ACA benchmark plan premiums increase in 2023 after falling since 2019

Premiums for Affordable Care Act benchmark plans rose across the country over the past year, with some of the lowest-cost silver plan premiums increasing in Illinois, according to a recent report from the Urban Institute.

From 2022 to 2023, monthly premiums on average increased for Blue Cross and Blue Shield of Illinois — one of the cheapest silver plans in Springfield and Chicago — by 2.5 percent in Springfield and 0.2 percent in Chicago.

Overall, the lowest silver premiums in Chicago increased by an average of 21.2 percent, in part due to a 22 percent increase for a plan by Ambetter, which researchers said was likely due to the insurer offering a “very low” 2022 rate.

Despite increases in some plans in urban and rural markets nationally, analysts attributed differences between the two to heightened competition in large cities, which drives lower rates.

“Rural healthcare is always going to be expensive,” said John Holahan, a fellow at the Urban Institute. “In an ideal world, big teaching hospitals would be incentivized (to expand) … If there are more providers, insurers can maybe negotiate better premiums.”

Inflation and the uncertain future of enhanced premium tax credits also contributed to higher premiums. While subsidies were extended last fall, insurers needed to prepare in case tax credits did not continue, Holahan said.

“Rule of thumb is that the more subsidized something is, the more healthy people will be more likely to buy insurance or go into a marketplace,” he said. “If they have to pay more, some healthy people will just forgo, figuring they’re healthy enough.”

Illinois was not the only state facing steeper premiums. While average premiums went down annually from 2019 to 2022, this year was a shift. Benchmark plan premiums went up nationally by an average of 3.4 percent in 2023.

– Elizabeth Casolo for Health News Illinois