Premium rate requests for the 2018 Affordable Care Act exchanges being released this week from individual states show a range from 6.7 percent in Vermont to 58.8 percent in Maryland.
Insurers are under a June 21 deadline to file their rate requests with the federal government. They and others are predicting double digit premium increases due to the Trump administration making no guarantee over the continuation of cost-sharing reduction payments.
The federal CSR subsidies allowed insurers to offer low-income consumers lower deductibles and out-of-pocket costs. Without them, premiums are expected to rise by at least 20 percent for 2018.
Blue Cross Blue Shield North Carolina has filed for a 22.9 percent increase in that state, according to The News & Observer.
BCBSNC Chief Executive Brad Wilson told Vox that after years of losses, the market was stabilizing and he had hoped to ask for an 8.8 percent rate hike this year, but because the CSRs aren't guaranteed, he had to raise the request.
Former rate requests by BCBSNC have been even larger, at a 24.3 percent rate increase in 2017 and a 32.5 percent increase in 2016, according to The News & Observer.
Cigna, which offers ACA plans in five counties in the North Carolina, has requested a 31.9 percent average rate increase, the report said.
In Connecticut, Anthem is requesting a 33.8 percent increase for policies marketed both on and off the exchange, according to the Insurance Department.
ConnectiCare Benefits has asked an average increase of 17.5 percent for policies sold exclusively on the exchange.
On Tuesday, Connecticut Insurance Commissioner Katharine L. Wade said the department has officially notified Anthem and ConnectiCare Benefits that their health rate requests for 2018 will be the subject of public hearings on June 14.
Wade has been holding such hearings for the past three years for rates filed by plans that affect the greatest number of Connecticut consumers.
Vermont is looking at ACA rate increase requests of 12.7 percent from Blue Cross and Blue Shield of Vermont, and a 6.7 rate increase from MVP Health Care.
Vermont regulates the hospital and health insurance markets in the state, and is about to embark on a five-year, all-payer model starting in 2018.
"There's a lot that goes into a rate," said Green Mountain Care Board Senior Healthcare Analyst Thomas Crompton. "Claim costs are the most prevailing factor."
Also, he said, Vermont tries not to slash requests so as to keep rates where they need to be.
"We have tried very hard to keep the rate where it needs to be in Vermont," Crompton said. "We regulate both the hospital and insurance rates."
The all-payer model aligns payers and sets targets for quality and total cost of care expenditures.
It's in effect in Maryland, where insurers have asked for rate increases of 18 to 58.8 percent, according to wtop.