As always, the Texas individual and small group markets are pretty messy. For starters, they have up to 20 individual market carriers depending on the year, along with over a dozen small group market carriers some years (this year they're at 17 and 8 respectively).
On top of that, as is also the case in some other states, some of the names of the insurance carriers can be confusing as hell. There's the "Insurance company of Scott & White" which seems to have changed its name to "Baylor Scott & White Insurance Co.," which isn't to be confused with "Scott & White Health Plans" and so on.
I was only able to acquire hard enrollment data for five of the carriers on the individual market this year, and one of those doesn't really count since they're brand new and don't have any (Wellpoint Insurance Co.). For another 11 of them the rate filings include the number of policyholders but not the actual number of covered lives; for those I'm using an average 1.4x multiplier, based on the actual multiplier found in the carriers I have both numbers available for.
Tennessee's preliminary 2025 individual & small group market health insurance rate filings are now available. Unfortunately, I can't find any unredacted filing forms for any of them (and in fact most of the rate filings aren't showing up in the SERFF database at all).
For the most part there's not much to see at first glance: Requested rate changes range from a 1.3% drop to a 3.9% increase on the individual market and from a 9.7% to 11.2% increase for small group plans. The unweighted averages are +1.4% and +10.6% respectively.
However, it also looks like several carriers are dropping out of each market in Tennessee: Alliant and US Health & Life (Ascension) don't show up on the federal Rate Review database for the individual market, while Aetna and CIGNA are missing for small group listings.
Assuming the exchange-based market makes up roughly 85% of total individual market enrollment in Tennessee, the total indy market should be around 628,000 people.
Pretty straightforward in the Mount Rushmore state. Three carriers on the individual market; around 56.4K enrollees total. The weighted average rate change across all three is +2.3% if approved as is.
Note that I've added a new feature to my rate change spreadsheet this year: I've started including the on exchange effectuated enrollmentas well as the subsidized on exchange enrollment as of February for every state. This will allow me to calculate the percent of the total individual market which is receiving ACA subsidies...at least in states where I'm able to figure out what total off-exchange enrollment is (typically only around half of them).
In South Dakota, for instance:
95.7% of on exchange enrollees are subsidized (49,250 / 51,416)
87.2% of the total market is subsidized (49,250 / 56,457)
On exchange enrollment makes up around 91% of the total individual market
For the small group market, there are five carriers this year; Medica Insurance Co. appears to be pulling out of the state. The weighted requested average rate change is a 2.8% increase.
Unfortunately, South Carolina is another state where they don't make unredacted rate filings available, either on the state insurance dept website, the federal Rate Review websiteor the SERFF database.
As a result, I'm limited to unweighted averages for both the individual and small group markets:
It's worth noting that Cigna Healthcare is dropping out of the South Carolina individual market next year, while Aetna is pulling out of the small group market (see below).
I got so far behind on my annual rate filing project that some of the states have started issuing their APPROVED changes before I got around to analyzing the REQUESTED rate changes. Ah, well...
PID is working with insurers to review proposed changes to ensure rates are adequate and fair.
Harrisburg, PA – The Pennsylvania Insurance Department (PID) today announced that 2025 rate changes requested by insurance companies currently operating in Pennsylvania's individual and small group markets are now available online. This initiative upholds the Shapiro Administration's commitment to providing consumers with the information they need when shopping for health insurance.
Rate filings for 2025 health insurance plans were submitted to PID on May 15, 2024. Ever since, PID has been working with insurers to review these insurance companies' proposed rate changes, as rates vary by plan and region and are subject to change by the Department to ensure rates are adequate and fair. Final approved rates will be made public in the fall.
LINSEY DAVIS: This is now your third time running for president. you [Trump] have long vowed to repeal and replace the Affordable Care Act, also known as Obamacare. You have failed to accomplish that. You now say you're going to keep Obamacare. Quote, unless we can do something much better. Last month you said, quote, we're working on it. So tonight, nine years after you first started running, do you have a plan and can you tell us what it is?
Oklahoma is another state where I have no access to the actual enrollment data--all I have to go by are the average requested rate changes for each carrier on the individual and small group markets. As a result, the averages for each market are unweighted.
For individual market plans, that unweighted average is a slight decrease of 0.7%, though the carriers range from as low as a 12% drop to as high as a 10% increase.
It's worth noting that BlueLincs HMO, which was only added to the OK individual market last year, is already being removed from it. In fact, as shown below, it looks like BlueLincs was a special line of policies offered at the point of a regulatory gun; apparently Blue Cross was required to create it as an option for group coverage members who move off of employer coverage. However, that regulation was apparently changed shortly thereafter, and no one ever actually enrolled in a BlueLinc plan anyway, so that's that.
For the small group market, average requested rate hikes range from as little as 4.0% to as much as a 15.2. The unweighted average is 8.3%
1 in 7 U.S. residents covered through Affordable Care Act health insurance marketplaces over the last decade, with all-time high enrollment under Biden-Harris Administration
WASHINGTON – Today, the U.S. Department of the Treasury released new data showing that nearly 50 million Americans, or 1 in 7 U.S. residents, have been covered through the Affordable Care Act marketplaces since January 2014. Under the Biden-Harris Administration, which has lowered the cost of marketplace coverage by expanding the premium tax credit, the number of Americans covered through the marketplaces has significantly increased, reaching an all-time high of 20.8 million following open enrollment for 2024—18.2 million Americans have enrolled for the first time since January 2021.
As a result, I've been able to put together a weighted average requested rate increase for the individual market, which comes in at +3.9%.
For the small group market, I have to go with an unweighted average of +12.0%. It's also worth noting that it looks like one of Aetna's divisions is pulling out of the OH small group market, as are two fof the 4 (!) UnitedHealthcare divisions and possibly AultCare, although I'm not sure about that one.
North Dakota only has 3 carriers participating in their individual health insurance market and four in their small group market, since it appears that Health Partners will be pulling out of the latter next year.
For the indy market, the weighted average premium increase being requested is a painful 16.7%, although this may be off slightly due to Medica's enrollment number being a rough estimate (last year's total ND market was only 45,000 people; I'm assuming Medica only has around 2,000 enrollees this year).
For the small group market, I only have the unweighted average rate hikes, which come in at 10.8%.
Ah, at last, another state which includes both the average requested rate changes for 2024 as well as the number of enrollees each carrier has for both the individual and small group markets in clear, transparent language!
Generally, according to NC Insurance laws, health insurance rates must not be excessive, inadequate, or unfairly discriminatory, and must exhibit a reasonable relationship to the benefits provided in the policy.
Overall, individual market carriers in North Carolina are requesting 7% rate increases in 2025 for unsubsidized policies, while small group market carriers are asking for a 6.5% bump. It's worth noting that one of the three (!) UnitedHealthcare divisions is pulling out of the NC small group market next year for whatever reason.
The bad news is that I was only able to acquire effectuated enrollment for 3 of New Mexico's 4 individual market carriers participating in 2025 (a fifth carrier, Western Sky, is dropping out of the market entirely).
The good news is that I'm able to roughly estimate the enrollment of the remaining carrier (BCBS NM) if I look at on-exchange effectuated enrollment as of February and assume that another 10% or so is off-exchange. That gives me an estimated weighted average increase of 10.6%.
Even if that estimate is wrong, it doesn't make much difference since the unweighted average is around 10.1% anyway.
As for the small group market, I only have an unweighted average there of 8.6%.
New Jersey individual & small group market carriers are asking for unweighted average rate increases of 7.3% and 4.5% respectively for 2025. However, the unweighted averages don't tell the whole story--the carriers are asking for rate hikes ranging from as low as 3.8% to as high as 16.2% on the individual market, and from as low as an 18.8% reduction to a 12.3% increase for small group plans.
As is the case with far too many states these days, most of the rate filing memorandums are heavily redacted in New Jersey, making it nearly impossible to get ahold of the actual enrollment numbers, which means I have no way of running a weighted average on either market.
I should note that the 433,000 estimate for New Jersey's total individual market is based on the assumption that 90% of it is via the ACA exchange, with only 10% being enrolled off-exchange.
Nevadans Get a Preview of 2025 Proposed Health Insurance Rate Changes for Upcoming Open Enrollment
Starting today, Nevada consumers who shop for their health insurance on the individual health insurance market can view and provide comments on proposed rate changes for Plan Year 2025.
The Nevada Division of Insurance (Division) has received and made public on its website the 2025 proposed rate changes from health insurers intending to sell plans on and off the Silver State Health Insurance Exchange (the "Exchange"). The Exchange is the state agency that assists eligible Nevada residents to purchase affordable health and dental plans.
Nebraska doesn't even bother listing indy/small group plan rate filings on their own insurance department website...the link goes directly to the federal Rate Review database. The problem with this is that very few filings here are unredacted, which means it's difficult to acquire the policy enrollees for many carriers needed to run a weighted average.
Nebraska has 4 carriers on the individual market for 2025: BCBS, Medica, NE Total Care and Oscar Health. The unweighted average rate increase being requested is around 4.0%.
For the 4 Small Group market carriers, I do have enrollment data for two of them, but without knowing the other two this isn't terribly useful. The unweighted average rate change being requested there is a 9.3% increase.
The good news is that this year at least, the SERFF database has both the average rate changes as well as the 2024 effectuated enrollment for all carriers on both the individual and small group markets. There's one curiousity, however: For the small group market, UnitedHealthcare shows up in the SERFF database but doesn't appear on the federal Rate Review website.
This doesn't really move the needle much either way, however, since UHC only reports having 250 enrollees anyway.
In any event, individual market carriers are requesting average 8.3% rate increases, while small group carriers are asking for similar 8.6% hikes.
Not a whole lot stands out to me other than SSM Health Insurance apparently dropping out of the states indy market and a new carrier, Bankers Reserve Life Insurance, newly joining it.
At the same time, the Missouri small group market appears to be losing two carriers (or three depending on your POV): Aetna Health, Aetna Life and Cigna Health & Life are all missing from the 2025 filing summaries as well as the federal Rate Review database.
In any event, the MO individual market is looking at average premium reductions of 1.7% if approved as is, while small group plans are likely to increase by about 7.9% overall.
As always, these are subject to state regulatory review and approval.
Unfortunately, Mississippi is another state which provides zero useful rate filing data for my purposes (preliminary or final) prior to the Open Enrollment Period launching. The only data I have is from the federal Rate Review website, and even the filing forms there are heavily redacted, so all I can put together are unweighted averages for the 2025 calendar year.
It's worth noting that Vantage Health Plan appears to be dropping out of the individual market, while All Savers appears to be dropping out of the states small group market (at least, neither one shows up on the Rate Review site or in a SERFF search, anyway).
With that in mind, unsubsidized individual market enrollees are looking for unweighted average increases of around 1.8%, while small group carriers are hoping to increase rates by around 9.8% (again, unweighted).
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.
I'm pleasantly surprised to report that after several years of Kentucky's rate filings being heavily redacted, this year at least (and hopefully going forward), I was able to acquire the actual enrollment data for all of them...not just the individual market, but the small group market as well!
There are four carriers offering policies on the KY individual market (Anthem, CareSource, Molina and WellCare), with an weighted average rate change request of 8.5%, while the small group carriers are requesting steeper average increases of 17.8% for what seems to be shrinking market.
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.
