August 2025

Originally posted 8/04/25

via the North Carolina Insurance Dept:

Initial Affordable Care Act Rates for 2026 have been posted

The North Carolina Department of Insurance has posted the rate changes requested by insurers for the 2026 plan year individual and small-group market plans offered under the Affordable Care Act.

Posting of the requested rates is part of the rate review process required by the Centers for Medicare and Medicaid Services (CMS). Unlike some types of insurance, the NCDOI does not set rates for health insurance.

Via the New Mexico Office of Superintendent of Insurance (OSI):

Santa Fe, NM – The New Mexico Office of the Superintendent of Insurance (OSI) has approved 2026 rates for individual market Affordable Care Act (ACA) plans sold on and off BeWell, the New Mexico Health Insurance Marketplace, with an average increase of 35.7%. Today, 75,000 New Mexicans buy health insurance through BeWell and 88% of enrollees qualify for federal and state premium assistance.

However, there's an important caveat:

While it appears that Congress will allow enhanced federal Premium Tax Credits to expire, New Mexico’s Health Care Affordability Fund (HCAF) will cover the loss of the enhanced premium tax credits for households with income under 400% of the Federal Poverty Level (or $128,600 for a family of four), providing up to $68 million in premium relief for working families who enroll in coverage through BeWell in 2026. Federal and state premium assistance will continue to reduce the impact of the rate increases.

Overall preliminary rate changes via SERFF database, South Dakota Insurance Dept. and/or the federal Rate Review database.

Avera Health Plans:

(Unfortunately, Avera hasn't provided a justification summary and has almost completely redacted their actuarial memo, making it impossible for me to know what their current enrollment is; see below)

Overall preliminary rate changes via the SERFF database, New Mexico Insurance Dept. and/or the federal Rate Review database.

Blue Cross Blue Shield NM

Blue Cross and Blue Shield of New Mexico (BCBSNM) is filing new rates to be effective January 1, 2026, for its Individual ACA metallic coverage. As measured in the Unified Rate Review Template (URRT), the range of rate changes for these plans is an increase of 18.4% to an increase of 49.6%.

The cost relativities among plans are different from the experience period to the prospective rating period due to anticipated non-uniform changes in network reimbursement levels. Additionally, the rates vary by plan due to the leveraging and utilization differences driven by variations in member cost sharing. Therefore, the proposed rates and rate changes may vary by plan.

Changes in allowable rating factors, such as age and geographical area, may also impact the premium amount for the coverage.

Hoo boy. Via the Delaware Insurance Dept:

Plan year 2026 health and dental insurance rate filings, as proposed, are available for the companies listed below. These filings are subject to actuarial review. Additional companies will be listed as their filings are received. Any insurance filings already approved are available to the public through the NAIC’s System for Electronic Rate and Form Filing (SERFF) interface. There is no fee for using SERFF. Rate info can also be accessed at the Rate Review  page at Healthcare.gov

AmeriHealth Caritas VIP Next, Inc:

• Company Legal Name AmeriHealth Caritas VIP Next, Inc.
• Market for which proposed rates apply (Individual or Small Group) Individual
• Total proposed rate change (increase/decrease) 46.20% increase
• Effective date of proposed rate change January 1, 2026

Summary

Overall preliminary rate changes via SERFF database, state insurance dept. website and/or the federal Rate Review database.

Hawaii Medical Service Association:

Our requested rates include only the amounts needed to cover the expected health care benefits of our members, the cost of administering their benefits, expected Affordable Care Act (ACA) fees, and a small charge to help manage the risk of offering benefits to this population.

We based our rate increase request on a review of past costs of benefits and other expenses. These historical costs are adjusted for trend, to account for expected changes in use of medical services, cost inflation, and other factors that affect the cost of care. We also adjusted costs for benefit changes, which were largely made to comply with government mandated plan designs. Administrative expenses have been relatively flat over the past couple of years.

Originally posted 1/30/25

Vermont has around ~32,000 residents enrolled in ACA exchange plans, 93% of whom are currently subsidized. I estimate they also have another ~2,000 unsubsidized off-exchange enrollees.

Combined, that's ~35,000 people, although the official carrier rate filings claim it's more like 36,000 statewide.

Originally posted 1/07/25

Tennessee has around ~642,000 residents enrolled in ACA exchange plans, 95% of whom are currently subsidized. I estimate they also have another ~9,000 unsubsidized off-exchange enrollees.

Combined, that's ~652,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 609,000 statewide.

Originally posted 12/30/24

New Jersey has around ~513,000 residents enrolled in ACA exchange plans, 85% of whom are currently subsidized. I estimate they also have another ~76,000 unsubsidized off-exchange enrollees.

Combined, that's ~590,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 550,000 statewide.

Originally posted 1/03/25

Oregon has around ~140,000 residents enrolled in ACA exchange plans, 80% of whom are currently subsidized. I estimate they also have another ~34,000 unsubsidized off-exchange enrollees.

Combined, that's ~173,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 162,000 statewide.

Originally posted 12/20/24

Oklahoma has around ~293,000 residents enrolled in ACA exchange plans, 93% of whom are currently subsidized. I estimate they also have another ~7,000 unsubsidized off-exchange enrollees.

Combined, that's ~315,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 300,000 statewide.

Originally posted 12/05/25

New Hampshire has around ~70,000 residents enrolled in ACA exchange plans, 71% of whom are currently subsidized. I estimate they also have another ~14,000 unsubsidized off-exchange enrollees.

Combined, that's 85,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 80,000 statewide.

Originally posted 12/28/24

Mississippi has around ~338,000 residents enrolled in ACA exchange plans, 98% of whom are currently subsidized. I estimate they also have another ~14,000 unsubsidized off-exchange enrollees.

Combined, that's 352,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 330,000 statewide.

Originally posted 1/18/25

Missouri has around ~417,000 residents enrolled in ACA exchange plans, 94% of whom are currently subsidized. I estimate they also have another ~3,600 unsubsidized off-exchange enrollees.

Combined, that's ~420,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 392,000 statewide.

Originally posted 1/01/25

Louisiana has around ~293,000 residents enrolled in ACA exchange plans, 96% of whom are currently subsidized. I estimate they also have another ~13,000 unsubsidized off-exchange enrollees.

Combined, that's 306,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 286,000 statewide.

Originally posted 12/04/24

Massachusetts has around 390,000 residents enrolled in ACA exchange plans, 83% of whom are currently subsidized. I estimate they also have another ~27,000 unsubsidized off-exchange enrollees.

Combined, that's ~417,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to perhaps ~400,000.

Originally posted 1/02/25

Kansas has around 200,000 residents enrolled in ACA exchange plans, 94% of whom are currently subsidized. I estimate they also have another ~6,000 unsubsidized off-exchange enrollees.

Combined, that's ~206,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be down to more like 192,000 statewide.

Originally posted 12/09/24

Indiana has around 359,000 residents enrolled in ACA exchange plans, 90% of whom are currently subsidized. I estimate they also have another ~6,700 unsubsidized off-exchange enrollees

Combined, that's 5.3% of their total population.

Assuming the national average 6.6% net enrollment attrition rate thru April reported by the Centers for Medicare & Medicaid Services applies to Indiana, however, that would knock the current enrollment down to more like 341,000 statewide.

Originally posted 12/31/24

Hawaii has around 26,000 residents enrolled in ACA exchange plans, 83% of whom are currently subsidized. I estimate they also have perhaps another ~1,700 unsubsidized off-exchange enrollees.

Combined, that's 1.8% of their total population.

Assuming the national average 6.6% net enrollment attrition rate thru April reported by the Centers for Medicare & Medicaid Services applies to Hawaii, however, that would knock the current enrollment down to more like 24,000 statewide.

Originally posted 6/06/25

Tennessee ACA exchange carriers were instructed to provide two sets of rate filings for 2026: One which assumes CSR reimbursement payments won't be reinstated, one which assumes they are reinstated. In addition, both sets of filings assume that IRA subsidies won't be extended; all but one carrier clarified how much extending the IRA subsidies would impact 2026 premium changes.

Alliant Health Plans: Alliant is requesting a nominal 0.3% increase next year if CSR payments aren't reinstated and a 1.0% drop if they are. In both cases, premiums would be 2.8% lower if IRA subsidies were to be extended by Congress:

It was just a couple of weeks ago that the official (if preliminary) 2026 ACA individual market rate filings for Wyoming insurance carriers went live on the federal rate review website.

I published a writeup about these just 3 days ago; unlike some states, Wyoming was pretty easy to break out as they only have three carriers on the indy market, all of which also made their current enrollment data easy to find.

The landscape isn't pretty: BCBS is seeking average rate increases of 20.7%; UHC wants 29.1%, and Mountain Health Co-Op, which has around 9,600 enrollees, was asking for a whopping 32% average premium hike.

Keep in mind that Wyoming already has among the most expensive individual market policies in the country, with premiums averaging over $1,000/month.

Originally posted 2/05/25

Alaska has around ~28,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. They also have an unknown number of off-exchange enrollees in ACA-compliant individual market policies. Overall, including net attrition, I estimate their total enrollment both on & off exchange to be perhaps ~27,000 or so.

Overall preliminary rate changes via the SERFF database, Alaska Insurance Dept. and/or the federal Rate Review database.

Moda Assurance Co:

(Moda has heavily redacted their actuarial memo and isn't providing the number of current enrollees)

The average rate change is X.XX% as shown on Worksheet 2 of the URRT. The proposed rate Proposed Rate Increase change varies by product and plan, and the proposed rates vary by plan, age, geographic area, and tobacco use. The average rate change was calculated by comparing the weighted average premium for members on current plans and rates to the weighted average premium for members on renewal plans and rates.

A summary of the major components and their contribution to the rate change is provided in the table below.

Components of the rate change / % Impact

Overall preliminary rate changes via the SERFF database, Oklahoma Insurance Dept. and/or the federal Rate Review database.

Blue Cross Blue Shield of OK

Scope, Range, and Best Estimate of the Rate Increase

Blue Cross and Blue Shield of Oklahoma (BCBSOK) is filing new rates to be effective January 1, 2026, for its Individual ACA metallic coverage. As measured in the Unified Rate Review Template (URRT), the range of rate increases for these plans is 12.3% to 51.5%.

...Changes in allowable rating factors, such as age, geographical area, or tobacco use, may also impact the premium amount for the coverage.

There are currently 128,181 members on Individual Affordable Care Act (ACA) plans that may be affected by these proposed rates.

Celtic Insurance

Overall preliminary rate changes via the SERFF database, New Jersey Insurance Dept. and/or the federal Rate Review database.

Aetna Life Insurance Co:

(Aetna/CVS is pulling out of the entire individual market nationally; I've estimated their current enrollment, see below for methodology)

AmeriHealth HMO:

AmeriHealth HMO, Inc. ("AHNJ”) is revising premium rates for the New Jersey Individual Health ACA compliant products, effective from January 1, 2026. Rate increases average 16.8%, ranging from 16.8% to 16.8%. The proposed revisions to each plan are shown on the last page of this exhibit. About 35 members will be affected.

AmeriHealth Insurance Co of NJ

Overall preliminary rate changes via SERFF database, state insurance dept. website and/or the federal Rate Review database.

Aetna Life Insurance Co:

(Aetna/CVS is dropping out of the individual market in all states; I estimate they have around 35,000 enrollees in Kansas who will have to find a different carrier for 2026)

Blue Cross Blue Shield of Kansas City:

Blue Cross and Blue Shield of Kansas City (BCBSKC) is requesting an average rate change of -6.1% for 2025 individual rates as compared to 2023 individual rates and calculated by the URRT. The changes vary by plan, with a minimum rate change of -10.8% and a maximum rate increase of 1.8%.

Table 2.1 summarizes proposed rate increases effective January 1, 2026, and displays significant factors driving the proposed rate increases. Note that this rate buildup is illustrative of changes occurring from 2025 to 2026, and is therefore not reflective of factors displayed in Worksheet 1, Section II of the URRT, which pertains to changes from the experience period (2024) to the projection period (2026). Factors found in The URRT are discussed in later sections.

Originally posted 1/06/25

Delaware has ~53,000 residents enrolled in ACA exchange plans, 91% of whom are currently subsidized. They also have an unknown number enrolled in off-exchange plans. Overall, with net attrition, I estimate current total enrollment is down a bit to perhaps 52,000 today.

Originally posted 12/23/24

Connecticut has around ~151,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have another ~7,000 unsubsidized off-exchange enrollees.

Combined, that's 158,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 150,000 statewide.