Pennsylvania Health Premiums Set to Soar Next Year
Nearly Half a Million Residents Face Significant Increases
Hundreds of thousands of Pennsylvanians may soon experience a substantial rise in their health insurance costs. Insurers operating on the state’s Affordable Care Act (ACA) marketplace, Pennie, are proposing average premium hikes of 19% for individuals and 13% for small businesses.
Insurers Seek Major Rate Hikes
These proposed increases represent a significant jump from last year, when average rate hike requests hovered around 8%. The Pennsylvania Insurance Department is currently reviewing these proposals to ensure they are justifiable and non-discriminatory. The department’s review considers factors such as past rate changes, cost projections, and the potential impact on consumers.
Major Insurers Submit Proposals
Western Pennsylvania’s leading health insurers, UPMC and Highmark, have submitted requests for increases that, while below the average, are still considerable. UPMC is asking for individual plan premium increases ranging from 12% to 16%. Highmark’s request for individual plans falls between 14% and 18%.
For small business plans, UPMC is requesting increases between 7% and 9%. Highmark’s proposed hikes for these plans are steeper, ranging from 12% to 23%, affecting a plan covering northeastern Pennsylvania and representing the highest proposed increase by any insurer in the state.
Factors Driving Premium Increases
Regulators cite several reasons for these anticipated hikes, including escalating healthcare costs, increased utilization of medical services, and the impending expiration of enhanced premium tax credits that have helped make insurance more affordable on the ACA marketplace. Pennie estimates that its enrollees have saved approximately $600 million annually due to this expiring program.
Highmark, in its justification for the proposed increases, pointed to these same factors, along with pent-up demand for medical care following the pandemic.
“We are committed to offering the high-quality coverage and experience that our Pennsylvania ACA members and small group employers have come to expect from Highmark.”
—David Golebiewski, Highmark Spokesperson
“We are committed to continued work with the Insurance Department to continue to make affordable, high quality coverage options for consumers.”
—Denise Hughes, UPMC Spokesperson
Consumer Action Encouraged
Pennsylvania Insurance Commissioner Michael Humphreys advised residents to actively compare plans to secure the best coverage at a reasonable price.
“This year, even more than previous years, Pennsylvanians should consider shopping around to find the best plans to meet their individual needs, at a price that makes sense for their current financial situation.”
—Michael Humphreys, Pennsylvania Insurance Commissioner
A comprehensive list detailing proposed rate changes by insurer and plan is available on the Insurance Department’s website. The public can submit comments on these rate requests via email to ra-in-comment@pa.gov until September 2.
For context on rising healthcare costs, a recent report by KFF found that deductibles and out-of-pocket spending for employer-sponsored health insurance have also seen significant increases in recent years, contributing to overall higher healthcare expenses for individuals and families (KFF 2023 Employer Health Benefits Survey).
