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Kentucky Health Insurance Exchange Marketplace

Open enrollment for 2021 health insurance plans will run from November 1, 2020, to December 15, 2020. Residents of Kentucky who experience qualifying events can still enroll or make changes to their coverage for 2020.

Two insurers provide coverage in Kentucky’s exchange, and although enrollment dropped in 2019 and again in 2020, it is still higher than it was in 2017, thanks to significant enrollment growth in 2018. Although Humana left the individual market at the end of 2017, their health insurance plans were only available in 2017 in a single county in Kentucky, so the effect of their exit was fairly minor.

Additionally, CareSource expanded its coverage area for 2020, so residents in 56 counties can now pick from both Anthem and CareSource. People in the other 64 counties only have one insurer offering Kentucky health insurance plans, although there are still multiple plan options available because insurers offer a variety of plans.

Kentucky had a gubernatorial election in November 2019 — just days after the beginning of open enrollment for 2020 health plans — in which Governor Matt Bevin, who was a strong opponent of the Affordable Care Act, was defeated by Kentucky’s Democratic Attorney General, Andy Beshear, who supports the Affordable Care Act. One of Beshear’s first acts as governor was to annul the Medicaid work requirement that the Bevin administration had created. Beshear has also started transitioning Kentucky back to an entirely state-run exchange after Bevin switched from the state’s successful state-run platform to the HealthCare.gov platform in 2017.

Kentucky’s uninsured rate has dropped considerably under the Affordable Care Act, thanks in large to the state’s expansion of Medicaid. Based on the official US census data, Kentucky’s uninsured rate was 14.3 percent in 2013. As of 2018, it stood at 5.6 percent, up slightly from a low of 5.4 percent in 2017 (nationwide, the uninsured rate has been edging upward under the Trump administration).

Proposal of Increase in Average Rates by 11% for 2021 by Kentucky’s Exchange Insurers

Kentucky State’s health insurers had to file proposed rates for 2021 coverage by June 1, 2020, and the Kentucky Department of Insurance has published details of the proposed rate changes.

• CareSource: 5.3 percent increase. CareSource has 35,697 memberships in these plans. CareSource did not comprise a COVID-19 factor in their proposed rates for 2021, noting that there is too much doubt to determine whether costs will be higher, lower, or unchanged due to the virus.
• Anthem: 16.6 percent increase. Anthem has 39,165 memberships in these plans (another area of the filing says 45,000). Anthem’s filing notes that part of the rate increase is because of an assumption that morbidity will increase in the individual market in 2021 as a result of the “selective shifting into and out of the individual market,” which is expected to be “more pronounced in 2021 as a result of uncertain economic conditions, loss of group coverage and income loss [driven by the coronavirus pandemic.]” The proposed rates also comprise a 4.5 percent increase in expected morbidity due to the elective procedures being completed in 2021 after being delayed in 2020 because of the Covid-19 pandemic.

Generally, across both of Kentucky’s market insurers, the weighted average proposed rate increase for 2021 is around 11 percent. This is significantly larger than the average rate increases insurers in many other states have proposed for 2020 (thus far, the average across 18 states is around a 2 percent increase). The Kentucky Department of Insurance is reviewing the rates to determine whether they are justified, to post final rate changes by fall.

Resources and References:

• Health Insurance Coverage in the U.S. in 2013
• Health Insurance Coverage in the U.S. in 2017