Charles Gaba's blog

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 1/10/25

USE THE DROPDOWN MENU ABOVE TO PICK A STATE.

9/29/25: Welcome Paul Krugman subscribers! I greatly appreciate the shoutout by him but should add the following clarification:

Regarding the chart below which he reposted comparing the original ACA subsidy scale to the current version: You probably think that if the enhanced subsidies expire it will revert back to the original version, which would be bad enough. In fact, however, the Trump Regime has also made THAT version even worse, like so:

Ever since the MAGA Murder Bill (officially H.R. 1, the so-called "One Big Beautiful Bill Act") was passed by Republicans in the U.S. Senate & House and signed into law by Donald Trump a few days ago, I've seen a growing conventional wisdom taking hold on social media: People keep claiming that either all, "nearly all" or at least "most of" the budget cuts & other gutting of various programs and departments won't actually kick in until after the November 2026 midterms.

Now, don't get me wrong--most of those making these claims are well-intentioned; they're saying this cynically, to underscore how disingenuous Congressional Republicans are by back-loading the pain until the midterms are safely in their rearview mirrors. And, to be fair, much of the damage won't being until well after next November.

Over at The New Republic, Greg Sargent has taken this thinking one step further, noting that by delaying so much of the ugliness of the new law until 2027 or beyond...

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 8/13/25

SCROLL DOWN FOR IMPORTANT UPDATES

Overall preliminary rate changes via the Florida Office of Insurance Regulation and/or the federal Rate Review database.

Aetna Health inc:

(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.

Originally posted 12/22/24

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.

Originally posted 12/27/24

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.

Combined, that's ~668,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 623,000 statewide.

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 6/19/25

SCROLL DOWN FOR UPDATE

Blue Care Network:

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.

Blue Cross Blue Shield of Michigan:

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