Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.
However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.
As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.
Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.
Every year, I spend months painstakingly tracking every insurance carrier rate filing nationally for the upcoming year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.
Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:
After last year's near-chaos on Virginia's individual market, things seem to be much calmer & less interesting this year. The premium increases for 2025 being requested by individual market carriers have a weighted average of 4.0%, while small group market carriers are asking for 6.8% increases on average.
The most noteworthy news for 2025 is that Aetna Life Insurance (their EPO division) is exiting the Virginia market, although Aetna Health (HMOs) is sticking around.
UPDATE: I thought Piedmont was also pulling out in 2025, but it turns out they left Virginia's individual market last fall at the very last minute.
In addition, it looks like Aetna is pulling completely out of the small group market, as is Innovation Health and, again, Piedmont Community.
Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.
Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:
Via the New York Dept. of Financial Services, the preliminary, weighted average rate increases being requested for individual market health insurance policies for 2025 sound bad: 16.6% overall according to DIFS. I get a slightly lower weighted average of 16.2%, but it still ain't pretty.
Two of the highest increases are for carriers which are only offering policies off-exchange next year and which have fewer than 100 enrollees each anyway (Aetna and UnitedHealthcare Insurance Co. of NY); I assume they're both winding down their operations in the state.
As for the rest, they range from requested average increases of "only" 8.8% for the other UHC division to a stunning 51% rate hike by Emblem (HIP). The justification summaries are below the table.
It's important to remember that these are not final rate increases--New York in particular has a tendency to slash the requested rate hikes down significantly before approving them.
The Oregon Division of Financial Regulation (DFR) has finalized the rate decisions for 2025 health insurance for the individual and small group markets. The division reviews and approves rates for these markets through a detailed and transparent public process before they can be charged to policyholders.
This transparent process includes actuarial analysis provided to the public, public hearings, and a public comment period. Annually, insurance companies submit rate filings for the upcoming plan year. These filings are rigorously reviewed by division actuaries during a monthslong public review process. That process is now final and Oregonians will see an average rate increase of 8.3 percent in the individual market and a 12.2 percent increase in the small group markets.
Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has 9 different carriers participating in the individual market in 2025. This is down from ten this year--ConnectiCare appears to be dropping out of the Massachusetts market.
One thing which sets Massachusetts (along with Vermont) apart from every other state is that their Individual and Small Group risk pools are merged for premium setting purposes.
Normally you would think this would make my job easier, since I only have to run one set of analysis instead of two...but until recently, it was surprisingly difficult to get ahold of exact enrollment data for each carrier on the merged Massachusetts market (and even more difficult to break out how many are enrolled in each market since they're merged...not that that's relevant to the actual rate changes).
OLYMPIA, Wash. — Thirteen health insurers filed an average requested rate increase of 11.3% for Washington's individual health insurance market. The proposed plans and their rates are currently under review and final decisions will be made this fall.
"I recognize that any proposed increase in price is deeply upsetting to those struggling to pay for coverage today,” said Insurance Commissioner Mike Kreidler. “People should know that these rates are not final and my office will be carefully reviewing each request to validate the assumptions being made by our state’s insurers. We will do everything under our authority ensure that any rate changes are justified."
Health Carriers Propose Affordable Care Act Premium Rates for 2025 New carrier files to enter individual market statewide
BALTIMORE – The Maryland Insurance Administration has received the 2025 proposed premium rates for Affordable Care Act products offered by health and dental carriers in the individual, non-Medigap and small group markets, which impact approximately 496,000 Marylanders. This includes rate submissions from Wellpoint Maryland Inc., an HMO that will begin offering Affordable Care Act products in Maryland for the first time.
