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.
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
Florida has over ~4.7 MILLION residents enrolled in ACA exchange plans, 97% of whom are currently subsidized. I also estimate they have perhaps ~112,000 unsubsidized off-exchange enrollees.
Combined, that's over 4.8 million people, or a stunning 20.3% of their total population. 1 in 5 Floridians are enrolled in ACA exchange healthcare coverage (assuming CMS's 6.6% net national attrition rate applies to Florida specifically, the actual number of current enrollees is more like 4.5 million, or 19% of the state population).
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.
South Carolina has around ~632,000 residents enrolled in ACA exchange plans, 95% of whom are currently subsidized. I estimate they also have another ~36,000 unsubsidized off-exchange enrollees.
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.
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.
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.
The proposed rate change of 27.3% applies to approximately 204,837 individuals. Absolute Total Care’s projected administrative expenses for 2026 are $90.21 PMPM. Administrative expense does not include $17.94 for taxes and fees. The historical administrative expenses for 2025 were $78.35 PMPM, which excludes taxes and fees. The projected loss ratio is 82.6% which satisfies the federal minimum loss ratio requirement of 80.0%.
