2022 Rate Changes

Every year, I spend months painstakingly tracking every insurance carrier rate filing 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. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:

  • How many effectuated enrollees they have enrolled in ACA-compliant individual market policies;
  • What their average projected premium rate increase (or decrease) is for those enrollees (assuming 100% of them renew their existing policies, of course); and
  • Ideally, a breakout of the reasons behind those rate changes, since there's usually more than one.

Unfortunately, there are about a dozen states where due to the carriers and/or the state insurance departments heavily redacting the rate filing documentation, I've been unable to fill in the actual number of people enrolled by some or all of the insurance carriers within that state's individual market. This means that the average premium rate changes listed (shown in grey) are unweighted averages, not weighted.

This can make a big difference in some cases: Let's say you have 2 carriers in a state, one raising rates by 10% and the other raising them by 1%. The unweighted average increase would be 5.5%. However, what if it turns out that the first carrier has 90% of the market share while the second only has 10%? That would mean a weighted average increase 9.1%. The unweighted average is the best I can do for these states without knowing the market share breakout, however.

As of this writing, I've plugged in the preliminary (requested) 2022 statewide average rate changes for all 50 states plus the District of Columbia, giving a national average increase of 3.9% overall. I've also entered the final (approved) averages for 19 states so far. For those states, the national weighted average increase is a bit higher, 4.8%. This will likely drop as more final averages are entered in the coming weeks hover; the odds are high that once every state is filled in, the final average increase will be slightly lower than the preliminary average.

UPDATE 10/19/21: I've filled in the final/approved averages for Oregon, Indiana, Delaware, Connecticut and Idaho, which collectively whittle the final national average down from 4.8% to...4.6%.

UPDATE 10/21/21: I've managed to get hard enrollment numbers (allowing weighted changes) as well as approved rate changes for North Dakota, Arizona and South Carolina. In addition, Wisconsin's insurance dept. issued their weighted, approved average as well.

With these updates, the preliminary national average increases to 4.1%, while the approved average (across 29 states) is down to 4.2%.

UPDATE x2 10/21/21: OK, I'm on a roll today: I've also managed to get more accurate enrollment data for Alabama as well as confirming AL's approved rate changes, and have also filled in the enrollment data for Iowa carriers (again, confirming approved changes), which allowed me to run the weighted average statewide. None of these changes moves the needle on either preliminary or approved rate changes, however.

UPDATE 10/22/21: Added approved rate changes for Colorado, Michigan & Montana.

UPDATE 10/27/21: Added approved rate changes for Ohio, Tennessee, South Dakota, North Carolina & Arkansas, along with some updates/corrections to enrollment data & carrier participation for a few other states.  Also revised estimated total market enrollment for the 7 states which I don't have hard data available for.

UPDATE 11/02/21: Now that the 2022 Open Enrollment Period has officially launched, the federal Rate Review website has been updated with approved rates for all 50 states + DC, allowing me to fill in the remaining states.

Overall, it looks like the average unsubsidized rate increase is around 3.5% nationally.

(click image for higher-resolution version)


Wyoming is the smallest state and only has two carriers offering individual market policies (and just three offering small group plans). This makes it pretty simple for me.

Unfortunately, neither their insurance department website nor their SERFF filings give any indication of the enrollment numbers for any of the carriers, making it impossible to calculate a weighted average for either market. Then again, assuming a roughly even market share split, the unweighted averages should be pretty close: -4.1% individual market, +1.0% small group.


Tennessee's proposed 2022 rate filings are pretty straightforward...no new entrants or drop-outs among the carriers in either the individual or small group markets, and the SERFF filings actually include the enrollment totals for all of them in both markets (a rarity these days!).

The weighted average premium increase for unsubsidized enrollees is 4.4% for indy market enrollees and 8.9% on the small group market.

UPDATE 10/26/21: Well, it looks like all of the requested rates have been approved by the TN regulators without any changes on either market.

South Dakota

South Dakota's 2022 rate filings are pretty straightforward. There's still just two carriers offering policies on the individual market (Avera and Sanford), while it looks like UnitedHealthcare may be dropping out of the states small group market (they have a rate filing in the SERFF database, but it doesn't show up on the federal Rate Review database, and even the SERFF filing doesn't lis any specific rate increase or decrease).

Assuming all are approved as is, residents are looking at a 1.4% rate drop on the individual market and a 4.0% increase for small group plans.

UPDATE 10/26/21: Sure enough, it looks like all rate requests have been signed off on as is.

South Carolina

Unfortunately, the South Carolina Insurance Dept. website isn't particularly helpful when it comes to getting the annual rate filing data for these analyses--they post a link to the federal Rate Review website and the SERFF database, but that's it...and most of the filings don't show up in SERFF, while the Rate Review database actuarial memos are all heavily redacted.

As a result, all I have is the unweighted 2022 average rate changes, which are basically flat for the individual market and down around 4.4% for small group plans.

The other noteworthy item is that it looks like UnitedHealthcare is pulling completely out of South Carolina's ACA-compliant small group market, though it's possible that they just haven't been added to the federal Rate Review database yet.

Rhode Island

Via the Rhode Island Insurance Dept:

State of Rhode Island Office of the Health Insurance Commissioner Requested and Approved Summary for 2022 Rates in the Individual, Small Group, and Large Group Markets

The Rhode Island Office of the Health Insurance Commissioner (OHIC) has completed its review of plan year 2022 rates for the individual, small group, and large group markets. This document is a summary of the requested and approved amounts for each insurer by market.

As required by the ACA, OHIC reviews premiums in the individual and small group markets by examining the following components:


The Oklahoma Insurance Department put out the following press release about a week ago:

Oklahoma Consumers Have More Health Insurance Options for 2022 ACA Plans

OKLAHOMA CITY – The Oklahoma Insurance Department (OID) announced today which health health insurance companies will be offering plans in the Oklahoma Affordable Care Act (ACA) Marketplace for 2022. Two new insurers will be joining the Marketplace next year giving Oklahoma consumers more health insurance options. Starting this year, consumers will also have an extra 30 days to make plan selections during the ACA Open Enrollment Period for individual health insurance plans running from November 1, 2021 through January 15, 2022.


The Ohio Insurance Department does this weird thing where they list all of the carriers offering policies on the individual market and list the weighted average year over year premium change...but they don't list the actual rate increases for each carrier.

For the small group market I don't think they even do that; I have to rely on the federal Rate Review site, which almost never provides enrollment data.

Fortunately, for the indy market at least, all of the requested rate filings are available via the SERFF database, along with enrollment figures for 9 of the 10 carriers in the market. For the tenth (AuitCare), I used an estimate based on last years' hard number. Unfortunately, I still don't know the approved rates for any of them, but it looks like the state regulators chopped them down somwhat, since the weighted average comes in at 4.8% vs. the requested 8.4% statewide.

North Carolina

The most remarkable thing about North Carolina's 2022 ACA carrier rate filings aren't the rate changes themselves--they range from -15% to +14.6%, nothing shocking--but the sheer explosion in competition coming to both the individual and small group markets.

NC's indy market is going from five carriers to ten in one shot, with Aetna, AmeriHealth, Celtic, Friday and UnitedHealthcare all jumping into the risk pool. On the small group side, there are two new entrants: Bright Health and Friday Health Plans.

In any event, overall, the average preliminary rate increase for unsubsidized enrollees is averaging 8.7%, while small group plans are going up by an average of 9.8%.

New Mexico

New Mexico's final/approved 2022 premium rate changes are now live, though the searchable database seems to be having some technical layout glitches. For some reason there's a good 5-6 entries for each carrier instead of just 2 (one for the individual market, one for small group plans); I think this is because New Mexico requires separate filings for on- and off-exchange policies, although there seem to be duplicates even then.

In any event, of the 30+ states I've written up so far, New Mexico has by far the highest average unsubsidized rate increases, at 15.5%. Most of this is due to Molina Healthcare's shocking 25.6% increase, which seems to have been approved as is. True Health is also asking for double-digit increases on the individual market.

The Small Group market in the Land of Enchantment is also in the double digits, at +11.5% on average. Presbyterian not only has two small group entries, they seem to have dramatically different enrollment numbers for each; I'm not sure what to make of that.

Washington State

Back in July, I posted a summary of Washington State's preliminary 2022 ACA premium rate change filings for the individual and small group markets. At the time, WA carriers were requesting average increases of 5.5% for the former and 4.1% for the latter. 

A few weeks back (Sept. 20th), the state insurance dept. issued their final/approved rate changes for 2022...but only for the individual market, and even then, only for carriers offering on-exchange policies. The small group filings and those for 3 of the 15 individual market carriers which only offer off-exchange policies are still pending review. However, those three only have a combined total enrollment of around 1,300 people, and the requested rate change for one of them partly cancels out the other two, so unless there's some truly eyebrow-raising changes to the final rates, I don't expect this to move the needle much:

Average 4.17% rate change approved for 2022 Exchange health insurance market