2025 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 had enrolled in ACA-compliant individual market policies as of early this year;
  • 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 16 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 in those states the average premium rate changes listed (shown in grey) are unweighted averages, not weighted.

This can make a big difference.

  • 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.

In some of these states I've been able to acquire the actual effectuated enrollment for some carriers on the individual market but not all of them. In those states, combined with an educated guess as to the total market size, I've been able to run partially-weighted averages:

  • Let's suppose there are 4 carriers offering individual market policies in a state, but I only have the actual enrollment for the first two (30,000 and 120,000 respectively).
  • Let's say the average rate changes for each carrier are +12%, +4%, +1% and -3%
  • An unweighted average would be +3.5%, completely ignore the enrollment numbers.
  • Let's further say that according to the official CMS report, that state had 170,000 people enrolled in on-exchange policies as of February.
  • If I assume 85% of their enrollees did so on exchange, that would put the total market at 200,000 people. It would also mean the other 2 carriers with unknown enrollment numbers had 50,000 between them. I'd then assume 25,000 apiece in order to run a semi-weighted average.
  • This would give a semi-weighted average of +3.95%, rounded up to +4.0%.

The problem with doing this is that I'm making two big assumptions: First, that on-exchange enrollees make up 85% of the total; second, that the "missing" enrollees are evenly spread across the other two carriers. However, it's still more accurate than just running a completely unweighted average.

As of September 24th, I have the preliminary (requested) 2025 statewide average rate changes for all 50 states plus the District of Columbia, giving a national average requested rate increase of 6.13%. Again, it's important to remember that this includes 16 states where I've had to use either unweighted or partially-weighted averages.

I've also been able to run the numbers for the final, approved rate changes in 17 states (all of which happen to be fully weighted). Across those 17 states only, the final average premium increase for unsubsidized individual market enrollees is 7.3%. This will shift higher or lower as each of the remaining states has their 2025 rate changes finalized.

Originally posted 8/09/23; updated 11/07/23

Louisiana's rate filing database is frustrating, because it's both highly-detailed and confusing at the same time.

They break out the filings not between Individual and small group markets or on- vs. off-exchange policies, but between rate increases over and under 10%. Normally that would be fine, but they also have multiple listings within each market for several carrier.

Not that any of that matters this year, as they don't appear to have posted any of the ACA-compliant individual market filings there anyway. I had to rely entirely on the federal Rate Review site, and the filings there still don't include enrollment data for most carriers, so the averages below are all unweighted only:

  • Individual Market: Around 3.0% lower (in fact, 4 of the 5 carriers on the market next year are dropping average premiums at least slightly)
  • Small Group Market: 9.6% higher

It's worth noting, however that Louisiana Healthcare Connections appears to be dropping out of the individual market entirely.

Kansas

Kansas is another state where the annual rate filings are redacted for many of the carriers; as a result, I can only run a semi-weighted average, and even that is dependent on my estimate of the total individual market size being accurate (my general rule of thumb as long as the enhanced subsidies of the IRA are in place is that about 90% of most states individual market enrollment is on-exchange unless I have data proving otherwise).

With that in mind, the carriers on the Kansas individual market are asking for rate hikes ranging from 2.1% - 24.4%, with an estimated semi-weighted average of 8.9%.

For the small group market, I can't even run a semi-weighted average since I have no idea what the KS small group market size is overall, but the unweighted average rate hikes being requested is 14.9%.

It's also worth noting that unless I'm missing something, US Health & Life Insurance seems to be pulling out of the Kansas individual market, while both Aetna and Cigna seem to be missing from the small group market.

Iowa

Here's the preliminary 2025 ACA individual and small group market rate filings. Unfortunately, the effectuated enrollment isn't available this year for the carriers in either market, so I can only offer unweighted averages...which include a 3.1% reduction on the indy market and a 6.9% increase for small group enrollees.

the only other noteworthy item is that it looks like HealthPartners UnityPoint is dropping out of Iowa's small group market next year...but with 9 other carriers participating there's still plenty of options for that population.

 

Georgia's health department doesn't publish their annual rate filings publicly, but they don't hide them either; I was able to acquire pretty much everything via a simple FOIA request. Huge kudos to the GA OCI folks!

Georgia's individual market has grown dramatically over the past two years; it went from 660,000 in 2023 to 813,000 people in 2024 to a stunning 1.3 MILLION this year. The weighted average rate increase for unsubsidized enrollees will go up 9.9% if state regulators approve all of the carrier requests as is.

via Covered California: (this is actually from nearly a month ago; somehow I missed it at the time):

SACRAMENTO, Calif. — Covered California announced its health plans and rates for the 2025 coverage year with a preliminary weighted average rate increase of 7.9 percent.

The rate change can be attributed to many factors, including a continued rise in health care use, increases in pharmacy expenditures, the rising cost of care, labor shortages and other issues affecting the health care industry.

Because of the robust financial help available to Covered California enrollees, many will see a small impact, if any, to their monthly cost. Covered California, with the support of Gov. Newsom and the California Legislature, has worked to reduce the impact of increased consumer costs in 2025 by providing more support for its state-enhanced cost-sharing reduction (CSR) program, which will eliminate deductibles and lower the cost of care for over a million Californians.

The good news about New Hampshire's health insurance market is that they're the only state without its own ACA exchange which produces publicly-accessible monthly reports on individual on-exchange market enrollment. The bad news is that they don't seem to publish the actual rate filings in an easy-to-read format, which means I'm left with the federal rate review website, which sometimes posts average rate requests which don't match up with the actual filings...but it's gonna have to do here. 

With these two data sources in hand, New Hampshire's individual market carriers are asking for a weighted average increase of 4.8%. It's important to note that Anthem Health Plans and Matthew Thornton Health Plan are listed as separate carriers on the federal Rate Review website (with separate average rate requests), but on the state's monthly report, they're merged into a single listing.

With no way of knowing what the actual enrollment breakout is between these two, I'm assuming a 50/50 split.

Alaska is a sparsely populated state with only two carriers on their individual market and four on their small group market. Alaska's insurance department website is useless when it comes to getting rate filings or enrollment data; I had to use the federal Rate Review site to even get the requested rate changes.

Fortunately, both carriers (Premera Blue Cross and Moda Health Plan) include summaries which list their current enrollment data. Unfortunately, the average rate increase being requested by the carriers for 2025 is up another 17%. While nearly all ACA exchange enrollees receive financial subsidies, this is still pretty steep for the few who aren't.

From Premera's summary:

Originally posted 8/05/24; updated 9/19/24

The good news is that RateReview.HealthCare.Gov has posted the preliminary 2025 rate filing summaries for every state, making it much easier to pin down which carriers are actually participating in the individual & small group markets next year, as well as what the carriers average requested rate changes are in states which don't publish that data publicly (or which make it difficult to track down if they do).

The bad news is that in many of those states, acquiring the actual enrollment data is even more difficult, as their rate filings tend to be heavily redacted.

Michigan

The Michigan Dept. of Financial Services hasn't issued any press release yet, but nearly all 2025 preliminary rate filings for the MI individual and small group markets are available via the SERFF database.

The most noteworthy item in Michigan's individual market is that there's a new entry: HAP CareSource. I'm assuming this is some sort of joint insurer effort by CareSource and Health Alliance Plan (which has only offered off-exchange ACA plans for several years now) but am not certain about that.

In terms of actual rate hikes, most of them are in the mid single digits, but Priority Health, which holds exactly 1/3 of the market share (equal to Blue Cross when you combine their PPO & HMO divisions), is seeking an eye-opening 18.9% average rate increase.

With Priority Health included in the mix, rate increases being requested by Michigan indy market carriers average 10.5% for 2025.

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