October 2025

Originally posted 8/07/25

Overall preliminary rate changes via SERFF database, state insurance dept. website and/or the federal Rate Review database.

Aetna Life Insurance Co:

(Aetna/CVS is dropping out of the individual market in all states; I estimate they have around 35,000 enrollees in Kansas who will have to find a different carrier for 2026)

Blue Cross Blue Shield of Kansas City:

Blue Cross and Blue Shield of Kansas City (BCBSKC) is requesting an average rate change of -6.1% for 2025 individual rates as compared to 2023 individual rates and calculated by the URRT. The changes vary by plan, with a minimum rate change of -10.8% and a maximum rate increase of 1.8%.

Originally posted 8/08/25

Overall preliminary rate changes via SERFF database, Mississippi Insurance Dept. website and/or the federal Rate Review database.

Ambetter of Magnolia Inc.

The proposed rate change of 39.0% applies to approximately 142,324 individuals. Ambetter of Magnolia Inc.’s projected administrative expenses for 2026 are $89.76 PMPM. Administrative expense does not include $34.22 for taxes and fees. The historical administrative expenses for 2025 were $73.84 PMPM, which excludes taxes and fees. The projected loss ratio is 84.4% which satisfies the federal minimum loss ratio requirement of 80.0%.

Blue Cross Blue Shield of MS:

The 2026 monthly health insurance premium is made up of four pieces: estimated claim costs, administrative costs, taxes and fees, and risk/profit margin.

via Access Health CT:

HARTFORD, Conn. (Oct. 30, 2025) — Access Health CT (AHCT), Connecticut’s official health insurance marketplace, today announced it will hold several enrollment fairs in November to help Connecticut residents shop, compare and enroll in health or dental coverage. They can also renew their coverage. Enrollment fairs are one-day events for customers to get in-person help from experts. The fairs will take place in Danbury, Manchester, Norwalk, Norwich, New London, Stratford and Willimantic. All help is free. 

Open Enrollment begins Nov. 1, 2025 and ends Jan. 15, 2026.

When you enroll affects when your coverage starts. If customers enroll on or before Dec. 15, 2025, coverage will start Jan. 1, 2026. If they enroll between Dec. 16, 2025 and Jan. 15, 2026, coverage will begin Feb. 1, 2026. 

You may have seen this jaw-dropping nonsense yesterday, but if you didn't, here it is again:

Reporter: Unless ACA subsidies are extended, the average plan will increase by somewhere around 115%

(CMS Director) Dr. Oz: Where'd you get that number?

Reporter: The Kaiser Family Foundation

Dr. Oz: They retracted that. Here's the truth. The average American who's on ACA is gonna pay $13 more than this year. That's not a big issue.

(sigh) where to begin...

Last month I posted an analysis of total enrollment in ACA health insurance exchange coverage nationally which broke the data out by Congressional District partisan lean as well as according to what percent of the vote Donald Trump received a year ago.

My conclusion? Around 20% more QHP/BHP enrollees live in House districts won by Republicans than those won by Democrats last fall…but there’s still an awful lot of blue district residents who are getting hit hard.

Over 26 million Americans in BOTH red and blue districts & states are going to be screwed in the near future if the enhanced tax credits are allowed to expire & the PAPI change is kept in place, and millions of them will lose healthcare coverage completely.

Today, with Supplemental Nutrition Assistance Program (SNAP) benefits also about to be cut off to over 40 million Americans by Congressional Republicans, I decided to take a similar look at how that breaks out along partisan lines.

Originally posted 12/16/25

Wisconsin has around ~293,000 residents enrolled in ACA exchange plans, 98% of whom are currently subsidized. I estimate they also have another ~19,000 unsubsidized off-exchange enrollees.

Combined, that's ~333,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 311,000 statewide.

Originally posted 8/11/25

SCROLL DOWN FOR UPDATES

Overall preliminary rate changes via the SERFF database, Wisconsin Insurance Dept. and/or the federal Rate Review database.

Aspirus Arise Health Plan of WI

The average proposed rate increase of 12.6%, effective January 1, 2026 is expected to impact 13,677 members, based on membership as of March 31, 2025. The rate increase varies by plan, ranging between 4.4% and 20.5%. Rate changes vary by plan due to the impact of changes in benefits and rating adjustments to account for the non-funding of Cost Sharing Reduction (CSR) payments.

Originally posted 8/08/25

SCROLL DOWN FOR UPDATES

Overall preliminary rate changes via the SERFF database, North Dakota Insurance Dept. and/or the federal Rate Review database.

Blue Cross Blue Shield of ND:

(Unfortunately, BCBSND's actuarial memo is heavily redacted, so I don't know their current enrollment. I've had to make an educated guess on that; see below.)

I've already noted that 17 states have launched window shopping for the 2026 ACA Open Enrollment Period (OEP), allowing residents of the following states to plug their household information into their states ACA exchange website to see just how much their net health insurance premiums are going to increase starting January 1st, 2026:

Almost exactly a year ago I began my 2025 ACA Open Enrollment Period guide with the following words:

This is the best OEP ever for the ACA for several reasons:

• The expanded/enhanced premium subsidies first introduced in 2021 via the American Rescue Plan, which make premiums more affordable for those who already qualified while expanding eligibility to millions who weren't previously eligible, are continuing through the end of 2025 via the Inflation Reduction Act;

• A dozen states are either launching, continuing or expanding their own state-based subsidy programs to make ACA plans even more affordable for their enrollees;

• 100,000 or more DACA recipients are finally eligible to enroll in ACA exchange plans & receive financial assistance!

What a difference a year can make.

In the middle of the ongoing 2026 ACA Tax Credit Expiration Crisis, healthcare think tank KFF (formerly the Kaiser Family Foundation) published the annual update to their Employer Health Benefits Survey analysis, finding that...

Annual Family Premiums for Employer Coverage Rise 6% in 2025, Nearing $27,000, with Workers Paying $6,850 Toward Premiums Out of Their Paychecks

• More of the Largest Firms Cover GLP-1s for Weight Loss, and Use Is Higher Than Expected; Some May Be Limiting Coverage

Family premiums for employer-sponsored health insurance reached an average of $26,993 this year, KFF’s annual benchmark health benefits survey of large and smaller employers finds. On average, workers contribute $6,850 annually to the cost of family coverage, with employers paying the rest.

Originally posted 7/17/25

Well, the Colorado Dept. of Regulatory Agencies isn't mincing words:

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.

via the Michigan Dept. of Insurance & Financial Services:

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.

Fair enough so far...

Originally posted 8/7/25

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.)

HMO Louisiana:

Every year, even when the ACA is running smoothly, there are always changes in market participation, as different insurance carriers enter or exit the individual market in certain states or either expand or shrink what parts of the state they offer healthcare policies in.

2026 is no exception, and given the massive turmoil the ACA exchanges are undergoing right now (due primarily to the expiring federal tax credits as well as regulatory changes made by the Trump Regime's so-called "Integrity & Affordability Rule"), there's either 13 or 32 insurance carriers throwing in the towel in one or more states, depending on how you count a carrier operating in multiple states or under multiple subsidiary brandings.

It's important to keep in mind that the following list probably isn't comprehensive--it includes the carriers which I've confirmed are pulling out statewide (with one exception: Meridian Health Plan of Michigan is only pulling out of parts of the state). There's likely one or two that I've missed, especially given that several of these have only made their final decisions within the past week or so.

via the NJ Dept. of Banking & Insurance:

 Funding supports free one-to-one assistance to residents looking for coverage through the State’s Official Health Insurance Marketplace

TRENTON — Governor Phil Murphy and New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman today announced $5 million in Navigator grant awards among 30 community organizations to provide assistance in connecting uninsured residents to health coverage through Get Covered New Jersey, the State’s Official Health Insurance Marketplace, during the Open Enrollment Period and throughout the year. The 2025–2026 Open Enrollment Period starts November 1, 2025, and ends January 31, 2026.

Grant-funded Navigators will provide free, unbiased outreach, education, and enrollment assistance, in more than 10 languages in all 21 counties, to residents shopping for quality, affordable health insurance and will also assist residents in applying for financial help. Since 2019, the Murphy Administration has awarded over $28 million to fund Navigator organizations.

Originally posted 8/8/25

Overall preliminary rate changes via the SERFF database, Alabama Insurance Dept. and/or the federal Rate Review database.

Blue Cross Blue Shield of AL

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

...Expiring Enhanced Advance Premium Tax Credits

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.

Originally posted 1/04/25

Georgia has around ~1.5 MILLION residents enrolled in ACA exchange plans, 93% of whom are currently subsidized. I estimate they also have another ~30,000 unsubsidized off-exchange enrollees.

Combined, that's 1.54 million people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 1.44 MILLION statewide.

Originally posted 12/13/24

Michigan has around 531,000 residents enrolled in ACA exchange plans, 91% of whom are currently subsidized. I estimate they also have another ~64,000 unsubsidized off-exchange enrollees.

Combined, that's 595,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 556,000 statewide.

How did we get here?

Originally posted 8/04/25

10/15/25: Scroll down for FINAL rate filings

via the Pennsylvania Insurance Dept:

Pennsylvanians can submit comments on rate requests and filings through September 2

Harrisburg, PA – The Pennsylvania Insurance Department (PID) today announced that the 2026 rate changes requested by insurance companies currently operating in Pennsylvania’s individual and small group markets are now available. On average, all Pennsylvania health insurers are requesting premium increases in plan year 2026: 19% increase to premiums in the individual market (for people who buy their own insurance), and a 13% increase to premiums in the small group market (for small businesses). 

Originally posted 1/21/25

California has ~1.98 MILLION residents enrolled in ACA exchange plans, over 88% of whom are currently subsidized. They also have an estimated ~470,000 off-exchange enrollees. Combined, that's over 2.4 million people, or 6.2% of their total population.

Originally posted 12/18/24

Idaho has around 117,000 residents enrolled in ACA exchange plans, 86% of whom are currently subsidized. I estimate they also have another ~9,000 unsubsidized off-exchange enrollees, although the actual rate filings (summarized later in this post) put the off-exchange total at a much higher ~47,000.

Combined, that's 6.2 - 8.0% of their total population.

Assuming the national average 6.6% net enrollment attrition rate thru April reported by the Centers for Medicare & Medicaid Services applies to Idaho, however, that would knock the current enrollment down to more like 118,000 statewide.

As anyone not under a rock for the past few months knows by now, the improved federal Affordable Care Act tax credits which were put into place by President Biden and Congressional Democrats starting in 2021 are currently scheduled to expire at the end of December, just 2 1/2 months from now.

If this happens, the consequences for ~24 million Americans will be devastating, with average health insurance premiums more than doubling and millions being priced completely out of the insurance market altogether.

On top of this, the Trump Regime has also made administrative regulatory changes to how the ACA is structured resulting in the remaining tax credit formula becoming even less generous yet, while also eliminating eligibility for either financial assistance or even ACA enrollment whatsoever to many other Americans.

Originally posted 7/18/25

I still have the preliminary 2026 rate filings to analyze for about 10 more states, but I'm taking a break to go back and revisit ARKANSAS.

Back on July 18th, I posted my original analysis of ACA-compliant individual & small group market filings for Arkansas insurance carriers. At the time, I found that the weighted average increases being requested for individual market policies averaged a disturbingly high 26.2%. Here's what the breakout looked like:

This is pretty bad, of course, especially when paired with the expiration of the improved IRA financial subsidies as well as the modified PAPI formula, which is what determines the Applicable Percentage Table.

For many years, the District of Columbia has had among the most generous Medicaid income eligibility thresholds in the country, with children and pregnant women in households earning up to 324% of the Federal Poverty Level (FPL) being eligible as well as parents earning up to 216% FPL and childless adults earning up to 210% FPL*. As a result, nearly 37% of DC's total population is enrolled in Medicaid.

(sigh) OK, I'm not sure if we've reached the 5th or 6th chapter in this ongoing saga, but I hope it's the last one.

When we last left our story (just 5 days ago), I noted that both the current number of enrollees as well as the average rate increases for each of the carriers on the Arkansas individual market had jumped all over the place at least 4 times, and that while it's common for these numbers to change a bit here and there throughout the multi-month filing process, both the degree of some of the changes as well as the circumstances surrounding them were often far beyond what I've typically seen in over a decade of tracking this stuff:

Given all the confusing numbers I've posted before, I've boiled it all down to the simplified tables below which illustrate the mess:

I already wrote about this over a month ago but it didn't get the attention it deserved at the time, and given that we're much closer to the actual 2026 ACA Open Enrollment Period starting and that there's been another important development since then, I figured I should post an updated entry about it.

In late August, the New Mexico Office of Superintendent of Insurance (OSI) dropped the bad news:

Santa Fe, NM – The New Mexico Office of the Superintendent of Insurance (OSI) has approved 2026 rates for individual market Affordable Care Act (ACA) plans sold on and off BeWell, the New Mexico Health Insurance Marketplace, with an average increase of 35.7%. Today, 75,000 New Mexicans buy health insurance through BeWell and 88% of enrollees qualify for federal and state premium assistance.

However, there was an extremely important caveat:

The Centers for Medicare & Medicaid Services just published updated enrollment data for Medicare, adding June 2025 to the data archive.

Whether the data posted since January 20, 2025 is accurate or not, I can't say for certain, but at least they're updating it...and so far, at least, I don't see anything in their monthly reports which is setting off any obvious red flags.

In any event, according to the latest report, as of June 2025:

Twelve years ago, the Wall St. Journal ran a story about the impact of the American Taxpayer Relief Act of 2012, a sweeping tax bill signed into law by President Obama which locked in the Bush tax cuts for lower & middle-class households while allowing them to expire on schedule for wealthier Americans:

A compromise measure, the Act gives permanence to the lower rate of much of the Bush tax cuts, while retaining the higher tax rate at upper income levels that became effective on January 1 due to the expiration of the Bush tax cuts. It also establishes caps on tax deductions and credits for those at upper income levels. It does not tackle federal spending levels to a great extent, rather leaving that for further negotiations and legislation. The American Taxpayer Relief Act passed by a wide majority in the Senate, with both Democrats and Republicans supporting it, while most of the House Republicans opposed it.

Originally published 8/04/25

Via the Utah Insurance Dept:

BridgeSpan Health Co:

The projected average rate change for plans effective January 1, 2026 is 16.0% which is an average rate change of about $87 per member per month (pmpm). Because 16.0% (or about $87) is an average, it is possible to have a different rate change. Factors affecting a member's premium are age, tobacco use, family composition, plan, and geographic area. Expected cost differences by product are updated every year to ensure premium differences are appropriate. BridgeSpan has approximately 200 members enrolled in this line of business as of March 2025.

...The rate change described above is driven by the following factors:

• Medical Trend : 9.1%
• Change in Benefits, Age, Area, and Network : -1.5%
• Change in Market Morbidity : 5.0%
• Exchange User Fees : 1.0%
• Other : 2.0%

Other includes: actual results vs. expected, changes to admin expenses, and rx rebates. Actual results vs. expected reflect differences between actual results and past assumptions, including a true-up of market morbidity estimates

originally posted 7/17/25

via the Iowa Insurance Division:

Iowa Code §505.19 requires the Commissioner to hold a public hearing on a proposed individual health insurance rate increase which exceeds the average annual health spending growth rate as published by the Centers for Medicare and Medicaid Services of the United State Department of Health and Human Services.  For 2026 the growth rate is 5.6%.

The Iowa Insurance Commissioner will hold a public hearing regarding the relevant rate increases on August 19, 2025.

The purpose will be to hear public comments on the proposed increase in the base premium rate. Consumers wishing to make a public comment at the hearing are encouraged to attend the hearing via the live webcast. 

All comments received will be considered public records and will be posted here. The Consumer Advocate will present the public comments received at the hearing.

SCROLL DOWN FOR UPDATES

Every year, I spend months painstakingly tracking every insurance carrier rate filing (nearly 400 for 2025!) for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need.

I really only need three pieces of information for each carrier:

Originally posted 6/19/25

via the Minnesota Commerce Dept:

Federal policy shifts drive higher 2026 rates for individual and small group health plans

State actions blunt increases tied to the reconciliation bills and policy direction of the federal government

St. Paul, MN: Health insurers have submitted their proposed increased rates to the Minnesota Department of Commerce for 2026 plans available to Minnesotans who buy individual or small group health insurance through MNsure or directly through insurers. These proposed rates apply to coverage starting Jan. 1, 2026, with open enrollment beginning Nov. 1, 2025.