Charles Gaba's blog

Originally posted 12/10/24

New York has around ~222,000 residents enrolled in ACA exchange plans, 63% of whom are currently subsidized. I estimate they also have another ~31,000 unsubsidized off-exchange enrollees.

Combined, that's ~253,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 235,000 statewide.

Originally posted 12/08/24

Virginia has ~388,000 residents enrolled in ACA exchange plans, 86% of whom are currently subsidized. They also have over 22,000 off-exchange enrollees. Combined, that's 411,000 people with ACA market coverage, or 4.6% of the total population.

Originally posted 1/01/25

8/31/25: SEE IMPORTANT UPDATE AT BELOW!!

New Mexico has around ~70,000 residents enrolled in ACA exchange plans, 85% of whom are currently subsidized. I estimate they also have another ~8,000 unsubsidized off-exchange enrollees.

Combined, that's 78,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 70,000 statewide.

Originally posted 1/25/25

South Dakota has around ~54,000 residents enrolled in ACA exchange plans, 94% of whom are currently subsidized. I estimate they also have another ~3,000 unsubsidized off-exchange enrollees.

Combined, that's ~58,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 54,000 statewide.

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 Vermont's Green Mountain Care Board:

May 13, 2025

Green Mountain Care Board Receives 2026 QHP Rate Requests Amid Rising Health Care Costs

Montpelier, VT – On May 12, 2025, the Green Mountain Care Board (GMCB) received the 2026 individual and small group health insurance premium rate filings from BlueCross and BlueShield of Vermont and MVP Health Plan. The filings will be posted on GMCB’s rate review website. The average rate increases being requested are shown below:

Originally posted 8/7/25

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

Ambetter Health of LA:

The proposed rate change of 16.4% applies to approximately 97,401 individuals. Ambetter Health of Louisiana’s projected administrative expenses for 2026 are $91.51 PMPM. Administrative expense does not include $17.45 for taxes and fees. The historical administrative expenses for 2025 were $79.64 PMPM, which excludes taxes and fees. The projected loss ratio is 81.4% which satisfies the federal minimum loss ratio requirement of 80.0%.

CHRISTUS Health Plan:

(as far as I can tell, CHRISTUS is dropping out of the Louisiana individual market...they aren't listed on the federal Rate Review database website, nor do they show up in the LA SERFF filings or on the LA Insurance Dept. website.)

HMO Louisiana:

Via the Massachusetts Division of Insurance:

Merged Market Summary for Proposed Rates Effective for 2026

The following tables depict the proposed overall weighted average premium increase and the key assumptions behind premium development for the merged (individual and small employer) market filed by insurance carriers as part of the Massachusetts Division of Insurance rate review process (for rates effective in 2026). This information is subject to change as the rate review process continues.

The Health Care Access Bureau within the Massachusetts Division of Insurance is currently reviewing these assumptions. This review process will culminate in a final decision in August 2025.

There are 711,563 consumers enrolled in merged (individual/small group) market plans (data as of December 2024).

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 the SERFF database, Texas Insurance Dept. and/or the federal Rate Review database.

Access to Care Health Plan:

(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."