Chaos from Congressional Republicans Leads to Average Premium Increases of Over 28% for 2026
Average increases as high as 38% have been requested for the Western Slope, and insurance companies estimate nearly 100,000 Coloradans will lose their health insurance coverage
DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA) released the preliminary information on private health insurance plans for 2026 for the individual market (for people that don’t get coverage from an employer plan). The filings will be public once the DOI finishes the preliminary completeness review on or about Friday, July 18.
DIFS Encourages Michiganders to Plan for Health Insurance Coverage Now for 2026
(LANSING, MICH) The Michigan Department of Insurance and Financial Services (DIFS) is encouraging Michiganders to be ready for the upcoming Health Insurance Marketplace Open Enrollment period, which starts Nov. 1. A record 530,000 Michiganders are currently enrolled in health insurance through the Marketplace. Recent federal changes, as well as expiring tax credits, mean it has never been more important to review your insurance coverage and make a selection during the upcoming Open Enrollment period.
(Aetna/CVS announced last spring that they're pulling out of the individual market in EVERY state in 2026.)
AmeriHealth Caritas Florida:
Amerihealth Caritas Florida, Inc. (AHC) has offered comprehensive and fully insured coverage to members in the individual ACA market since 2023. AHC is filing a rate increase for 2026 products. The plans associated with this filing will be offered both on and off the Federally Facilitated Marketplace (FFM) in Florida.
Overall preliminary rate changes via SERFF database, state insurance dept. website and/or the federal Rate Review database.
Ambetter Health of LA:
The proposed rate change of 16.4% applies to approximately 97,401 individuals. Ambetter Health of Louisiana’s projected administrative expenses for 2026 are $91.51 PMPM. Administrative expense does not include $17.45 for taxes and fees. The historical administrative expenses for 2025 were $79.64 PMPM, which excludes taxes and fees. The projected loss ratio is 81.4% which satisfies the federal minimum loss ratio requirement of 80.0%.
CHRISTUS Health Plan:
(as far as I can tell, CHRISTUS is dropping out of the Louisiana individual market...they aren't listed on the federal Rate Review database website, nor do they show up in the LA SERFF filings or on the LA Insurance Dept. website.)
Merged Market Summary for Proposed Rates Effective for 2026
The following tables depict the proposed overall weighted average premium increase and the key assumptions behind premium development for the merged (individual and small employer) market filed by insurance carriers as part of the Massachusetts Division of Insurance rate review process (for rates effective in 2026). This information is subject to change as the rate review process continues.
The Health Care Access Bureau within the Massachusetts Division of Insurance is currently reviewing these assumptions. This review process will culminate in a final decision in August 2025.
There are 711,563 consumers enrolled in merged (individual/small group) market plans (data as of December 2024).
Blue Cross and Blue Shield of Nebraska (BCBSNE) is setting new rates for its Individual ACA market business in Nebraska. The rate change will take effect January 1, 2026, and will impact an estimated 22,300 members. On average, rates will go up by 20.5% compared to 2025 individual rates. Depending on the network and plan, rate changes will range from a decrease of 1.1% to an increase of 33.3%. Additionally, premiums will go up a bit each year as people get older, even if their plan rates stay the same.
BCBSNE used its own claims and enrollment data, and other publicly available information to set these rates.
Just a few days ago I reported that the final, approved 2026 individual market rate filings in Michigan have been published to the SERFF database, for an overall weighted average rate increase of 20.1% marketwide:
This hasn't been officially published by the Michigan Dept. of Insurance & Financial Services yet, and technically speaking the filings aren't 100% approved yet, but 10 out of 11 filings have been moved to "complete pending form review" which I think just means that a supervisor has to give the paperwork a final once-over to make sure there are no typos etc.
*Also, Meridian Health Plan (which holds an impressive 30% of the total ACA indy market in MI when you include the carriers dropping out) is listed as "draft decision forwarded to Manager" so if any of them end up being off I'd guess it would be that one.
The average rate increase included in this filing is 19.3%, affecting over 210,000 members.
The main factors driving the need for this increase are:
Alabama market membership loss and remaining members projected to be less healthy following expiration of enhanced premium subsidies in place since 2021
Projected claim cost trends are higher for 2025 than anticipated in the 2025 filing and are projected to continue into 2026
Administrative costs increased in 2025 and are expected to rise further in 2026 due to new eligibility and billing rules, along with a higher Exchange User Fee
Originally posted 7/21/25; See important updates below.
It's a little awkward to try & pull quotes from Georgia's actuarial memos because they're heavily redacted (see attachments below), but fortunately I also have access to other "just the facts" filing documents which include the hard data I need to compile my weighted averages. These forms--officially called "Rate Filing Transmittal Form LH-T1" and "Unified Rate Review" forms--include, among lots of other numbers, the preliminary avg. rate change being requested for the carrier's individual (or small group) market plans, as well as the number of current effectuated enrollees they have.
In addition, I have alternate rate filings for Georgia individual market carriers which specifically state what their requested rate changes would be if the enhanced premium tax credit subsidies provided by the American Rescue Plan Act & Inflation Reduction Act were to be extended for at least one more year, providing a clear apples to apples comparison.
BCN is filing a year-over-year average rate increase for 2026 for all individual products that were offered in 2025 of 16.3%. Significant contributors to rate change are outlined in the table below:
Experience Restate 4.0%
Medical and pharmaceutical price and utilization trend 5.4%
ARPA Subsidy Expiration Impact 4.6%
Benefit Change and CSR -2.6%
Margin Impact 1.2%
...Incorporated in the above, BCN assumed an additional pharmacy price trend due to tariffs, as follows:
Generic +2.5%
Brand +10%
Specialty 0%
Total Impact +2.5%
...Consistent with the 2025 filing, BCN has assumed no CSR payments will be made by the federal government for 2026. Therefore, rates for Silver plans offered on exchange are 20.5% higher than if the federal government funded CSR subsidies.
