FINAL unsubsidized 2024 premiums: +6.6% across 26 states

Rate Changes

Every year I pore over hundreds of annual health insurance policy rate filings from carriers participating in the individual and small group markets, attempting to run weighted average rate changes on a state-by-state level. I then compile all 50 states (+DC) into a national weighted average rate change table.

I generally do this twice for every state: First, over the spring and summer, I crunch the numbers for the carriers preliminary rate change requests. These are submitted to the state regulatory authorities (or in a few cases, federal regulators), who run their own actuarial analysis and then either approve the requests as is, lower the requested rates or (in a few cases) even raise rates more than requested, since part of the regulators job is to ensure that the insurance carriers have enough cash flow to actually pay their claims over the upcoming year.

In some cases, the carriers actually resubmit revised filings later on in the summer if there's some material change to their finances, the marketplace or other policies which change their analysis.

Then, in the late summer/early fall, I go back and run through the approved/final rate filings and compare those against the preliminary requests. 

USUALLY I'm able to track down and analyze this data for the carriers in a good 40+ states. However, over the past few years it's become more and more difficult to get ahold of the final rate filings ahead of the November 1st Open Enrollment Period (OEP).

As a result, this year, just two days ahead of the 2024 OEP, I only have final filings for 25 states +DC, although I also have the preliminary filings for the other 25 states.

With that in mind, here's what it looks like:

  • Preliminary 2024 Rate Changes (all 50 states +DC): +6.2%
  • FINAL 2024 Rate Changes (25 states +DC): +6.6%
  • Final 2024 Rate Changes for all 50 states +DC assuming the remaining states are all approved as is: +5.6%

Of course, some of the rate changes in the remaining states will be different from what was requested, but this at least gives a rough idea of where things stand. The final rates should be filled in at the federal RateReview.HealthCare.Gov website on Wednesday.

Overall, it looks like unsubsidized enrollees will be paying an average of roughly $40 more per month or $480 more per year for ACA exchange policies. Of course, ~90% of exchange enrollees are subsidized, and many of those who haven't been are eligible for subsidies by transferring from off-exchange to on-exchange plans.