Cost Of CT Health Plans To Rise Again In 2025

The cost of individual health plans sold on and off Connecticut’s Affordable Care Act Exchange will rise by an average of 5.9% next year, less than insurers had requested — but an amount still considered “unaffordable and unsustainable” by the state’s attorney general when coupled with previous years’ increases.

Small group policies will go up by an average of 7.8%.

Insurers had sought higher increases — an average of 8.3% for individual plans and 11.9% for small group plans. The policies cover about 200,000 people. The increases apply to plans that are fully insured, subject to regulation by the state.

Insurance Commissioner Andrew Mais said in a statement, “Our priority is always the consumer. Our team of actuaries and professionals has carefully reviewed and appropriately reduced the requested health insurance rate increases for 2025.” Mais continued, “While we’ve made progress in mitigating these increases, the challenge remains in addressing the root causes driving health care costs upward. Our objective is clear: to ensure that Connecticut consumers have access to a competitive health insurance market while managing costs effectively.

Mais said, “The rates … reflect our commitment to protecting consumers from unsupported increases and ensuring that health insurance remains both fair and accessible in Connecticut.”

But Attorney General William Tong said the year-over-year rate hikes on health plans are unaffordable for Connecticut families and individuals.

Rates went up by an average of 9.4% on individual plans this year and 7.4% on small group plans. In 2023, individual plans rose by an average of 12.9%, while small group policies increased by an average of 7.9%.

Tong said, “I appreciate that the Insurance Department reduced the requested rate hikes, but these year-after-year increases remain simply unaffordable and unsustainable. They reflect the inability of insurers to negotiate provider reimbursement rates that are consistent with other measures of inflation in the Connecticut economy.” Tong added, “I agree fully with Commissioner Mais that we need to address the root cause of these ballooning rates — the skyrocketing cost of health care. Insurers are not passive players in this broken dynamic — in fact, they profit from it. If insurers are unwilling or unable to effectively negotiate cost controls, we need to take a tough look at our incentives and our laws to force that change.”

Residents, legislators and advocates took issue with the proposed rate hikes at a public hearing last month, and the head of the state’s Office of Health Strategy said the increases are far higher than Connecticut’s health care cost growth benchmark.

Three insurers sell policies on the exchange: Anthem Health Plans, CTCare Benefits Inc, and ConnectiCare Insurance Company Inc.

Anthem asked for an average increase of 9.8% on its individual policies next year; it was granted a 5.6% hike. The plans cover 33,939 people. It also sought a 14.9% average increase on its small group policies that cover 27,565 residents. The insurance department approved 5.1%.

ConnectiCare Benefits Inc requested an average hike of 12.7% on individual plans that cover 64,482 people. A 10.3% increase was authorized.

ConnectiCare Insurance Company Inc asked for a 17.5% average increase on individual policies but was granted 15.3%. About 12,000 people are enrolled in these plans.

Earlier this year, the legislature’s Insurance and Real Estate Committee considered a measure that would have required the state to weigh affordability during its annual rate review process for health plans, but the committee concluded its work without passing any bills.

Rosana Ferraro, program lead for health justice policy and advocacy for Universal Health Foundation of Connecticut, said, “We appreciate Commissioner Mais and the Connecticut Insurance Department’s willingness and diligence in ensuring that individual and small business health insurance rates are not excessive.” Ferraro added, “We are disappointed that we have not been able to legislate a consideration for affordability in these rates, as even with [the department’s] lowering of rates, individuals and small businesses are struggling to cover health insurance costs.

Ferraro said, “Rates for these markets are the canaries in the coal mine — these rising rates mark the higher costs for health insurance for everyone across all markets. These rates are indicative of a problem we all struggle with — affording care we need.”

Sean King, the state’s interim health care advocate, said, “[Office of the Health Care Advocate] is grateful that Commissioner Mais and his team at the insurance department conducted a thorough and thoughtful review of the eight rate filings.” King continued, “Unfortunately, this reduction of insurer profits and premiums may not be enough for many of the 200,000 Connecticut residents who rely on these coverage options to meet their needs.

King said, “Health care in Connecticut is still at an inflection point, and policymakers will need to take more bold and swift actions to improve access and affordability for all.”

Open enrollment for the 2025 coverage year begins November 1.