What's Behind Health Insurance Rate Increases? An Examination of What Insurers Reported to the Federal Government in 2012–2013

December 19, 2013

Authors: Michael J. McCue, D.B.A., and Mark A. Hall, J.D.
Contact: Michael J. McCue, D.B.A., Professor, Virginia Commonwealth University, mccue@vcu.edu
Editor: Deborah Lorber


Health Insurance Rate Increases



The Affordable Care Act requires health insurers to justify rate increases of 10 percent or more for nongrandfathered plans in the individual and small-group markets. Analyzing these filings for rates taking effect from mid-2012 through mid-2013, insurers attributed the great bulk—three-quarters or more—of these larger rate increases to routine factors such as trends in medical costs. Insurers attributed only a very small portion of these medical cost trends to factors related to the Affordable Care Act. The ACA-related factor mentioned most often, but only in a third of the rate filings in this study, was the requirement to cover women’s preventive and contraceptive services without patient cost-sharing. But, the insurers who point to this requirement or other ACA-related costs attributed only about 1 percentage point of their rate increases to the health reform law.


M. J. McCue and M. A. Hall, What's Behind Health Insurance Rate Increases?, The Commonwealth Fund, December 2013.