Charles Gaba's blog

A few weeks ago I posted my analysis of the preliminary 2026 individual & small group market filings for New Hampshire, concluding that the state is looking at average rate hikes of around 22.4% for the indy market and perhaps 13% for small group plans.

For the individual market, this is actually slightly lower than the national average (23.4%), and New Hampshire will still end up with the 2nd-lowest avg. premiums in the country (Idaho should be slightly lower next year), but 22.4% is still pretty steep, and the state insurance dept. isn't happy about it:

 

New Hampshire Insurance Department Urges Health Carriers to Submit Revised 2026 Premium Rates Reflecting Current Economic Conditions

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

April 2025 Key Findings - Medicaid and CHIP Enrollment

• In May 2025, 78.1 million individuals were enrolled in Medicaid and CHIP.
• 70.8 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
• 40.9 million adults were enrolled in Medicaid, and there were 37.2 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

IMPORTANT: See here for methodology & state-by-state analysis

Every year, I spend months painstakingly tracking every insurance carrier rate filing (nearly 400 for 2025!) for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

As of September 2nd, I've managed to fill in preliminary weighted average 2026 rate filings for all 50 states +DC as well as the final/approved rate filings for 15 states.

While it will move up or down slightly as more states finalize their 2026 filings, as of this writing, the weighted average rate increase for unsubsidized enrollees is 23.4% nationally.

This is the 2nd highest year-over-year gross rate hike since the ACA overhauled the individual market starting in 2014.

And yes, a significant chunk of this is due specifically to three factors:

This actually happened a couple of weeks ago but I've been playing catchup after being on vacation for a week or so...

Via NY State of Health:

Estimated Health Impacts of Almost $13 Billion Annually, Paralyzing Our Health Care System

1.5 Million New Yorkers Stripped of Health Care Coverage and Become Uninsured; Projected $8 Billion in Losses for New York’s Hospitals

Governor Kathy Hochul today joined U.S. Representative Ritchie Torres, local elected officials, doctors, and healthcare leaders to warn of the destructive ramifications of President Trump and Congressional Republicans’ “Big Ugly Bill” on New York State. The cuts imposed by Washington Republicans are expected to have a significant impact, with an anticipated nearly $13 billion affecting New Yorkers healthcare system. Additionally, approximately 1.5 million New Yorkers are projected to lose their health insurance coverage, while over 300,000 households are expected to lose some or all of their SNAP benefits.

Well this is a welcome bit of good news. While ACA major medical health insurance policy premiums are set to skyrocket in 2026 (largely due to Congressional Republicans allowing the improved premium subsidies to expire while the Trump Administration changes the underlying tax credit formula to make it significantly less generous), Covered California just announced that 2026 premiums for their standalone dental plans are set to cost pretty much the same next year:

Covered California Announces Premium Change for 2026 Dental Plans After Another Year of Steady Growth

La versión en español de este Comunicado puede ser descargada en este enlace.

SACRAMENTO, Calif. — Covered California announced that the statewide weighted average rate change for dental plans offered through the marketplace in 2026 will be 0.35 percent.

Originally posted 8/7/25

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

Anthem Health Plans of KY:

This filing includes an average rate change of 24.0%, excluding the impact of aging, effective January 1, 2026. At the individual plan level, rate increases range from 11.1% to 28.9% for renewing plans. A subscriber’s actual rate could be higher or lower depending on the geographic location, age characteristics, dependent coverage, and other factors.

Unfortunately, Anthem doesn't provide their actual 2025 individual market enrollment; I've had to estimate this based on marketwide estimated enrollment; see below.

Caresource Kentucky Co:

(CareSource announced that they are dropping out of the Kentucky individual market next year. I estimate they have perhaps 26,000 individual market enrollees in the state who will have to shop around for a new carrier.)

Molina Healthcare of KY:

Originally posted 1/16/25

Nevada has around ~110,000 residents enrolled in ACA exchange plans, 87% of whom are currently subsidized. I estimate they also have another ~23,000 unsubsidized off-exchange enrollees.

Combined, that's 133,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 120,000 statewide.

Originally posted 6/02/25

Hot off the presses via the New York Dept. of Financial Services:

MVP Health Plan, Inc.

Generally, once a year MVP files for a change to the current premium rates on file for their products based on a review of the adequacy of the rate level. Premiums need to be sufficient to cover all medical and pharmacy claims submitted from covered members, cover the administrative cost of operations, Federal and New York State taxes/assessments levied and New York State statutory reserve requirements.

MVP is proposing a premium rate adjustment effective January 1, 2026. Policyholders will be charged the proposed premium rates upon renewal in 2026 pending New York State’s Department of Financial Services review. There are 13,062 policyholders and 19,125 members currently enrolled in Individual MVP Health Plan, Inc. plans. The proposed premium rate adjustment represents an average increase of 8.00%. Premium changes will vary by plan design.

Premium rates are changing due to the following reasons:

Originally posted 8/05/25

via the Nevada Insurance Dept:

JULY 31st, 2025 - Nevadans Get a Preview of 2026 Proposed Health Insurance Rate Changes for Upcoming Open Enrollment

[CARSON CITY, NV] - Starting August 1st, 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 2026.

The Nevada Division of Insurance (Division) has received and made public on its website the 2026 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.

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.