Health Insurance Premium Increases in the Individual Market Since the Passage of the Affordable Care Act. Methods


There is no comprehensive source of data on premiums in the individual market, although data being gathered by the Centers for Medicare & Medicaid Services (CMS) will fill this gap in the future. By contrast, there is a consistent source of longitudinal, nationally representative data on premiums for employer-sponsored group insurance, the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) conducted by the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics (NCHS).[4]

This policy brief analyzes data on rate increases in the individual market from 2009 to 2013, using data available on state insurance websites and data obtained directly from states. We analyze data from 9 states in 2009, 11 states in 2010, and 15 states in 2011 and 2012. Preliminary data from 10 states are available for 2013. The analytic sample includes approximately 300 rate filings in 2011 and 2012, covering 2.6 to 2.7 million policyholders, or over 35 percent of all non-group policyholders in the country. The analytic sample is not a random sample of all non-group policies — results in states without public websites might be different than those results in the states with available data. All results in this brief are weighted by the number of policyholders. Details on methods are in the Appendix.

We use two methods to assess the effects of the Affordable Care Act on rate increases in the individual market. First, we analyze trends over time in the proportion of filings that requested an increase of 10 percent or more. It is plausible that insurers seeking to avoid scrutiny of their rate increase requests would have been more circumspect in proposing increases of 10 percent or more after implementation of the rate review requirement in September 2011 than prior to implementation. Second, we compare the rate of increase in 2011, 2012, and 2013 to increases in 2009 and 2010. If the Affordable Care Act is causing the rate of premium growth to decrease (or increase), then the rate of premium growth post-Affordable Care Act should be lower (or higher) than prior to implementation of the Affordable Care Act. However, decreases (or increases) in premium growth might be due to factors other than the Affordable Care Act. To control for general trends in health care costs, which have moderated substantially over the past few years, we compare the rate of increase in premiums in the individual market to the rate of increase in the market for employer sponsored insurance (ESI), using data from the MEPS-IC.

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