Final 2025 Open Enrollment Report: Premiums & Financial Assistance

Next up: Premiums, Advance Premium Tax Credits (APTC) and Cost Sharing Reduction (CSR) assistance.

Nationally, the average unsubsidized premiums for 2025 exchange-based Open Enrollment Period enrollees is $619/month, up $14 or just 2.3% from $605 last year.

This is a noteworthy because 2025 ACA exchange premiums "should" have increase by more like 6-7% on average. This discrepancy is mostly because that 6-7% assumed that 100% of those enrolled in each plan in 2024 renewed the exact same policy (without any attrition or additional enrollment), which of course is never the case...even if total QHP selections were identical year over year, not all of the enrollees would be the same people, millions of them would switch to different policies and so on.

New Hampshire has the lowest average ACA premiums for the second year in a row at $469/month, while West Virginia once again has by far the highest at a whopping $1,170/month...up $51 from last year. Again, these are the unsubsidized average prices.

Once again, half (51%, actually) of all exchange enrollees receive Cost Sharing Reduction (CSR) assistance, ranging from just 3.7% in DC (where people earning up to 210% FPL are eligible for Medicaid instead) to over 77% of Mississippi enrollees.

As for APTC assistance, 92% of all exchange enrollees are eligible for premium subsidies again this year nationally, ranging from 28% in DC (again, Medicaid to 210% FPL) up to just about every enrollee in Mississippi (98%).

Again: The vast majority of the 22.4 MILLION Americans receiving APTC help this year are going to be royally screwed next year if the IRA subsidies expire.

If you disregard DC as well as MN & NY (both of which have BHP programs for enrollees earning up to 250/200% FPL respectively), the lowest-APTC state is New Hampshire at 71% of all enrollees.

Click table for higher-res version: