CHIA found that, overall, the individual purchaser market segment experienced decreases in average premiums (-3.4%) and cost-sharing (-8.0%) between 2015 and 2016. CHIA also found that unsubsidized plans experienced higher premium growth and larger cost-sharing increases than ConnectorCare Plan. (State’s subsidized health insurance exchange.)
…Overall financial trends for individual purchasers were
driven, in large part, by enrollment growth in ConnectorCare plans with lower
premiums.Between 2015 and 2016, enrollment in unsubsidized individual
plans in Massachusetts increased by 6.5% to over 97,000 members, while
ConnectorCare enrollment grew by 51.4% to nearly 170,000 members
Enrollment and cost trends for individual plans purchased outside
the employer-sponsored insurance system reflect a combination of
individual purchasing decisions, population health characteristics, policy
and regulatory measures, and broader trends in health care spending.
Between 2015 and 2016, unsubsidized individual plan premiums grew
more slowly than the statewide average premium, and ConnectorCare
premiums actually decreased. For unsubsidized plan members, modest
premium growth was offset by increased cost-sharing obligations.
Members enrolled in ConnectorCare plans would have experienced higher
cost-sharing were it not for subsidies that preserved low out-of-pocket
spending. In the coming years these trends will be challenged by the
discontinuation of CSR subsidies in late 2017 and other potential changes
at the federal level. which may have a substantial effect on enrollment,
premiums, and cost-sharing for individual purchasers, depending on how
states offset these changes.