By Joel S. Ario, Managing Director, Manatt Health, and Sabrina Corlette, Research Professor and Project Director, Georgetown University Health Policy Institute’s Center on Health Insurance Reforms

The start of the 2021 rate review process for the Affordable Care Act (ACA) Marketplaces coincided with the initial outbreak of COVID-19 cases, and early forecasts were ominous, with projections of rate increases as high as 40 percent. There was also widespread concern about how to set rates when insurers’ COVID-19-related costs looked anything but predictable. In short, after a period of relative stability in Marketplace rates, it looked like enrollees might be in for a roller-coaster ride.

Thankfully, the worst-case scenarios did not materialize, partly because the costs of treating COVID-19 have been lower than expected, and insurers are benefiting from enrollees’ deferring or canceling care as the pandemic continues to surge. That is not the whole story, however. The failure to beat back the virus over the summer and the emergence of new treatments as well as a potential vaccine extended the uncertainty for insurers over their 2021 costs. This could have led to a turbulent rate review process were it not for the lessons learned in prior years about effective rate regulation.

“Stable Rates Reflect Strength of ACA Marketplaces,” a new expert perspective and infographic authored by Joel S. Ario and Sabrina Corlette and prepared in partnership with the Robert Wood Johnson Foundation’s State Health and Value Strategies program, discusses how the rate review process has developed since the first ACA open enrollment period in 2013, and how those developments came together this year to enable regulators and insurers to manage uncertainty and achieve more stable rates for the 2021 plan year.

To access the full expert perspective, click here. To access the infographic, click here.