2017 enrollment. This is being done to curb the potential financial effects of absorbing Blue Cross Blue Shield customers who will need to re-shop for health insurance after BCBS leaves the market. Minnesota Commerce Commissioner Mike Rothman stressed that everyone in Minnesota who shops through MNsure or a third-party will receive health insurance – it just may not be from the provider you would’ve preferred. In Minnesota, it will be crucial to shop early to guarantee a spot with your preferred provider.
UnitedHealthcare is exiting the Mississippi marketplace at the end of 2016. UnitedHealthcare was the only insurer to offer plans in every Mississippi county. Mississippi residents will have a choice between Humana or Ambetter (Magnolia Health). Using a weighted average, premiums are expected to increase around 16% across these two carriers.
UnitedHealthcare will no longer offer health insurance plans in Missouri as of the end of 2016. Aetna is also leaving the Missouri marketplace, but will continue to offer plans off the exchange. Most counties in Missouri will only have one choice of carrier for 2017, unless they look off-exchange. The average premium is expected to increase around 16%.
Starting next year, Missouri will start collecting and reviewing rate increase proposals from health insurance companies, a practice that they currently have no participation in. Expect to see more news about this for the 2018 open enrollment period.
No carriers are leaving the Montana marketplace for 2017, but rates are expected to increase dramatically, especially for Blue Cross Blue Shield customers. Premium increases for BCBS plans range from 40% on the low end to 108% on the high end, for an average increase of 62%. (The weighted average premium increase across all carriers is almost 50%.)
This increase shocked the Montana Insurance Commissioner, so much so that she called a public hearing to discuss BCBS’ proposed premiums. It should be noted, however, that even states that review premium increase requests do not actually have the power to force insurance companies to change their final premiums.
Both UnitedHealthcare and Blue Cross Blue Shield are leaving the Nebraska exchange at the end of 2016, leaving just Medica and Aetna to cover Nebraska residents. Premiums are expected to increase almost 35%, on average, across these two carriers.
All of the carriers who offered plans in 2016 are coming back to Nevada Health Link for 2017 – even UnitedHealthcare, which is exiting the marketplace in most of the other states where it previously offered plans. Premiums for marketplace plans will increase almost 11% across all carriers.
Four carriers will offer health insurance through the New Hampshire exchange in 2017: Ambetter, Anthem, Harvard Pilgrim Health Care, and Minuteman Health. Premiums are expected to increase anywhere between 4 and 60%, depending on your plan. Plans offered by Minuteman Health are expected to increase in price most dramatically – anywhere between 25 and 60%.
Three carriers are exiting the New Jersey exchange at the end of 2016: Health Republic Insurance of New Jersey, UnitedHealthcare, and Oscar. This leaves just AmeriHealth and Horizon Blue Cross Blue Shield selling health insurance on the New Jersey exchange. Premiums for both on- and off-exchange plans are expected to increase around 9%. Off-exchange plans from Oxford Health Insurance Company, Aetna, and Cigna will be available.
Good news and bad news for New Mexico residents: While Blue Cross Blue Shield of New Mexico is returning to beWellnm, the New Mexico health insurance exchange, Presbyterian Health Plan will no longer offer on-exchange plans. Presbyterian plans will still be available off-exchange.
On average, New Mexicans can expect a premium increase of about 39% across all carriers – this number is skewed somewhat, however, as BCBS’ increase is based on 2015 premiums, not 2016 premiums.
In 2017, the average premium increase for a health insurance policy in the state of New York is expected to be 17.3%. This includes both on and off-exchange plans.
New York passed a law this year that allows the beginning of a pregnancy to act as a qualifying event for a Special Enrollment Period. At the federal level, only the birth of a baby qualifies women for a Special Enrollment Period, not the beginning of the pregnancy.
Additionally, victims of domestic violence or spousal abandonment, along with dependent children, qualify for Special Enrollment Periods.
Despite talk that they may leave the exchange, Blue Cross Blue Shield of North Carolina will continue to offer plans statewide in North Carolina for 2017. BCBS customers should expect their premiums to increase, on average, around 24.3%.
UnitedHealthcare is leaving the North Carolina marketplace at the end of 2016, as is Aetna. Cigna will offer plans for some counties near Raleigh and Durham.
Good news for many North Dakota residents: Blue Cross Blue Shield of North Dakota, the health insurer with the most enrollees in North Dakota by far, will decrease their premiums by 1.57% averaged out across all of their plans. This means that the majority of North Dakota residents who enrolled in health insurance through the exchange will pay less for health insurance in 2017 than they did in 2016.
Medica and Sanford, the two other health insurers in North Dakota, are, on average, increasing their premiums by 14.3% and 7.85%, respectively.
Three carriers who offered plans on the exchange in 2016 are exiting the Ohio marketplace at the end of the year: InHealth Mutual, Aetna, and All Savers (UnitedHealthcare).
Healthspan has been purchased by Medical Mutual, and Healthspan members will be automatically enrolled in Medical Mutual coverage if they do not choose another plan during open enrollment.
Premiums in Ohio are expected to increase 12.6%, on average. Members of Buckeye Community Health Plan will actually see a slight decrease over last year of anywhere between .79% and 1.14%.
UnitedHealthcare is exiting the Oklahoma marketplace, leaving Blue Cross Blue Shield of Oklahoma the only health insurance carrier left on the exchange. BCBS are increasing the premiums on their plans by 76%, on average.
Two carriers are exiting the Oregon exchange at the end of 2016: LifeWise Health Plan and Trillium. Additionally, Oregon Health Co-op shut down as of July 31 of 2016. Seven carriers will be left on the exchange for 2017, though many of them are decreasing their coverage areas, which may lead to less choice in your specific county.
Premiums are expected to increase 24.22% across all carriers (weighted average based on market share).
UnitedHealthcare will no longer offer health insurance on the Pennsylvania exchange as of the end of 2016. The approximate average rate increase for 2017 across Pennsylvania’s remaining insurers will be 23.6%.
UnitedHealthcare is exiting HealthSource RI, the Rhode Island health insurance exchange, at the end of 2016. There are two carriers remaining on the marketplace: Blue Cross Blue Shield of Rhode Island and Neighborhood Health Plan of Rhode Island. BCBS is increasing the price of their plans by 5.9%, while Neighborhood Health is decreasing the price of their plans by 5.9%.
There will only be one carrier on the exchange in South Carolina for 2017. UnitedHealthcare, Coventry (Aetna), and BlueChoice, a subsidiary of Blue Cross Blue Shield, are exiting the exchange as of the end of 2016. Blue Cross Blue Shield will continue to offer plans statewide, with prices increasing approximately 14%.
South Dakota has two carriers on the exchange in 2017: Avera and Sanford. Premiums for on-exchange plans are expected to increase about 37%, on average, across those two carriers. Wellmark and DakotaCare will continue offering off-exchange plans.
UnitedHealthcare is exiting the Tennessee marketplace at the end of 2016. Blue Cross Blue Shield of Tennessee will exit Knoxville, Nashville, Memphis, and their respective metro areas, but still offer plans in rural counties. Over 100,000 exchange enrollees in those metro areas who were BCBS customers will have to find new coverage. Health insurance premiums in Tennessee will increase approximately 56%.
In 2017, the average premium increase for a health insurance policy in the state of Texas will be 35%. This includes both on and off-exchange plans. Premium subsidies are expected to cover much of the rate increase; as of the 2016 open enrollment period, 84% of people who enrolled in health insurance through the Texas exchange received a premium subsidy.
UnitedHealthcare is exiting the Texas exchange entirely at the end 2016. They will not offer individual off-exchange plans. Aetna is also exiting the exchange, but they will be offering off-exchange plans for individuals. Scott & White Health Plan are exiting the exchange, but will offer an off-exchange bronze plan for individuals.
Oscar is reducing their coverage in Texas – they’ll continue to offer plans in San Antonio, but are pulling out of the Dallas area.
Many insurers that are still offering on-exchange plans for 2017 are reducing PPO options. Blue Cross Blue Shield of Texas and Cigna are two health insurance companies that are completely discontinuing their on-exchange PPO plans for 2017.
Humana is exiting the individual health insurance market in Utah at the end of 2016. Molina, SelectHealth, and University of Utah Health Plans will continue to offer on-exchange plans in 2017. The average premium increase in Utah will be around 30%.
New to Vermont are "off-exchange" plans – individual health insurance plans that can be purchased outside of Vermont Health Connect, the official state exchange. These plans may give Vermonters more options when it comes to deciding on a new health insurance plan this winter. Premiums are expected to rise, on average, around 7%. Blue Cross Blue Shield of Vermont, which claims over 90% of the total health insurance market in Vermont, will increase their premiums by an average of 7.3% across all of their plans.
Virginia is one of their rare states where UnitedHealthcare will continue to offer plans on the exchange. Humana will be exiting the marketplace, however, at the end of 2016. Coventry customers will notice that they’re now Aetna customers; Aetna purchased Coventry in 2013, and the rebrand is now official in Virginia. Premiums are expected to increase 18.4% across all on-exchange plans (using a weighted average based on market share).
Nine carriers will offer plans on Washington Healthplanfinder, the official state exchange. UnitedHealthcare of Washington is leaving the exchange at the end of 2016, as is Health Alliance Northwest. Health Alliance Northwest will continue to offer off-exchange plans in 2017.
Premiums are expected to increase, on average, 13.5% across all carriers offering both on-exchange and off-exchange plans.
West Virginia residents will have two options on the exchange for 2017: Highmark Blue Cross Blue Shield and Caresource. These two companies requested premium increases of 31.82% and 49.8%, respectively. West Virginia’s premiums continue to be among some of the highest in the country, and while 88% of enrollees receive premium subsidies, many residents will feel the pain of these high premium increases in 2017.
Humana, UnitedHealthcare, and Ambetter are leaving Wisconsin entirely at the end of 2016, offering neither on-exchange nor off-exchange plans. Arise will leave the exchange in 2016, but still offer off-exchange plans. Children’s Community Health Plan is joining the exchange for 2017. While most plans are expected to increase their premiums anywhere between 5% and 40%, MercyCare is actually decreasing their rates by an average of 13%.
There’s only one carrier in Wyoming: Blue Cross Blue Shield of Wyoming. They’re expected to increase their premiums by 7.4%, averaged out across all of their plans.
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