After two years of overall average rate decreases, Maine’s three marketplace insurers initially all proposed single-digit rate increases for 2022. But in July 2021, the insurers revised their rate proposals, with two of the three proposing overall rate decreases. Those proposals have been approved by the Maine Bureau of Insurance:

• Anthem: Average rate decrease of 3%
• Harvard Pilgrim: Average rate increase of 1.1%
• Maine Community Health Options: Average rate decrease of 5.4%

Across all three insurers, that amounts to a weighted average rate decrease of just over 2% for 2022.

Maine’s new Clear Choice standardized plans (described above) will be available for purchase as of November 2021. Insurers have the option to keep existing plans as Alternative plan designs for 2022 if they choose to do so, but all insurers will also be offering the Clear Choice plans during the upcoming open enrollment period.

For perspective, here’s a summary of how premiums have changed in Maine’s exchange in prior years:

• 2015: Average premiums were the same or slightly lower than 2014 rates. Maine Community Health Options, which won a large percentage of 2014 enrollees, kept its rates flat for 2015. Anthem’s rates dropped an average of 1.1%. Harvard Pilgrim was new to the exchange for 2015, so had no applicable rate increase.
• 2016: Average rate increase of about 0.7%. For Community Health Options, rate changes ranged from an average 1.73% decrease to a 0.54% increase (note that Community Health Options plans for 2016 were no longer for sale in the individual market after December 26, 2015, and in hindsight, the rates that were approved for 2016 were too low). Anthem BCBS, which had “most” of the remaining market share, had average rate changes that ranged from a 1.1% decrease to a 5.49% increase. Harvard Pilgrim’s average rates decreased slightly for 2016.
• 2017: Average rate increase of 23.5%. As was the case in most of the country, rate increases were much more significant for 2017 than they had been in the prior two years. Anthem increased their average rates by 18%, Community Health Options (which had the bulk of the exchange market share) increased their average rate by 25.5%, and Harvard Pilgrim HMOs increased their average rate by 21.1%.
• 2018: Average rate increase of about 25%. The cost of cost-sharing reductions (CSR) began to be added to on-exchange silver plan premiums as of 2018 (this has continued to be the case). Regulators in Maine initially approved rate increases that were based on the assumption that the federal government would continue to reimburse insurers for the cost of CSR. But in October 2017, just two weeks before the start of open enrollment for 2018 coverage, the Trump Administration announced that the federal government would no longer fund CSR (but insurers were still obligated to provide CSR to eligible enrollees). Anthem left the exchange at the end of 2017 due to the lack of federal funding for CSR. Community Health Options and Harvard Pilgrim continued to offer plans, but they both added a substantial additional premium increase to silver plans to account for the cost of CSR.
• 2019: Average increase of 1%. Because Maine’s reinsurance program was approved and implemented, Anthem rejoined the exchange as of 2019. The Maine Bureau of Insurance had insurers file two sets of rates for 2019: One based on the assumption that the reinsurance program would be implemented, and the other based on the assumption that it wouldn’t. The rate filings are available via SERFF, and the Bureau of Insurance included the SERFF filing number for each insurer. The Maine Bureau of Insurance posted an overview of the state’s new reinsurance program. At ACA Signups, Charles Gaba calculated a weighted average rate increase of 1% for Maine’s individual market for 2019. It’s noteworthy that Community Health Options’ rate filing indicated that 5 percentage points of their rate increase was due to the repeal of the individual mandate penalty after the end of 2018, and another 5 percentage points was due to the Trump Administration’s new rules expanding access to short-term plans and association health plans. So without those changes, CHO would have implemented a significant rate decrease instead of a slight rate increase.
• 2020: Average rate decrease of about 1.6%. Maine regulators approved average rate decreases for Anthem and Harvard Pilgrim, and a slight increase for CHO. Initially, all three insurers had proposed modest rate increases, but they revised their filings in July 2019, with Anthem and Harvard Pilgrim proposing rate decreases instead, which were approved by state regulators.
• 2021: Average rate decrease of about 13%. Maine’s three individual market insurers filed proposed rates for 2021 in June 2020, and then revised their filings later in the summer (average proposed rate changes are summarized here by the Maine Bureau of Insurance). The proposed rate filings were approved by the Bureau of Insurance in late August, with an overall average rate decrease of 13.1%. Without Maine’s reinsurance program, premiums would have increased by 5% to 15%. Although rates were fairly stable nationwide for 2021, with small average decreases in many areas, Maine’s overall average decrease was much more significant than we saw in most states. But Maine’s rate decreases in the first two years its reinsurance program was in effect (2019 and 2020) were much less significant than the initial rate decreases we’ve seen in many of the other states that have implemented reinsurance programs. So it could just be that the reinsurance program had a delayed impact in Maine, with the major rate decrease coming a few years in, as opposed to right out of the gates.