SACRAMENTO, Calif. — Covered California Executive Director Jessica Altman issued the following statement on Speaker Emerita Nancy Pelosi’s announcement of her retirement on Thursday:
“After nearly four decades of unmatched public service, Speaker Emerita Pelosi leaves behind a legacy that continues to affect the lives of millions of Americans every day.
“Speaker Emerita Pelosi was one of the architects of the Patient Protection and Affordable Care Act and the driving force in making sure the landmark legislation became the law of the land in 2010.
“She was again the speaker of the House when the current Enhanced Premium Tax Credits were passed in 2021, further bringing down costs for consumers and making health insurance more affordable and accessible to more Americans than ever.
“Thanks to the speaker emerita’s tireless efforts, enrollment in Affordable Care Act marketplaces has more than doubled nationwide and currently provides health care coverage to over 24 million Americans, including nearly 2 million here in California.
Nevadans can now enroll in health insurance for 2026: 140 Qualified Health Plans from eight insurance carriers and new Battle Born State Plans for Nevadans to choose from
CARSON CITY, Nev. (November 3, 2025) – On November 1, Nevada Health Link kicked off the Open Enrollment Period for Plan Year 2026 with 140 Qualified Health Plans through eight brand-name private insurance carriers, including the new state-approved Battle Born State Plans (BBSPs). Nevadans can view, compare and shop plans now through January 15, 2026 on NevadaHealthLink.com.
New this year, Nevada Health Link will offer Battle Born State Plans or BBSPs.
Like all plans on the Marketplace, BBSPs will cover all ten essential health benefits, including hospitalization, doctor visits, emergency care, lab work and prescription drugs. These plans are required to be offered statewide, while also meeting specific reduction targets to bring costs down. This is especially significant for Nevadans living in rural areas, who will have more options this year when selecting a plan.
New “Yes, NY” Campaign Encouraging New Yorkers to Enroll in Quality, Affordable Health Coverage
Open Enrollment for 2026 Qualified Health Plans Began November 1 and Ends January 31, 2026
Enhanced Dental Benefits Introduced for 2026
ALBANY, NY (November 6, 2025) – The New York State Department of Health today announced the start of Open Enrollment for 2026 health insurance coverage through NY State of Health, the Official Health Plan Marketplace, launching a new statewide “Yes, NY” campaign to encourage New Yorkers to enroll in affordable, high-quality health coverage. Open enrollment runs from November 1, 2025, to January 31, 2026.
Amid federal health care changes negatively impacting Americans, Get Covered Illinois is here to help.
CHICAGO – Get Covered Illinois kicked off 2026 open enrollment and launched its “Here to Help” campaign across the state.
Open enrollment, which began on November 1 and runs through January 15, is the annual opportunity for Illinoisans to enroll in, renew, or change their health insurance plans. Nearly 466,000 Illinoisans purchased health coverage through Get Covered Illinois during open enrollment last year, a 17% increase from the previous year.
This year, Illinoisans will experience a new marketplace. Enrollees will apply for and enroll directly on GetCoveredIllinois.gov now that Illinois has officially transitioned to a state-based marketplace. They will also have access to increased support that is more tailored to their needs.
I've written multiple times in the past about "Silver Loading," the ACA health insurance policy pricing strategy in which insurance carriers load the extra cost of their Cost Sharing Reduction financial burden (the portion of deductibles, co-pays & coinsurance which they're required to cover themselves for low-income enrollees who select Silver plans) onto the gross premium of those same Silver plans.
It gets a bit wonky, but the bottom line is that Silver Loading results in the gross price of Silver ACA plans increasing significantly even if the price of Bronze, Gold & Platinum plans only go up modestly. This may sound bad, but stay with me.
From the carriers perspective, how the CSR load is allocated doesn't matter much as long as they aren't left stuck with the bill...but pricing the plans in this fashion has major implications for the enrollees themselves.
For nearly a year now, I've been writing about the upcoming expiration of the enhanced ACA premium tax credits (eAPTC) which have been in place for the past five years. They're currently scheduled to expire at the end of December, less than 2 months from today.
Over the past few weeks as the various ACA exchange websites brought their 2026 ACA window shopping live, I've started plugging in different household scenarios to see what actual, real world price hikes look like.
Throughout all of these examples, however, two things have remained consistent:
Wyoming has ~46,000 residents enrolled in ACA exchange plans, 95% of whom are currently subsidized. They also have an unknown number of off-exchange enrollees (likely only a few thousand at most). Combined, that's around 8% of their total population.
(Note, however, that the official actuarial rate filings for the 3 carriers offering coverage in the Wyoming individual market only report a combined total of around 39,000 enrollees as of spring 2025, or 6.6% of the total population).
Texas has ~3.9 MILLION residents enrolled in ACA exchange plans, 95% of whom are currently subsidized. I estimate they also have perhaps ~67,000 unsubsidized off-exchange enrollees.
Combined, that's over 4.0 MILLION Texans, although although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like ~3.8 million statewide.
Blue Cross Blue Shield of Wyoming (BCBSWY) has offered comprehensive and fully insured coverage to members in the Individual ACA market since 2014. BCBSWY is filing a rate increase for 2026 products. All plans will be offered statewide; plans with be offered either on or off the Federally Facilitated Marketplace in Wyoming.
(Access to Care Health Plan is a division of Sendero; unfortunately, they've heavily redacted their actuarial memo and I can't find a justification summary)
Aetna Health:
Aetna is dropping out of the individual market nationally in 2026. In texas, they've provided a market withdrawl letter which includes the exact number of current enrollees in each region of the state:
"Aetna is totally withdrawing from the individual (off and on-exchange) market, effective December 31, 2025. Individuals currently covered under an Aetna plan will need to make a different plan selection for 2026. In accordance with Texas and federal law, consumers will be given 180 days’ notice of the termination of their policy."
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.
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:
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.
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.
Nebraska has around ~136,000 residents enrolled in ACA exchange plans, 95% of whom are currently subsidized. I estimate they also have another ~2,000 unsubsidized off-exchange enrollees.
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.
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.
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.
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.
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.
(Unfortunately, Anthem has redacted their current enrollment total; see below)
This is a rate filing for the Individual market ACA-compliant plans offered by Anthem Health Plans of New Hampshire, Inc., also referred to as Anthem. The policy forms associated with these plans are listed below. The proposed rates in this filing are for a new HMO product that will be effective for the 2026 plan year beginning January 1, 2026, and apply exclusively to off-exchange plans.
Blue Cross and Blue Shield of Nebraska (BCBSNE) is setting new rates for its Individual ACA market business in Nebraska. The rate change will take effect January 1, 2026, and will impact an estimated 22,300 members. On average, rates will go up by 20.5% compared to 2025 individual rates. Depending on the network and plan, rate changes will range from a decrease of 1.1% to an increase of 33.3%. Additionally, premiums will go up a bit each year as people get older, even if their plan rates stay the same.
BCBSNE used its own claims and enrollment data, and other publicly available information to set these rates.
