2026 Rate Changes - Arkansas carriers REFILE w/35.7% rate hikes; ~166K enrollees facing MASSIVE rate hikes as Gov. Sanders blows a gasket over policies she supports

I still have the preliminary 2026 rate filings to analyze for about 10 more states, but I'm taking a break to go back and revisit ARKANSAS.

Back on July 18th, I posted my original analysis of ACA-compliant individual & small group market filings for Arkansas insurance carriers. At the time, I found that the weighted average increases being requested for individual market policies averaged a disturbingly high 26.2%. Here's what the breakout looked like:

This is pretty bad, of course, especially when paired with the expiration of the improved IRA financial subsidies as well as the modified PAPI formula, which is what determines the Applicable Percentage Table.

HOWEVER, about a week ago, the Center for Medicare & Medicaid Services (CMS) Rate Review website published the requested 2026 rate filings for every carrier in every state, and lo & behold, Arkansas carriers have refiled for even higher rate increases, pretty much across the board. In addition, the Arkansas Insurance Dept. has also posted the updated filings, although some of them don't match up with the CMS website for some reason.

Interestingly, while three of the filings are jaw-droppingly higher...the other three are actually lower than the initial filings, although only modestly so in two cases:

• Celtic/Ambetter: 20.1% >> 42.5% ⬆️ 22.4 pts
• QCA Health Plan: 30.1% >> 54.2% ⬆️ 24.1 pts
• HMO Partners: 20.9% >> 20.2% ⬇️ 0.7 pts
• QualChoice: 30.7% >> 54.4% ⬆️ 23.7 pts
• USAble Mutual: 25.8% >> 23.3% ⬇️ 2.5 pts
• USAble/Octave: 34.3% >> 25.5% ⬇️ 8.8 pts

Here's what it looks like plugged into the spreadsheet:

The number of current enrollees has also changed a bit for some of the carriers, although only slightly; this is actually fairly common, if irritating.

It's important to note again that while the total enrollment shown in both tables above add up to around ~350,000 or so, actual ACA exchange enrollment in Arkansas is only around 166,000, plus another few thousand enrolled in off-exchange individual market policies. The additional ~180,000 or so are actually enrolled in Arkansas' unique "Private Medicaid Option" program, "ARHOME" in which most people eligible for Medicaid expansion are instead enrolled in ACA exchange plans which are then entirely paid for with the Medicaid expansion funding instead.

It's an overly complicated & unnecessarily expensive way of providing healthcare coverage for this population, but it was the only way to get it through the deep red state legislature & governor at the time.

The end result is that the weighted average rate increase being requested by Arkansas carriers has jumped by nearly an additional 10 points, from around 26.2% to 35.7%.

Needless to say, this caused a significant amount of backlash in Little Rock, with die-hard MAGA Republican Gov. Huckabee Sanders issuing the following statement on August 6th:

Sanders Statement on Insurance Companies’ Premium Rate Hikes

LITTLE ROCK, Ark. – Following today’s filings from Centene Corporation and Blue Cross Blue Shield to raise premium rates on the insurance plans they offer in Arkansas by as much as 54% and 25.5%, respectively, Governor Sarah Huckabee Sanders released the following statement:

“Arkansans are tired of getting outrageous bills from multi-billion-dollar insurance companies, and my administration will not allow them to take advantage of our people. Nothing justifies year-over-year premium increases of this scale – it’s wrong and prohibited under Arkansas law.

“Arkansas’ Insurance Commissioner is required to disapprove of proposed rate increases if they are excessive or discriminatory, and these are both. I’m calling on my Commissioner to follow the law, reject these insane rate increases, and protect Arkansans.”

Note: In case you're confused by her including some carriers but not others, Centene Corporation is actually another name for Celtic Insurance, which is also another name for Ambetter...and, as it happens, so are QualChoice and QCA. Meanwhile, both USAble Mutual Insurance as well as Octave are subsidiaries (or "licensees?") of Blue Cross Blue Shield of Arkansas, as is HMO Partners dba Health Advantage.

Ain't the insurance industry grand?

You'll note that Sanders doesn't say a peep in her statement about the IRA subsidies expiring (which the carriers themselves say is responsible by itself for over ~20% of the unsubsidized rate hike) or the CMS "Integrity & Affordability Rule" which is also substantially weakening the subsidy levels & increasing both premiums as well as deductibles & co-pays.

By an amazing coincidence, this story at the Captive Insurance Times also ran on the same day, August 6th:

Arkansas insurance commissioner Alan McClain will step down from his post at the end of August, bringing to a close a five-year term in which he oversaw significant regulatory and market developments across the state.

McClain was appointed commissioner of the Arkansas Insurance Department in April 2020 by former Governor Asa Hutchinson and continued to serve under Governor Sarah Huckabee Sanders. His current term had been scheduled to run through 2027.

I'm not saying that these two events are connected, I'm just saying that it's interesting that both of them happened on the same day.

In any event, while the situation itself is indeed devastating, it's eye-rollingly amusing to see Sarah Huckabee Sanders flipping out over these admittedly shockingly high rate increases given that she's been completely onboard with every move being made by her fellow MAGA Republicans and the Trump Administration for years.

And yes, I've already gone ahead and (yet again) updated my look at how much these rate hikes, combined with Republicans allowing the IRA subsidies to expire and in conjunction with the PAPI formula change are gonna cause net premiums to spike for Arkansas enrollees.