Charles Gaba's blog

Originally posted 8/8/25

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

Blue Cross Blue Shield of AL

The average rate increase included in this filing is 19.3%, affecting over 210,000 members.

The main factors driving the need for this increase are:

• Alabama market membership loss and remaining members projected to be less healthy following expiration of enhanced premium subsidies in place since 2021
• Projected claim cost trends are higher for 2025 than anticipated in the 2025 filing and are projected to continue into 2026
• Administrative costs increased in 2025 and are expected to rise further in 2026 due to new eligibility and billing rules, along with a higher Exchange User Fee

...Expiring Enhanced Advance Premium Tax Credits

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 12/12/24

Washington State has around ~308,000 residents enrolled in ACA exchange plans, 73% of whom are currently subsidized. I estimate they also have another ~29,000 unsubsidized off-exchange enrollees.

Combined, that's ~338,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 305,000 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 12/17/24

Utah has around ~421,000 residents enrolled in ACA exchange plans, 95% of whom are currently subsidized. I estimate they also have another ~17,000 unsubsidized off-exchange enrollees.

Combined, that's ~438,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 410,000 statewide.

Originally posted 12/15/24

Rhode Island has around ~42,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have another ~3,000 unsubsidized off-exchange enrollees.

Combined, that's ~45,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 42,000 statewide.

Originally posted 2/4/25

West Virginia has ~67,000 residents enrolled in ACA exchange plans, 97% of whom are currently subsidized. They also have an unknown number of off-exchange enrollees (likely only a few thousand at most).

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 1/26/25

Illinois has around ~466,000 residents enrolled in ACA exchange plans, 90% of whom are currently subsidized. I estimate they also have another ~57,000 unsubsidized off-exchange enrollees.

Combined, that's ~523,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 488,000 statewide.

Originally posted 1/04/25

Georgia has around ~1.5 MILLION residents enrolled in ACA exchange plans, 93% of whom are currently subsidized. I estimate they also have another ~30,000 unsubsidized off-exchange enrollees.

Combined, that's 1.54 million people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 1.44 MILLION statewide.