Following in-depth reviews by independent actuaries and the Office of Value-Based Health Care Delivery, rates for regulated 2023 health, dental, and small group insurance plans were announced today. While premiums are rising steeply across the country, the extension of consumer-friendly subsidies through the Inflation Reduction Act, coupled with Delaware’s strong 2022 enrollment and 2023 Health Insurance Marketplace expansion, will limit consumer impact locally.

“This year, Delaware consumers have more carriers and plans to choose from than ever before, so they can find an affordable plan that meets their needs. We remain optimistic that this increased competition will lead to lower rates and higher care quality over time,” said Insurance Commissioner Trinidad Navarro. “Delawareans are facing rising costs in nearly every area of life and making difficult sacrifices to afford necessities – but let me be clear, no matter the financial cost, we cannot afford to sacrifice our health. We will continue to work to ensure that coverage is affordable and accessible to all residents.”

Two new health insurers will be joining the Marketplace for 2023. Before tax credits and subsidies, base rates for 21-year-old non-tobacco users range from $315 to $505 across 9 Aetna CVS Health plan options, and from $283 to $402 with AmeriHealth Caritas across 4 plan options. Returning ACA issuer Highmark Blue Cross Blue Shield of Delaware will be increasing rates 5.5% on average, with base rates for 17 plan options ranging from $249 to $618 including a catastrophic plan option. In the last few years, Highmark’s average rates have decreased roughly 10% despite this needed increase.

Plans on the marketplace are spread among metal-level categories – bronze, silver, gold, platinum and catastrophic – and are based on how enrollees choose to split the costs of care with their insurance company.

As always, Commissioner Navarro urges residents to be informed consumers and shop for the best plan for both their needs and their budget. 30 plans are available to Delawareans for the 2023 plan year, and local navigators are available to assist in choosing the right plan. Open Enrollment takes place November 1 through January 15.

Factors Involved in Expansion, Rates

Nationally, insurers are requesting increases due to inflation, increasing costs of care, and rising drug prices. In Delaware, both state and federal legislation contributed to the long-awaited carrier expansion and final rates.

“It’s no coincidence that Delaware was able to expand the number of carrier options on the Health Insurance Marketplace in the same year that laws limiting hospital price growth to appropriate, inflation-conscious levels became enforceable,” said Commissioner Navarro. “The hospital price growth law, for the first time in our state’s history, gave insurers leverage to negotiate lower costs for consumers while still ensuring that hardworking healthcare providers receive their fair share. We’re grateful to have worked with legislators and the Primary Care Reform Collaborative to put cost containment guardrails in place to curtail rising consumer expenses, encourage carrier expansion, and ensure the effectiveness of every dollar spent.”

With little financial limitations around hospital prices, private insurance plans pay the price – on average 224% more than Medicare plans, according to RAND Corporation.

During the rate filing process, questions also remained about the expiration of American Rescue Plan Act subsidies, which the department lobbied Delaware’s congressional delegation to extend. These subsidies lowered consumer costs significantly and contributed to the state’s largest-ever ACA enrollment, a year-over-year increase of 26.8%. Had these benefits expired, healthy consumers who were influenced to acquire coverage through the enhanced discounts may have left the marketplace, shrinking the risk pool and unbalancing rates. On August 16, President Biden signed the Inflation Reduction Act into law, extending subsidies into 2025.

Aside from potential enrollment increases due to the carrier expansion, future participation growth may come from Medicaid unwinding and income eligibility reviews. National efforts are underway to ensure smooth, affordable transitions to Marketplace coverage for those eligible.

Other ACA and ACA-Compliant Rates

Delta Dental will reduce both ACA and non-marketplace rates by an average of 4%, and Dominion Dental will increase ACA premiums by 2.2%. Metropolitan Life Ins. Co.’s small group non-marketplace dental plan rates will remain at their current level.

Returning off-market small group plans from Highmark will increase an average 2.4%, Optimum Choice plans will rise by 2.7%, and United Healthcare small group rates will increase by 2.8%. Aetna Health’s small group plans will increase 7.6%, and Aetna Life rates will increase 5.1% after an initial increase request of 8.8% was reduced. Aetna Health’s 9 off-marketplace individual plan rates will remain at their current level.

About ACA Plans

All ACA-compliant health plans offer essential health benefits, including coverage of pre-existing conditions, prescriptions, emergency services and hospitalization, mental and behavioral health coverage, outpatient care and telehealth, lab services, and more.

Open enrollment for 2023 Health Insurance Marketplace plans begins November 1. Residents may qualify to enroll or change plans based on special circumstances, such as income qualification, loss of health coverage, becoming a parent, or other qualifying factors throughout the year. Find out if you qualify for special enrollment.

Commissioner Navarro announces Health Insurance Marketplace expansion

Be aware of non-compliant alternative health plans

Consumers to have most options in history of Delaware Marketplace

After years of work to increase competition on the Delaware Health Insurance Marketplace, Insurance Commissioner Trinidad Navarro announced today that three health carriers intend to offer plans for the 2023 plan year – the most in the state’s history. AmeriHealth Caritas and Aetna CVS Health will join Highmark Blue Cross Blue Shield Delaware in offering coverage.

“Delaware’s Health Insurance Marketplace is more stable than ever before, with rates steadying and enrollment at an all-time high. The hard work we have put into this program is paying off, with multiple new carriers planning to offer 2023 coverage,” said Insurance Commissioner Trinidad Navarro. “I look forward to the benefits that increased competition will bring to our residents, and to continuing to improve healthcare accessibility and affordability across the state.”

From rising rates to insurer departure, the implementation of the Affordable Care Act in Delaware hasn’t always been smooth sailing. But with the state’s successful creation of a 1332 reinsurance program and federal threats of ending the critical program subsiding, rates have decreased more than 15% and remained stable, while enrollment has grown significantly.

“Today’s announcement is a testament to both the needs of Delawareans who have increasingly signed up for coverage, and to the strong regulatory environment we have built, which has helped insurers go from taking losses to being able to cover their expenses and consumers’ coverage needs.”

The announcement comes as carriers submit initial rate filings proposals pursuant to federal deadlines. These will undergo in-depth reviews by independent actuaries before the Insurance Commissioner approves and announces them later this year.

Advisory group will advance health care benchmark initiative to reduce costs, improve outcomes

WILMINGTON, Del. – Taking the next step in implementing a health care spending benchmark for Delaware, Governor John Carney has signed an executive order establishing the Health Care Delivery and Cost Advisory Group to provide feedback to the Secretary of the Department of Health and Social Services (DHSS) on how to measure and report the total cost of health care in Delaware and how to determine metrics across the health care system to create quality benchmarks.

The creation of the advisory group to implement the spending benchmark comes five months after the Governor signed House Joint Resolution 7 granting authority to DHSS to establish a benchmark with a growth rate for health care spending linked to the overall economy of the state. In June, the Centers for Medicare and Medicaid Services (CMS) released a 50-state analysis of per-capita health care spending showing Delaware had the third-highest rate in 2014 behind only Alaska and Massachusetts.

The CMS analysis of all insurance payers – Medicare, Medicaid and commercial – found that Delaware’s per-capita rate was $10,254, or more than 27 percent above the U.S. average of $8,045. Without changes, the analysis estimates that Delaware’s total health care spending will more than double from $9.5 billion in 2014 to $21.5 billion in 2025.

“Delaware has consistently ranked among the states that spend the most on health care, yet we’re not seeing the best results,” said Governor Carney. “High costs present a barrier to quality health care, squeeze family budgets, crowd out other important state investments, and prevent businesses from investing in innovation and job creation. We’re committed to addressing this issue, to bringing providers to the table, reducing costs, and improving health outcomes for Delawareans across our state.”

“We have the talent and the capacity in our Delaware health care community to move to better value in our health care system and deliver better outcomes for the people of our state,” said DHSS Secretary Dr. Kara Odom Walker, a board-certified family physician. “The advisory group gives us the unique opportunity to continue progress in a collaborative forum and gather input on how to best to track the trend lines in the total cost of health care over time.”

The advisory group will provide feedback to the DHSS Secretary on the selection of methodologies to measure and report on the total cost of health care in Delaware, and on the establishment of a spending growth target that will become Delaware’s cost benchmark. Advisory group members also will help identify which metrics should be used to create quality benchmarks across our healthcare system to reduce costs, and recommend changes to the Delaware Health Care Commission.

The advisory group will include the DHSS Secretary; Director of the Office of Management and Budget; Chair of the Delaware Health Care Commission; Chair of the Delaware Center for Health Innovation; hospital representatives; representatives from the insurance industry, a licensed physician; a health economist; and a business community representative.

A full list of members is available in the text of the Executive Order. The advisory group will dissolve on June 30, unless the period is extended.

Click here to watch a video message from Dr. Kara Odom Walker, Secretary of the Delaware Department of Health and Social Services, on the benchmark initiative.

To learn more about the health care spending benchmark, visit:
https://www.choosehealthde.com/Health-Care-Spending-Benchmark

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Related news:
Governor Carney Signs Legislation to Limit Growth in Health Care Spending
Op-Ed: Let’s Get Control of Health Care Spending
Secretary Walker Issues Report on Progress Toward Implementing a Health Care Spending Benchmark

New website includes information on healthcare benchmark initiative to reduce costs, improve outcomes for Delawareans

DOVER, Del. – Governor John Carney and the Department of Health and Social Services (DHSS) relaunched ChooseHealthDE.com on Tuesday to include information and resources about healthcare spending in Delaware, strategies to slow its growth and actions to better connect that spending to the health outcomes of Delawareans.

DHSS first launched ChooseHealthDE.com in 2013 as an information resource for people learning about coverage options through Delaware’s new Health Insurance Marketplace. Today, the website is expanding to include information for individuals and families, employers, healthcare providers and legislators about the value of healthcare and how to reduce the growth of spending while better linking payments to health outcomes.

“As I said last week in my State of the State, we are spending too much money on healthcare without getting good enough results. Now is the time to change the way we deliver care in our state,” said Governor Carney. “To help us understand our overall spending, we need transparency on healthcare costs. With ChooseHealthDE.com, we are taking another step in providing more transparency for individuals, families, employers, providers and legislators on how we spend our healthcare dollars and what we can do to change that trajectory.”

On Sept. 7, 2017, the Governor signed legislation authorizing DHSS to consult with stakeholders to establish a healthcare spending benchmark as a way to evaluate the total cost of healthcare in the state. Delaware ranked No. 3 in the nation in per-capita healthcare spending in 2014 – the latest year data is available – according to the Centers for Medicare and Medicaid Services (CMS). The CMS analysis of all insurance payers – Medicare, Medicaid and private – found per-capita spending in Delaware was $10,254, about 27 percent higher than the U.S. average of $8,045. Without changes, the analysis estimates Delaware’s total healthcare spending will more than double from $9.5 billion in 2014 to $21.5 billion in 2025. According to America’s Health Rankings, Delaware ranks No. 30 for overall health.

“In the move to value-based healthcare, the healthcare spending benchmark is a starting point,” said DHSS Secretary Dr. Kara Odom Walker, a board-certified family physician. “Working with hospitals and other healthcare providers, we need to transition to a point where we pay for the optimal health of consumers, rather than for hospital stays, tests and procedures, regardless of outcomes. Our goal of lowering costs while improving the overall health of Delawareans will take participation and input from all of us. ChooseHealthDE.com gives us a common portal from which to continue this work.”

ChooseHealthDE.com is divided into two sections: the Health Insurance Marketplace and the healthcare spending benchmark. In the new healthcare spending benchmark section, the site is divided among four target audiences: individuals and families, employers, healthcare providers and legislators. Each audience segment has strategies for success and a downloadable toolkit. A news and events section will provide details about upcoming events, legislation and reports, and public comment periods. A link to the Delaware Health Care Commission website provides background on previous events and reports associated with the healthcare spending benchmark.

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Two Additional Health Insurance Plans Now Available on the Marketplace

 Commissioner Stewart Announces Federal Renewal of Highmark Multi-State Options

 DOVER, DE–Insurance Commissioner Karen Weldin Stewart is pleased to announce that the U.S. Office of Personnel Management, OPM, has certified two multi-state health plans to be sold on the Delaware Health Insurance Marketplace for Plan Year 2015. OPM advised the Commissioner that contracts have been signed with the Blue Cross and Blue Shield Association, on behalf of its local plans, to renew two additional health insurance options under the federal Multi-State Plan Program.

The two plans increase the number of plans offered on the 2015 Marketplace to 25, four more than this year’s choices. Multi-state plans may be sold only through the Health Insurance Marketplace and must include the essential health benefits offered on all Marketplace plans. Enrollees in Multi-State Plans are eligible for the same income-based savings as enrollees in other Marketplace plans.

All 25 plans are available until the close of open enrollment, February 15, 2015. If you want coverage to begin on January 1, 2015, you must enroll or re-enroll in a plan by December 15, 2014.  For more information, go to www.choosehealthde.com.

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For more information contact Jerry Grant at 302-674-7303