Maine health insurance rates will go up next year — but could have been more, state says

File Photo / Pixabay Health insurance rates are going up in 2025.

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Health insurance rates for Maine’s individual and small group markets are scheduled to rise substantially next year.

But the Maine Bureau of Insurance said the newly approved rates actually reflect its work to lower the premiums that insurers initially proposed and to reduce rate disparities between northern and southern Maine.

“The bureau works hard to minimize increases in the cost of health insurance by scrutinizing annual health insurance rate filings and only approving rate changes that reflect medical trends and the projected cost of health care,” said Bob Carey, the bureau’s superintendent, in a news release this week.

“However, the underlying drivers of health care costs continue to push rates higher,” he continued. “These cost drivers include higher prices for hospitals and health care providers, accelerating prescription drug costs and increased utilization of services.”

The new rates will take effect on or after Jan. 1, 2025.

Over the past two months, the bureau said, it has worked with health insurers to bring down the figures they initially proposed.

As a result, initial rate increases that averaged 14.2% for individuals were reduced to approved increases averaging 8.6%, and rate increases went from 14.5% to 9.4% for small groups (such as employers with 50 or fewer workers).

For individuals, health plans with the largest membership saw the greatest rate reductions compared to their initial rate filing. Anthem Health Plans of Maine’s initial rate request of 14.7% was reduced to 7.4%; Maine Community Health options initial request of 13.2% was reduced to 8.1%; and Harvard Pilgrim Health Care’s initial request of 15.8% was lowered to 11.6%.

In the small group market, Anthem’s initial rate increase was lowered from 13.3% to 7.1%; and Maine Community Health Options was reduced from 19.6% to 13.1%.

In 2023, the Bureau of Insurance approved rate increases that averaged 14.6% for both individual and small-group coverage. Those increases took effect Jan. 1 this year.

Reinsurance windfall

The bureau said it was able to approve lower rates in part due to Maine’s reinsurance program, which leverages state and federal funds to reduce premiums. The Maine Guaranteed Access Reinsurance Association, a nonprofit that administers the state’s reinsurance program, uses public funds to lower premiums for individual and small group health plans, according to a news release.

The association received a larger than expected amount of federal pass-through funds for 2024, after the carriers filed their initial rate requests. The additional funds allowed the association’s board to reset the reinsurance program’s parameters to provide more funding for 2025.

The carriers subsequently refiled rate requests that fully reflected the association’s reinsurance program’s updated reinsurance parameters.

The bureau also directed carriers to adjust their geographic rating factors to reduce the disparity in rates between southern and northern Maine. That’s expected to mean that individuals and small groups in Aroostook, Hancock and Washington counties will see very modest or no premium increases in 2025 compared to other parts of the state.

“I urge individuals and small employers to shop around for coverage,” Carey said. “For individual purchasers, CoverMe.gov is a great resource that allows Maine residents to compare plans and rates, and to see if they may be eligible for federal premium subsidies. Small employers should talk to their insurance broker about their health plan options.”

To view the complete breakdown of the 2025 health insurance rate filings, click here.

To learn more about individual and small group health insurance options in Maine, click here.