US Health Insurance Market Annual Update
Annual US Health Insurance Market Update
As we approach the ACA/Obamacare open enrollment period for 2024 individual health insurance and the annual renewal for most small business group health plans, I am providing information regarding changes that are happening in the market in 2024 to help you get prepared to find the BEST possible health plan for your situation and needs.
I also know that if you are on an ACA/Obamacare individual plan you may have already received your current plan’s renewal information for next year, so I hope this also provides some context to the planned rate increases or decreases, plan changes and cancellations, etc. that you are seeing.
Below you will find updates and changes that are happening at the federal level as well as links to more information in the states where US Insurance Solutions is currently licensed. Click the link for your home state to get more information about what is happening where you live.
Please review this information and then, if you haven’t already done so, go to my online calendar (and at the bottom of this page) and set an appointment for us to talk about your options for next year.
General Update
In 2023 the focus of the current presidential administration has continued to be on expanding the ACA/Obamacare markets. Some of the key items included:
· Continuation of Enhanced Tax Credit Subsidies through 2025
· Monthly Special Enrollment Period (SEP) for people with incomes under 150% of the federal poverty level
· Fix of the “Family Glitch” for people with Employer coverage that is not affordable to their family
In 2024 the administration will continue their efforts to get more people into the ACA/Obamacare markets. However, this year the main change will come from a rule proposed to limit the term of Short Term Medical plans and possible changes to Fixed Benefit plans. See the following under the Alternative Health Plan Solutions Update for more information.
Another change by the administration will directly impact my efforts to work with clients on the federal marketplace by requiring agents and brokers to document consumers’ consent information. Because of this, I will be providing an online form to everyone I work with who buys coverage on the federal marketplace. This form indicates that each person gives their consent to work with me.
Alternative Health Plan Solutions Updates
As I have said the past two years, I have been anticipating that the Biden administration would propose a rule to limit the term of Short Term Medical plans to no more than 90 days nationwide. On July 7, 2023 that finally happened. The Departments of Health and Human Services, Labor, and Treasury published a proposed rule that would severely curb the utility of short-term, limited duration health insurance.
Under the new rules, plans that claim to be “short-term” health insurance would be limited to just three months, or a maximum of four months, if extended – instead of the current three-year maximum. And, under the proposed rules, plans are required to provide consumers with a clear disclaimer that explains the limits of their benefits, including to existing consumers currently enrolled in these plans.
IMPORTANT NOTE: While this rule will likely take effect around January 1, 2024, the one piece of good news is that it specifically states that anyone insured on a longer duration Short Term Medical plan prior to the rule taking effect will be allowed to keep that policy until the end of the term. So, for anyone interested in a Short Term Medical plan as part of their overall coverage, they can lock in coverage for up to 36 months, depending on the state where they live.
NEW OPTION: While Short Term Medical plans will be changing and won’t be a good long term option, I have recently come across a set of health plans that will work well for certain people in around 37 states. These plans are comprehensive coverage and compliant with ACA/Obamacare mandates. They also utilize a nationwide PPO network, so they offer a much better choice of providers than most ACA/Obamacare plans. All plans have a maximum out of pocket limit that will be $2,100 per year LESS than the maximum out of pocket for 2024 ACA/Obamacare plans. The standard rates for these plans are competitive with the full price without a subsidy on current, similar ACA/Obamacare plans for people in the 45-64 age range who do not qualify for a tax credit subsidy to purchase ACA/Obamacare plans.
I will be reaching out to current and former clients that I have identified who could benefit from changing to one of these plans. However, if you read this and you want to learn more about these plans, please reach out to me.
NOTE: All non-ACA/Obamacare alternative plans are available year-round. For both individuals and small groups. There is NO limited (open enrollment) period for these options.
Health Insurance Buffet – Alternative Individual Plans
As noted on our US Insurance Solutions home page, if you are looking for a better, more affordable individual/family health plan and make too much money to get a tax credit subsidy from the government, one of our NAHP alternative individual health plan solutions may be just what you need. Our Health Insurance Buffet program consists of the following:
NOTE: Given the above proposed rule, the Short Term Medical plans will remain in my Health Insurance Buffet program for the remainder of 2023 in the states where they are currently a good long-term option.
Primary (Main Course) plans – In addition to Short Term Medical*** plans that are available for up to 36 months in select states, our two main Fixed Benefit plan companies, Philadelphia American and Manhattan Life have each made significant upgrades to their plans in many states.
***Article: Short-Term Health Beats Individual Major Medical
Supplemental (Side Dish) plans – We also have expanded plan offerings and enhancements to available accident, critical illness and hospital indemnity plans. You can see many of these on our US Supplemental Coverage page.
Your Health Insurance “Plate” – We always work to provide you with the most comprehensive coverage we can offer to fit in your budget. We do that by combining the available Primary and Supplemental plans in your state into the best available package.
NOTE: All plans in our health insurance buffet require some level of health underwriting to be approved for coverage. For those who are approved, they do not cover pre-existing conditions for a minimum of 12 months after the enrollment date. Therefore, these plans are best suited for people without serious, ongoing health issues. We always evaluate each person’s situation to ensure we are recommending the best possible coverage.
Alternative Small Group Health Plans
If you own (or work for) a small business with under 50 employees, and meet certain criteria, one of our NAHP alternative group health plans could be a better option than an ACA/Obamacare, fully insured group health plan.
NOTE: We are seeing more companies that have traditionally offered fully insured small group plans offering alternative, Level Funded small group plan options.
Again, click on the link for your home state (below) to learn more about the alternative health plan changes and updates where you live.
On the other hand, for individuals who are eligible for a tax credit subsidy to help pay their premium and/or have significant health issues I can help find the best ACA/Obamacare individual plan.
Also, for small businesses who don’t have enough people for an alternative plan and/or have people with significant health issues in their group, I can help find the best fully insured ACA/Obamacare small group plan. Please review the following…
Federal ACA/Obamacare Changes
The following are some of the main changes and updates happening with ACA/Obamacare plans.
Individual Plans
Insurance companies participating in ACA/Obamacare individual markets:
For the first year in several years, it seems that the expansion by companies into the ACA/Obamacare markets is slowing down. I count two national companies expanding into new states and one leaving a few states. We also saw two companies, Friday Health and Bright Health exit all markets in 2023.
The following is information on the 2024 markets for most companies we represent.
Aetna – In 2024 Aetna will expand their list of states where they offer ACA/Obamacare plans. The current states are: AZ, CA, DE, GA, FL, MO, MD, NC, NJ, NV, TX and VA. The new states will include IN, KS, OH, MD and UT. They are also expanding in their existing markets, including more counties in Arizona, California, Florida, Georgia, Illinois, Missouri, New Jersey, Texas, and Southern Virginia.
Ambetter – Ambetter is in currently in 27 states. As of the end of September it appears that they will remain in the same states for 2024.
Cigna – In 2024 Cigna will be leaving Kansas and Missouri. They will now be in 14 states (AZ, CO, FL, GA, IL, IN, MS, NC, PA, TN, TX, SC, UT and VA). Check out the counties in each state where Cigna will offer coverage.
Medica – Medica currently offers their individual/family plans in 10 states.
Molina Healthcare – Molina currently offers their individual/family plans in 14 states (CA, FL, ID, IL, KY, MI, MS, NM, OH, SC, TX, UT, WA and WI). As of mid-September we have not heard about any expansion plans for 2024.
Oscar Insurance Corp – Oscar currently offers their individual ACA plans in the following states**: AZ, CA, FL, GA, KS, IA, IL, MI, MO, NJ, NC, NE, OH, OK (OKC), TN, TX, and VA. However, they plan to leave California in 2024.
United Healthcare – In 2023 the company offers plans in AL, AZ, CO, FL, GA, IL, KS, LA, MD, MI, MO, MS, NC, OH, OK, TN, TX, VA, and WA. In 2024, their footprint is expanding to four new states: New Jersey, New Mexico, South Carolina and Wisconsin.
US Health and Life Insurance/Ascension – In 2024 the company offers plans in IN, KS, MI, TN and TX. However, they will be exiting counties in each of those states.
**Not all markets in all states
Changes to out-of-pocket limits and deductibles:
For the ELEVENTH year in a row, the maximum deductible and out of pocket limits for ACA/Obamacare compliant plans are on the rise! The government sets a limit on how much these maximums can be. Family maximums can be twice as high as the maximum amount in a plan covering just one person (a “self-only plan”).
For 2024, the self-only maximum deductible and out of pocket limit can be up to $9,450 and the family maximum, up to $18,900.
For high-deductible plans that are compatible with Health Savings Accounts (HSAs) they are lower with limits up to $8,050 for individuals and $16,100 for families.
The maximum contribution limits to an HSA are $4,150 for an individual and $8,300 for a family. As always, there is an additional $1,000 “catch up” contribution amount for each individual age 55 and above.
IMPORTANT NOTE: These ever increasing deductibles and out of pocket maximums on ACA/Obamacare plans are a great reason to consider adding one or more supplemental plans from our Health Insurance Buffet (above) to help minimize your out of pocket costs for many healthcare services. If you qualify for the enhanced tax credit subsidy, you can use some of that subsidy to cover the premium on the supplemental plans.
Standardized Plans Required on Federal Marketplace:
In 2024 CMS is requiring all carriers offering plans on the Federal Marketplace to include four standardized plans. There will be two Bronze, one Silver and one Gold standard plan. This is only for states utilizing the Federal Marketplace. State based exchanges are not subject to this requirement.
Small Group Plans
While it looks like there are companies having small increases or small decreases in rates in the ACA/Obamacare small group market there seem to be more companies with rate increases near or over 10%.
I am continuing to see more companies and plan administrators offering alternative Level Funded health plan options. Including many of the traditional fully insured plan companies.
NOTE: In the State Changes section below I have outlined all the proposed rate changes I could find in your state for both individual and small group health insurers.
State by State Changes and Updates
As noted above, please click on the link for your state for more details on what is happening with both the Alternative Health Plans market and ACA/Obamacare plans where you live.
U.S. Insurance Solutions is here to help
Remember, you are NOT in this alone…I am here to help! As your Personal Health Insurance Advisor, my goal is to make your life easier by taking the hassle out of finding the right health plan for your situation and needs.
To discuss your health insurance options and make sure you have the best possible health plan for your situation, please go to the link above with the image that says CALL ME and schedule a call with me on a day and time that works for you, and I will call you to review your options.