California: *Final* avg. unsubsidized 2025 ACA rate changes: +7.7% individual market, +7.3% small group market

Back in late August, Covered California issued a formal press release stating that average 2025 rate increases for individual market policies would average 7.9% statewide.

However, that was actually only for the preliminary rate filings. In addition, at the time I only had access to California's on-exchange individual market enrollment data, so I had to guess at the off-exchange numbers.

The small group market was more frustrating: I only had enrollment data for about 1/3 of the carriers; the rest had redacted their enrollment information. This meant I couldn't even guess at a weighted average rate change.

Fortunately, my friend & colleague Louise Norris reminded me that California has, in addition to their official Insurance Department, a second insurance regulatory body, the Dept. of Managed Healthcare, which has its own database of individual, small group and large group market rate filings.

Thanks to this I've been able to fill in all of the missing data for both the indy and small group markets, including not just the final/approved rate changes but also the actual on+off exchange enrollment data for every carrier in both.

With that in mind, the final/approved weighted average unsubsidized rate increase for individual market plans is slightly lower at 7.7%, while small group market plans are going up by around 7.3% overall.

It's also important to note that it looks like Health Net of CA is not dropping out of the small group market as I had previously thought, though several others are (Cigna, Medi-Excel etc).

Finally, with the off-exchange enrollment data now available, it looks like I was off by a bit on my total market size estimate of 1.95 million; it turns out it's a bit larger, at 2.09 million.

This means that around 84% of all individual market enrollees are on-exchange in California. The rest likely consist of a combination of undocumented immigrants, ICHRA enrollees and some folks who simply still don't know that they're likely eligible for federal & state financial assistance if they enroll on-exchange.