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.
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.
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.
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:
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.)
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).
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.
(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."
(Unfortunately, Avera hasn't provided a justification summary and has almost completely redacted their actuarial memo, making it impossible for me to know what their current enrollment is; see below)
Blue Cross and Blue Shield of Montana (BCBSMT) filed rates to be effective January 1, 2026, for its Individual ACA metallic coverage. As measured in the Unified Rate Review Template (URRT), the range of rate changes for these plans is an increase of 0.9% to an increase of 42.5%.
Product Blue Preferred Blue Focus Changes in allowable rating factors, such as age, geographical area, or tobacco use, may also impact the premium amount for the coverage.
There are currently 44,116 members on Individual Affordable Care Act (ACA) plans that may be affected by these proposed rates.
Consistent with the filed URRT, earned premiums for Individual plans during calendar year 2024 were $252,957,302 and total claims incurred were $235,192,937. The proposed rates effective January 1, 2026, are expected to achieve the loss ratio assumed in the rate development.
Blue Cross and Blue Shield of New Mexico (BCBSNM) is filing new rates to be effective January 1, 2026, for its Individual ACA metallic coverage. As measured in the Unified Rate Review Template (URRT), the range of rate changes for these plans is an increase of 18.4% to an increase of 49.6%.
The cost relativities among plans are different from the experience period to the prospective rating period due to anticipated non-uniform changes in network reimbursement levels. Additionally, the rates vary by plan due to the leveraging and utilization differences driven by variations in member cost sharing. Therefore, the proposed rates and rate changes may vary by plan.
Changes in allowable rating factors, such as age and geographical area, may also impact the premium amount for the coverage.
Blue Cross and Blue Shield of Nebraska (BCBSNE) is setting new rates for its Individual ACA market business in Nebraska. The rate change will take effect January 1, 2026, and will impact an estimated 22,300 members. On average, rates will go up by 20.5% compared to 2025 individual rates. Depending on the network and plan, rate changes will range from a decrease of 1.1% to an increase of 33.3%. Additionally, premiums will go up a bit each year as people get older, even if their plan rates stay the same.
BCBSNE used its own claims and enrollment data, and other publicly available information to set these rates.
NJ Department of Banking and Insurance Releases Initial Health Insurance Rates for the Individual Market for Plan Year 2026
Federal Inaction on Enhanced Premium Tax Credits Among Issues Impacting Consumer Costs
TRENTON — The New Jersey Department of Banking and Insurance today announced that plan year 2026 health insurance initial rates have been submitted by insurance carriers operating in the individual market, which includes Get Covered New Jersey, the State’s Official Health Insurance Marketplace.
Plan year 2026 health and dental insurance rate filings, as proposed, are available for the companies listed below. These filings are subject to actuarial review. Additional companies will be listed as their filings are received. Any insurance filings already approved are available to the public through the NAIC’s System for Electronic Rate and Form Filing (SERFF) interface. There is no fee for using SERFF. Rate info can also be accessed at the Rate Review page at Healthcare.gov
AmeriHealth Caritas VIP Next, Inc:
Company Legal Name AmeriHealth Caritas VIP Next, Inc.
Market for which proposed rates apply (Individual or Small Group) Individual
Total proposed rate change (increase/decrease) 46.20% increase
Effective date of proposed rate change January 1, 2026
This actually came out a couple of weeks ago but ironically, I've been too swamped analyzing & posting 2026 rate filings for other states to get around to posting it here until now.
Overall preliminary rate changes via SERFF database, state insurance dept. website and/or the federal Rate Review database.
Hawaii Medical Service Association:
Our requested rates include only the amounts needed to cover the expected health care benefits of our members, the cost of administering their benefits, expected Affordable Care Act (ACA) fees, and a small charge to help manage the risk of offering benefits to this population.
We based our rate increase request on a review of past costs of benefits and other expenses. These historical costs are adjusted for trend, to account for expected changes in use of medical services, cost inflation, and other factors that affect the cost of care. We also adjusted costs for benefit changes, which were largely made to comply with government mandated plan designs. Administrative expenses have been relatively flat over the past couple of years.
Rate Watch is a convenient way for Hoosiers to access key data on Accident and Health rate filings submitted to the IDOI on or after May 1, 2010. Use it to determine which companies have requested rate changes, their originally requested overall % rate change, and the overall final % rate change approved. These are overall rate changes and are not individually specific. The table below is searchable and sortable. You can also download your filtered results by pressing the Save Excel File button at the bottom of the table. If you need the full data set, including a few additional columns, you can download the CSV file.
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
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.
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.
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.
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.
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).
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.
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.
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.
Oregon has around ~140,000 residents enrolled in ACA exchange plans, 80% of whom are currently subsidized. I estimate they also have another ~34,000 unsubsidized off-exchange enrollees.
North Dakota has around ~43,000 residents enrolled in ACA exchange plans, 91% of whom are currently subsidized. I estimate they also have another ~16,000 unsubsidized off-exchange enrollees.
Oklahoma has around ~293,000 residents enrolled in ACA exchange plans, 93% of whom are currently subsidized. I estimate they also have another ~7,000 unsubsidized off-exchange enrollees.
Nebraska has around ~136,000 residents enrolled in ACA exchange plans, 95% of whom are currently subsidized. I estimate they also have another ~2,000 unsubsidized off-exchange enrollees.
Pennsylvania has around ~496,000 residents enrolled in ACA exchange plans, 87% of whom are currently subsidized. I estimate they also have another ~103,000 unsubsidized off-exchange enrollees.
New Hampshire has around ~70,000 residents enrolled in ACA exchange plans, 71% of whom are currently subsidized. I estimate they also have another ~14,000 unsubsidized off-exchange enrollees.
North Carolina has around ~975,000 residents enrolled in ACA exchange plans, 94% of whom are currently subsidized. I estimate they also have another ~37,000 unsubsidized off-exchange enrollees.
Mississippi has around ~338,000 residents enrolled in ACA exchange plans, 98% of whom are currently subsidized. I estimate they also have another ~14,000 unsubsidized off-exchange enrollees.
The District of Columbia has around ~15,000 residents enrolled in ACA exchange plans. Unlike most states where nearly all ACA exchange enrollees are subsidized, in DC only around 28% are due to the District having an unusually high income eligibility threshold for Medicaid (210%).
DC also has a unique requirement that ACA individual market plans can only be sold on their ACA exchange; I'm assuming perhaps 1,000 off-exchange enrollees regardless but officially I believe this should be pretty much zilch. With net attrition since January, however, it looks like the grand total is actually a bit below 14,000 District-wide.
Montana has around ~77,000 residents enrolled in ACA exchange plans, 89% of whom are currently subsidized. I estimate they also have another ~8,400 unsubsidized off-exchange enrollees.
Missouri has around ~417,000 residents enrolled in ACA exchange plans, 94% of whom are currently subsidized. I estimate they also have another ~3,600 unsubsidized off-exchange enrollees.
It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.
In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.
Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:
Louisiana has around ~293,000 residents enrolled in ACA exchange plans, 96% of whom are currently subsidized. I estimate they also have another ~13,000 unsubsidized off-exchange enrollees.
Maryland has around 247,000 residents enrolled in ACA exchange plans, 76% of whom are currently subsidized. I estimate they also have another ~73,000 unsubsidized off-exchange enrollees.
Michigan has around 531,000 residents enrolled in ACA exchange plans, 91% of whom are currently subsidized. I estimate they also have another ~64,000 unsubsidized off-exchange enrollees.
Massachusetts has around 390,000 residents enrolled in ACA exchange plans, 83% of whom are currently subsidized. I estimate they also have another ~27,000 unsubsidized off-exchange enrollees.
Minnesota has around 151,000 residents enrolled in ACA exchange plans, 61% of whom are currently subsidized. I estimate they also have another ~62,000 unsubsidized off-exchange enrollees.
Kansas has around 200,000 residents enrolled in ACA exchange plans, 94% of whom are currently subsidized. I estimate they also have another ~6,000 unsubsidized off-exchange enrollees.
Kentucky has around 97,000 residents enrolled in ACA exchange plans, 86% of whom are currently subsidized. I estimate they also have another ~6,800 unsubsidized off-exchange enrollees.
Indiana has around 359,000 residents enrolled in ACA exchange plans, 90% of whom are currently subsidized. I estimate they also have another ~6,700 unsubsidized off-exchange enrollees
Iowa has around 136,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have another ~9,600 unsubsidized off-exchange enrollees.
According to the new report, total enrollment from September through December actually increased by just a hair (5,377) and still remained at over 20.7 million nationally, so it doesn't look like the Trump Admin has started cooking these particular books, at least not yet.
I've been able to cobble together more recent ACA expansion enrollment for about half of the 40 states (+DC) which participate in the program:
Hawaii has around 26,000 residents enrolled in ACA exchange plans, 83% of whom are currently subsidized. I estimate they also have perhaps another ~1,700 unsubsidized off-exchange enrollees.
Idaho has around 117,000 residents enrolled in ACA exchange plans, 86% of whom are currently subsidized. I estimate they also have another ~9,000 unsubsidized off-exchange enrollees, although the actual rate filings (summarized later in this post) put the off-exchange total at a much higher ~47,000.
Combined, that's 6.2 - 8.0% of their total population.
Alabama has around 477,000 residents enrolled in ACA exchange plans, 96% of whom are currently subsidized. I estimate they also have perhaps another ~33,000 unsubsidized off-exchange enrollees.
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:
Originally posted 7/21/25; See important updates below.
It's a little awkward to try & pull quotes from Georgia's actuarial memos because they're heavily redacted (see attachments below), but fortunately I also have access to other "just the facts" filing documents which include the hard data I need to compile my weighted averages. These forms--officially called "Rate Filing Transmittal Form LH-T1" and "Unified Rate Review" forms--include, among lots of other numbers, the preliminary avg. rate change being requested for the carrier's individual (or small group) market plans, as well as the number of current effectuated enrollees they have.
In addition, I have alternate rate filings for Georgia individual market carriers which specifically state what their requested rate changes would be if the enhanced premium tax credit subsidies provided by the American Rescue Plan Act & Inflation Reduction Act were to be extended for at least one more year, providing a clear apples to apples comparison.
Iowa Code §505.19 requires the Commissioner to hold a public hearing on a proposed individual health insurance rate increase which exceeds the average annual health spending growth rate as published by the Centers for Medicare and Medicaid Services of the United State Department of Health and Human Services. For 2026 the growth rate is 5.6%.
The Iowa Insurance Commissioner will hold a public hearing regarding the relevant rate increases on August 19, 2025.
The purpose will be to hear public comments on the proposed increase in the base premium rate. Consumers wishing to make a public comment at the hearing are encouraged to attend the hearing via the live webcast.
All comments received will be considered public records and will be posted here. The Consumer Advocate will present the public comments received at the hearing.
Pennsylvanians can submit comments on rate requests and filings through September 2
Harrisburg, PA – The Pennsylvania Insurance Department (PID) today announced that the 2026 rate changes requested by insurance companies currently operating in Pennsylvania’s individual and small group markets are now available. On average, all Pennsylvania health insurers are requesting premium increases in plan year 2026: 19% increase to premiums in the individual market (for people who buy their own insurance), and a 13% increase to premiums in the small group market (for small businesses).
(Unfortunately, no rate justification summary is available, and the full actuarial memo is heavily redacted. Policy enrollees are estimated based on marketwide estimated enrollment; see below.)
Banner/Aetna CVS:
(Dropping out of the individual market for 2026.)
I am writing to notify the Department that Banner Health and Aetna Health Plan Inc. (“Banner | Aetna”) will exit the individual health insurance market effective December 31, 2025. This notification is sent pursuant to Department guidance and Arizona statute 20-1380(D)(1). We made this decision after careful consideration and after evaluating the evolution of business at Banner | Aetna. The details of our individual market exit include the following:
(Unfortunately, Anthem has redacted their current enrollment total; see below)
This is a rate filing for the Individual market ACA-compliant plans offered by Anthem Health Plans of New Hampshire, Inc., also referred to as Anthem. The policy forms associated with these plans are listed below. The proposed rates in this filing are for a new HMO product that will be effective for the 2026 plan year beginning January 1, 2026, and apply exclusively to off-exchange plans.
It was just a couple of weeks ago that the official (if preliminary) 2026 ACA individual market rate filings for Wyoming insurance carriers went live on the federal rate review website.
I published a writeup about these just 3 days ago; unlike some states, Wyoming was pretty easy to break out as they only have three carriers on the indy market, all of which also made their current enrollment data easy to find.
The landscape isn't pretty: BCBS is seeking average rate increases of 20.7%; UHC wants 29.1%, and Mountain Health Co-Op, which has around 9,600 enrollees, was asking for a whopping 32% average premium hike.
Keep in mind that Wyoming already has among the most expensive individual market policies in the country, with premiums averaging over $1,000/month.
(Aetna/CVS announced last spring that they're pulling out of the individual market in EVERY state in 2026.)
AmeriHealth Caritas Florida:
Amerihealth Caritas Florida, Inc. (AHC) has offered comprehensive and fully insured coverage to members in the individual ACA market since 2023. AHC is filing a rate increase for 2026 products. The plans associated with this filing will be offered both on and off the Federally Facilitated Marketplace (FFM) in Florida.
(Aetna/CVS is pulling out of the entire individual market nationally)
Anthem Blue Cross of CA (DMHC)
This is a rate filing for the Individual market ACA‐compliant plans offered by Anthem Blue Cross (Anthem). The proposed rates in this filing will be effective for the 2026 plan year beginning January 1, 2026, and apply to plans both On‐Exchange and Off‐Exchange.
Anthem will continue to participate in its 2025 marketplace footprint consisting of rating areas 1-10 and 12-14 with EPO plans and rating areas 11 and 15‐19 with HMO plans.
Wyoming has ~46,000 residents enrolled in ACA exchange plans, 95% of whom are currently subsidized. They also have an unknown number of off-exchange enrollees (likely only a few thousand at most). Combined, that's around 8% of their total population.
(Note, however, that the official actuarial rate filings for the 3 carriers offering coverage in the Wyoming individual market only report a combined total of around 39,000 enrollees as of spring 2025, or 6.6% of the total population).
Alaska has around ~28,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. They also have an unknown number of off-exchange enrollees in ACA-compliant individual market policies. Overall, including net attrition, I estimate their total enrollment both on & off exchange to be perhaps ~27,000 or so.
Blue Cross Blue Shield of Wyoming (BCBSWY) has offered comprehensive and fully insured coverage to members in the Individual ACA market since 2014. BCBSWY is filing a rate increase for 2026 products. All plans will be offered statewide; plans with be offered either on or off the Federally Facilitated Marketplace in Wyoming.
The average proposed rate increase of 12.6%, effective January 1, 2026 is expected to impact 13,677 members, based on membership as of March 31, 2025. The rate increase varies by plan, ranging between 4.4% and 20.5%. Rate changes vary by plan due to the impact of changes in benefits and rating adjustments to account for the non-funding of Cost Sharing Reduction (CSR) payments.
(Moda has heavily redacted their actuarial memo and isn't providing the number of current enrollees)
The average rate change is X.XX% as shown on Worksheet 2 of the URRT. The proposed rate Proposed Rate Increase change varies by product and plan, and the proposed rates vary by plan, age, geographic area, and tobacco use. The average rate change was calculated by comparing the weighted average premium for members on current plans and rates to the weighted average premium for members on renewal plans and rates.
A summary of the major components and their contribution to the rate change is provided in the table below.
...This letter is formal notice that Aetna Health Inc. (“AHI”) intends to exit from the Individual health insurance market in Virginia effective January 1, 2026. Subject to the Department’s review, we will mail the 180-day notices of discontinuance to covered individuals.
As of May 2025, our records show that AHI has 9,810 subscribers and 13,721 total members in Virginia.
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:
(unfortunately, CareSource WV's actuarial memo is heavily redacted)
Highmark BCBS WV:
Highmark West Virgina (“Highmark WV”) is requesting an average ACA individual market rate increase of 17.0%, ranging from 15.2% to 23.3%. Products submitted with this filing will have effective dates from January 1, 2026 to December 31, 2026. This rate change is projected to affect 28,179 members.
Historical Financial Experience:
Highmark WV incurred an underwriting gain in its ACA individual market programs in 2024.
Change in Medical Service Costs:
The projected average cost of medical care for the projected population is expected to increase. The increase will emerge in utilization and average cost per service and is spread across all types of services.
The proposed rate change of 27.3% applies to approximately 204,837 individuals. Absolute Total Care’s projected administrative expenses for 2026 are $90.21 PMPM. Administrative expense does not include $17.94 for taxes and fees. The historical administrative expenses for 2025 were $78.35 PMPM, which excludes taxes and fees. The projected loss ratio is 82.6% which satisfies the federal minimum loss ratio requirement of 80.0%.
Scope, Range, and Best Estimate of the Rate Increase
Blue Cross and Blue Shield of Oklahoma (BCBSOK) is filing new rates to be effective January 1, 2026, for its Individual ACA metallic coverage. As measured in the Unified Rate Review Template (URRT), the range of rate increases for these plans is 12.3% to 51.5%.
...Changes in allowable rating factors, such as age, geographical area, or tobacco use, may also impact the premium amount for the coverage.
There are currently 128,181 members on Individual Affordable Care Act (ACA) plans that may be affected by these proposed rates.
(Unfortunately, BCBSND's actuarial memo is heavily redacted, so I don't know their current enrollment. I've had to make an educated guess on that; see below.)
(Aetna/CVS is pulling out of the entire individual market nationally; I've estimated their current enrollment, see below for methodology)
AmeriHealth HMO:
AmeriHealth HMO, Inc. ("AHNJ”) is revising premium rates for the New Jersey Individual Health ACA compliant products, effective from January 1, 2026. Rate increases average 16.8%, ranging from 16.8% to 16.8%. The proposed revisions to each plan are shown on the last page of this exhibit. About 35 members will be affected.
The proposed rate change of 39.0% applies to approximately 142,324 individuals. Ambetter of Magnolia Inc.’s projected administrative expenses for 2026 are $89.76 PMPM. Administrative expense does not include $34.22 for taxes and fees. The historical administrative expenses for 2025 were $73.84 PMPM, which excludes taxes and fees. The projected loss ratio is 84.4% which satisfies the federal minimum loss ratio requirement of 80.0%.
Blue Cross Blue Shield of MS:
The 2026 monthly health insurance premium is made up of four pieces: estimated claim costs, administrative costs, taxes and fees, and risk/profit margin.
Arizona has around 423,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have perhaps another ~8,000 unsubsidized off-exchange enrollees.
Overall preliminary rate changes via SERFF database, state insurance dept. website and/or the federal Rate Review database.
Aetna Life Insurance Co:
(Aetna/CVS is dropping out of the individual market in all states; I estimate they have around 35,000 enrollees in Kansas who will have to find a different carrier for 2026)
Blue Cross Blue Shield of Kansas City:
Blue Cross and Blue Shield of Kansas City (BCBSKC) is requesting an average rate change of -6.1% for 2025 individual rates as compared to 2023 individual rates and calculated by the URRT. The changes vary by plan, with a minimum rate change of -10.8% and a maximum rate increase of 1.8%.
Table 2.1 summarizes proposed rate increases effective January 1, 2026, and displays significant factors driving the proposed rate increases. Note that this rate buildup is illustrative of changes occurring from 2025 to 2026, and is therefore not reflective of factors displayed in Worksheet 1, Section II of the URRT, which pertains to changes from the experience period (2024) to the projection period (2026). Factors found in The URRT are discussed in later sections.
Open Enrollment Period through Get Covered New Jersey Begins November 1, 2025
TRENTON — New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman today announced a total of $5 million in available grant funds for community organizations to apply to serve as state-certified Navigators for the Get Covered New Jersey Open Enrollment Period and throughout 2026. Navigators offer free, unbiased, community-based education and assistance to consumers seeking to enroll in health insurance through Get Covered New Jersey, the State’s Official Health Insurance Marketplace.
Delaware has ~53,000 residents enrolled in ACA exchange plans, 91% of whom are currently subsidized. They also have an unknown number enrolled in off-exchange plans. Overall, with net attrition, I estimate current total enrollment is down a bit to perhaps 52,000 today.
The projected average rate change for plans effective January 1, 2026 is 16.0% which is an average rate change of about $87 per member per month (pmpm). Because 16.0% (or about $87) is an average, it is possible to have a different rate change. Factors affecting a member's premium are age, tobacco use, family composition, plan, and geographic area. Expected cost differences by product are updated every year to ensure premium differences are appropriate. BridgeSpan has approximately 200 members enrolled in this line of business as of March 2025.
...The rate change described above is driven by the following factors:
Medical Trend : 9.1%
Change in Benefits, Age, Area, and Network : -1.5%
Change in Market Morbidity : 5.0%
Exchange User Fees : 1.0%
Other : 2.0%
Other includes: actual results vs. expected, changes to admin expenses, and rx rebates. Actual results vs. expected reflect differences between actual results and past assumptions, including a true-up of market morbidity estimates
Healthy Alliance Life Insurance Company (HALIC) has filed for premium rate changes for its Affordable Care Act (ACA) compliant Individual health insurance plans. This filing includes an average rate change of 21.23%, effective January 1, 2026, with plan prices changing between 18.75% and 24.73%. The price changes will impact about 52,000 people that have HALIC plans now and will keep HALIC plans next year. An insured person’s actual rate increase could be higher or lower depending on their benefit, where they live, how old they are, number of children, and if they use tobacco.
The Department of Insurance receives preliminary health plan information for the following year from insurance carriers by June 1 and reviews the proposed plan documents and rates for compliance with Idaho and federal regulations.The Department of Insurance does not have the authority to set or establish insurance rates, but it does have the authority to deem rate increases submitted by insurance companies as reasonable or unreasonable. After the review and negotiation process, the carriers submit their final rate increase information. The public is invited to provide comments on the rate changes. Please send any comments to Idaho Department of Insurance.
Connecticut has around ~151,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have another ~7,000 unsubsidized off-exchange enrollees.
Arkansas has around 166,000 residents enrolled in ACA exchange plans, 92% of whom are currently subsidized. I estimate they also have perhaps another ~11,000 unsubsidized off-exchange enrollees.
Whether the data posted since January 20, 2025 is accurate or not, I can't say for certain, but at least they're updating it...and so far, at least, I don't see anything in their monthly reports which is setting off any obvious red flags.
In any event, according to the latest report, as of April 2025:
