Before the enactment of the Affordable Care Act, annual premium increases were highly variable and increases averaged 10 percent or more at the state-level. From 2008 to 2010, the average annual rates of premium increases in the individual market ranged from 9.9 percent to 11.7 percent. In 2010, many increases were in the range of 9 to 15 percent, but a full quarter of issuers increased premiums by 15 percent or more. The average annual state-level increase was 10 percent or higher.12
After the enactment of the Affordable Care Act in 2010, average rate increases moderated to 7.0 percent in 2011 and 7.1 percent in 2012. The average rate increase was 10.3 percent in 2013, but would have been 8.7 percent if the high increases in one state, California, were excluded.
12 To gather baseline premium information, ASPE commissioned NORC, at the University of Chicago, to collect data from a sample of state insurance departments for the period 2008-2011 (the number of states grows from 16 to 21 states over those years) (accessed at http://www.aspe.hhs.gov/health/reports/2014/Premiums/20121119%20PremTren...). In addition, ASPE analyzed available data from individual market rate filings submitted for 2012 (39 states) and 2013 (40 states) from rate grant states, publicly available state data, and data from several non-grantee states. ACA rate review grants significantly increased the number of states posting their rate filings on websites, making data collection easier. However, these data should be used with caution because there was no national source of comparable data, plans varied in what services were covered, applicants could be medically underwritten in most states, and the available data has significant limitations and omissions.