If this happens, it would mean the ACA exchange market would drop by more than 1/3 from the ~24.2 million currently enrolled (myself & my own family included).
However, I've repeatedly stated that even this is likely a low estimate--the remaining ~16 million exchange enrollees would still be hit with MASSIVE (and in some cases eye-poppingly huge) premium hikes which would force them to drop to far worse plans (meaning much higher deductibles & co-pays; worse provider networks and so on).
The good news is, the Illinois Insurance Dept. now provides a handy, simple table with the actual average rate changes as well as direct links to the actuarial memos & other filing forms for every carrier, which made it easy for me to plug in the effectuated enrollment & calculate the weighted average rate hikes for every carrier in both the individual and small group markets.
The bad news is, the actuarial memos themselves are heavily redacted, meaning I'm unable to see how much of the rate hikes are due to the IRA subsidies expiring, CSR payments being reinstated or Trump's tariffs.
More than 400,000 Washingtonians will lose health insurance if ‘Big Beautiful Bill’ passes
Washington Health Benefit Exchange warns of looming rise in uninsured Washingtonians if Senate passes Reconciliation Bill
OLYMPIA, Wash. - The Congressional Reconciliation bill and loss of enhanced federal tax credits would result in 16 million Americans losing coverage, according to the Congressional Budget Office, with more than 400,000 predicted to lose coverage in Washington state.
“The reconciliation bill now headed to the Senate would make it much harder for Washingtonians to get and stay covered,” said Ingrid Ulrey, CEO of Washington Health Benefit Exchange. “While there has been much attention on the bill’s effects on Medicaid — which will be devastating — it is important to understand that it would also create a massive new layer of red tape and higher costs for people who purchase private health insurance on the Exchange.”
Back in March, the Health & Human Services (HHS) Dept. and the Centers for Medicare & Medicaid Services (CMS) proposed a so-called "Marketplace Integrity & Affordability Rule" which would include sweeping changes to how the ACA exchanges (both the federal one (HealthCare.Gov) and the 20-odd state-based ones (Covered California, MNsure, etc) operate, as well as who is or isn't eligible to enroll in ACA exchange coverage, restrictions on subsidy eligibility and so forth.
Many of these changes are simply repeals/reversals of improvements put into place during the Biden Administration; others are completely new ones being put into place by the Trump Regime under RFK Jr. & Dr. Oz.
However, until today, these were still technically only proposed changes. Now they're official. The final version isn't quite as bad as it could have been, and there's one or two items on the list which I'm not that upset about, but overall...yeah, it's pretty ugly.
Secretary Kennedy, Administrator Oz to Host Press Conference to Discuss Groundbreaking Health Insurance Reform
WASHINGTON, DC—FRIDAY, JUNE 20, 2025—U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. and Centers for Medicare and Medicaid Services Administrator Mehmet Oz will host a press conference to discuss a breakthrough in health insurance that will improve access to care for millions of Americans.
WHEN: Monday, June 23 at 2:45 PM ET
Press should arrive by 1:45 PM for priority placement
Press must have REAL ID to enter the building
WHERE:
Hubert H. Humphrey Building Auditorium
200 Independence Ave SW
Washington, D.C. 20009
PARTICIPANTS:
HHS Secretary Robert F. Kennedy, Jr.
CMS Administrator Mehmet Oz, M.D.
Federal policy shifts drive higher 2026 rates for individual and small group health plans
State actions blunt increases tied to the reconciliation bills and policy direction of the federal government
St. Paul, MN: Health insurers have submitted their proposed increased rates to the Minnesota Department of Commerce for 2026 plans available to Minnesotans who buy individual or small group health insurance through MNsure or directly through insurers. These proposed rates apply to coverage starting Jan. 1, 2026, with open enrollment beginning Nov. 1, 2025.
BCN is filing a year-over-year average rate increase for 2026 for all individual products that were offered in 2025 of 16.3%. Significant contributors to rate change are outlined in the table below:
Experience Restate 4.0%
Medical and pharmaceutical price and utilization trend 5.4%
ARPA Subsidy Expiration Impact 4.6%
Benefit Change and CSR -2.6%
Margin Impact 1.2%
...Incorporated in the above, BCN assumed an additional pharmacy price trend due to tariffs, as follows:
Generic +2.5%
Brand +10%
Specialty 0%
Total Impact +2.5%
...Consistent with the 2025 filing, BCN has assumed no CSR payments will be made by the federal government for 2026. Therefore, rates for Silver plans offered on exchange are 20.5% higher than if the federal government funded CSR subsidies.
Last month, in response to House Republicans passing their version of the budget resolution bill, I broke out total enrollment in Medicaid via ACA expansion, ACA exchange Qualified Health Plan (QHP) enrollment and ACA-based Basic Health Plan (BHP) enrollment by Congressional District in order to try and get a sense of just how many Americans healthcare coverage is at risk from the bill...and how that breaks out along partisan lines at the House District level.
As I noted at the time, Republicans seem to be under the impression that it will mostly be Democrats who get screwed by their bill, since 9 of the 10 non-expansion states are Republican strongholds...while some Democrats seem to be under the impression that it will mostly be rural MAGA republicans who get screwed.
Senate GOP tax bill would hit politically explosive Medicaid provision
The Finance Committee is due to brief members on its megabill draft text Monday night.
Senate Republicans are seeking to ratchet up savings from a politically explosive policy within Medicaid to pay for their megabill, and it’s already setting off shockwaves through Capitol Hill.
The Senate Finance Committee’s forthcoming portion of the party-line tax and spending package would lower the Medicaid provider tax to 3.5 percent, according to three people with direct knowledge of the legislation who were granted anonymity to discuss it.
With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.
USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.
The 4,000 California National Guard soldiers who President Donald Trump surged into Los Angeles remain unpaid due to delays in issuing official activation orders, leaving compensation and benefits in limbo.
According to more than a dozen Guardsmen across four units who spoke to Military.com, none has received formal activation orders, the critical paperwork that not only authorizes their duty status, but also unlocks pay, Tricare health benefits and eligibility for Department of Veterans Affairs services. Without those orders, troops remain in a legal and administrative limbo.
Multiple defense officials with direct knowledge of the situation told Military.com the chaotic and sudden activation of troops has effectively clogged up the flow of administrative work.
16 Million Americans Would Become Uninsured Due to Reconciliation Bill and Loss of Tax Credits; 8.2 Million in Marketplaces Alone
Leaders from State-based Health Insurance Marketplaces, Enrollees, Providers, and Small Business Highlight Potential, Devastating Impacts
(Washington, DC) The Congressional Reconciliation bill and loss of federal tax credits would result in 16 million Americans losing health coverage, including 8.2 million enrolled in Health Insurance Marketplaces. By stripping millions of lives from the Marketplaces, health care will be more expensive, harder to access, create a strain on health care systems, and hurt small businesses.
Governor Kathy Hochul today released new data showing the massive impact the GOP’s ‘Big Ugly’ Reconciliation Bill would have on New York families. The latest bill threatens to severely disrupt health coverage for millions of New Yorkers. In addition to increasing the number of uninsured by 1.5 million and stripping $13.5 billion in annual funding from New York’s healthcare system, the bill would trigger steep increases in private health insurance premiums for vulnerable New Yorkers and impose excessive burdens on consumers enrolling through NY State of Health, the State’s official health plan marketplace.
Each year insurers that sell Individual and Small Group plans in Maine's pooled risk market must submit their proposed forms and rates to the Bureau of Insurance, using the System for Electronic Rate and Form Filing (SERFF). Details of the filings submitted to the state since June 10, 2010 can be viewed in the system.
Anthem Health Plans of Maine:
The proposed rates have been developed from 2024 Individual and Small Group ACA combined experience, and the proposed average annual rate change at the Merged Market level is 18.0%.
The proposed annual rate changes by product for Individual range from 17.9% to 20.6%, with rate changes by plan from 10.1% to 30.0%. These ranges are based on the renewing plans, and are consistent with what is reported in the Unified Rate Review Template. Exhibit A shows the rate change for each plan.
Factors that affect the rate changes for all plans include:
The Supreme Court seemed likely to uphold a key preventive-care provision of the Affordable Care Act in a case heard Monday.
Conservative justices Brett Kavanaugh and Amy Coney Barrett, along with the court’s three liberals, appeared skeptical of arguments that Obamacare’s process for deciding which services must be fully covered by private insurance is unconstitutional.
But the plans were on display…”
“On display? I eventually had to go down to the cellar to find them.”
“That’s the display department.”
“With a flashlight.”
“Ah, well, the lights had probably gone.”
“So had the stairs.”
“But look, you found the notice, didn’t you?”
“Yes,” said Arthur, “yes I did. It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard.”
The Connecticut Insurance Department has posted the initial proposed health insurance rate filings for the 2026 individual and small group markets. There are 8 filings made by 7 health insurers for plans that currently cover approximately 224,000 people (158,000 individual and 66,000 small group).
Anthem has filed rates for both individual and small group plans that will be marketed through Access Health CT, the state-sponsored health insurance exchange. ConnectiCare Benefits Inc. (CBI) and ConnectiCare Insurance Company, Inc. have filed rates for the individual market on the exchange.
Before I continue, note that yes, I'm aware the 17.8% average shown below doesn't match the 22.9% average in the headline above. There's a reason for this which should be obvious if you read on:
The 2026 rate proposals for the individual and small group market are on average higher than last year:
Tennessee ACA exchange carriers were instructed to provide two sets of rate filings for 2026: One which assumes CSR reimbursement payments won't be reinstated, one which assumes they are reinstated. In addition, both sets of filings assume that IRA subsidies won't be extended; all but one carrier clarified how much extending the IRA subsidies would impact 2026 premium changes.
Alliant Health Plans: Alliant is requesting a nominal 0.3% increase next year if CSR payments aren't reinstated and a 1.0% drop if they are. In both cases, premiums would be 2.8% lower if IRA subsidies were to be extended by Congress:
There was a lot to unpack there, all of it pretty horrible...but I felt one provision in particular was worth its own separate post:
Funding Cost-Sharing Reductions.
Enacting section 44202 would affect the cost-sharing reductions that the ACA requires insurers to offer to eligible people who purchase silver plans through the marketplaces. Those reductions increase the actuarial value—the average share of covered medical expenses paid by the insurer—above the amount in other silver plans, resulting in lower out-of-pocket costs for eligible enrollees. To be eligible for cost-sharing reductions an enrollee’s income must generally fall between 100 percent and 250 percent of the FPL; the subsidy varies with income.
BALTIMORE (June 3, 2025) – The federal budget reconciliation bill passed by the House earlier this month will have significant consequences for the Affordable Care Act in Maryland, if it becomes law as is. For the nearly 250,000 Marylanders who buy health insurance through Maryland Health Connection this bill will increase premium costs, and create unnecessary, inefficient barriers to enrollment.
“For many of those enrolled in Maryland Health Connection, this proposed bill will drive up prices and increase the barriers to quality health insurance,” said Michele Eberle, executive director of Maryland Health Benefit Exchange. “Maryland Health Connection has increased enrollment by 40% in the last four years, because people who know how important health insurance is have found it affordable.”
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).
The Congressional Budget Office has published several projections about how many people would lose healthcare coverage and/or become uninsured (these aren't the same thing) under various versions of the #OneBigUglyBill Act passed by House Republicans, which is currently beginning its next phase over on the Senate side of the Capitol.
Their most recent projection put the total at around 11.7 million when you include some technical weirdness which I'm a little vague about...plus another 3.8 million if you include their projection from December 2024 regarding the impact of the upgraded ACA subsidies included in the Inflation Reduction Act being allowed to expire at the end of this year. This placed the grand total at around 15.5 million...except they more recently sent a letter to the House Energy & Commerce Committee which bumped this estimate up a bit more, putting the combined total at 15.9 million.
I joined Simon Rosenberg of Hopium Chronicles yesterday to discuss the House GOP budget bill (aka the #MAGAMassacreBill) and the Trump Regime's all-out assault on the U.S. healthcare system.
Oregonians continue to have at least five health insurance companies to choose from in every Oregon county as companies file 2026 health insurance rate requests for individual and small group markets
In-depth rate review process just beginning, opportunities for public review and input remain through June 20
June 2, 2025
Oregon health insurers have submitted proposed 2026 rates for individual and small group plans, launching a months-long review process that includes public input and meetings.
Five insurers will again offer plans statewide (Moda, Bridgespan, PacificSource, Providence, and Regence), and Kaiser is offering insurance in 11 counties, giving six options to choose from in various areas around the state.
Health Carriers Propose Affordable Care Act Premium Rates for 2026
Anticipated loss of federal enhanced premium tax credits leads to highest individual market rate increases proposed since the start of Maryland’s reinsurance program
BALTIMORE – The Maryland Insurance Administration has received the 2026 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 502,000 Marylanders.
Governor Kathy Hochul today was joined by the Democratic Leader of the U.S. House of Representatives Congressman Hakeem Jeffries and leaders in the health care and labor sectors to sound the alarm on the detrimental effects of several healthcare provisions already passed by the House of Representatives in the Republican budget reconciliation bill. These provisions collectively amount to an annual loss of nearly $13.5 billion for New Yorkers and our healthcare sector, jeopardizing healthcare access for millions of New Yorkers and threatening the state’s hospitals and healthcare providers.
“Republicans in Washington have made it abundantly clear that they are determined to dismantle the social safety net that millions of New Yorkers rely on to secure their basic necessities,” Governor Hochul said. “They are specifically targeting essential and life-saving programs such as Medicaid and food stamps with the consequence that everyday Americans will bear the brunt of this attack. I am committed to utilizing litigation and other appropriate tools to safeguard and protect New Yorkers.”
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:
