- Vermont residents who buy private health insurance through the state's marketplace could face sharp increases next year in the premiums they pay. Insurers MVP Health Care and Blue Cross Blue Shield of Vermont are asking the state to approve the boosts, with both citing medical and drug cost pressures.
- MVP Health Care has asked state regulators to sign off on a 17% average rate increase for individual and family plans offered in 2023 through the Vermont Health Connect marketplace. Blue Cross Blue Shield of Vermont is seeking a 12% jump, according to its recent filing with the state.
- For small businesses that buy insurance coverage for their employees through Vermont's exchange, MVP proposed an average premium rate boost of nearly 17%, while Blue Cross Blue Shield of Vermont asked for an average increase of about 13%.
The proposed rate increases in Vermont underscore the variability in marketplace plan costs across states, at a time when Affordable Care Act premiums overall have been declining. The average premium for ACA marketplace coverage fell nearly 2% in 2022, the third consecutive yearly decrease, according to a recent Urban Institute analysis funded by the Robert Wood Johnson Foundation.
The report said many of the states with higher premiums, including Vermont, were smaller and had less competitive insurance markets.
A record 14.5 million people are enrolled in insurance coverage through the ACA marketplace this year, as federal relief funds helped make exchange plans more affordable, according to the CMS. Of that total, about 10.3 million Americans use the federal Healthcare.gov online exchange, with the remainder enrolled in state marketplace plans.
Blue Cross Blue Shield pointed to hospital and prescription drug expenses, particularly the price of life-saving specialty drugs, as the two biggest pressures on the cost of healthcare in Vermont. "When these costs are brought under control, premiums will closely follow," the insurer told state regulators.
Hospital budgets are rising as facilities in Vermont continue to struggle to cope with the COVID-19 pandemic, Blue Cross Blue Shield said.
MVP, however, said it is assuming the cost and use of services related to COVID-19 will decline in 2023, shaving about 1% from premiums for individuals from small group premiums. Still, MVP sought rate increases ranging from 10% to 24% in the individual market and from 9% to 20% for its small group coverage.
Blue Cross Blue Shield asked for premium rate increases ranging from about 10% to 16% in both its individual market and small group plans.
Blue Cross said the proposed increases for its individual plans were reduced by 2% because of its efforts to verify that services are billed correctly and fairly, programs to lower prescription drug costs for its members and required changes in cost-sharing aspects of the plans.
For small group plans, billing verification and drug cost containment efforts decreased the rate request by 1.3%, but cost-sharing changes bumped up member premiums by 0.3%, Blue Cross said. It launched Vermont Blue Rx last year, which works to reduce members' drug costs for both individual and small group plans.
More than 16,000 Blue Cross Blue Shield of Vermont members are enrolled in individual plans that would be affected by the rate hikes. Another 19,000-plus Vermonters are enrolled in Blue Cross small group plans.
MVP insures more than 15,000 people in individual plans and nearly 21,000 in small group plans.
Vermont's Green Mountain Care Board is expected to make a decision in early August on both the Blue Cross and MVP Health Care rate proposals, following a public comment period that ends July 21. For the 2022 plan year, the board approved reduced MVP and Blue Cross rate proposals before approval.