Charles Gaba's blog

Originally posted 8/04/25

via the North Carolina Insurance Dept:

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.

Originally posted 6/06/25

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 12/28/24

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.

Combined, that's 352,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 330,000 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 1/20/20

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.

Combined, that's 139,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 130,000 statewide.

Originally posted 2/05/25

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.

Originally posted 1/02/25

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.

Combined, that's ~206,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be down to more like 192,000 statewide.

Originally posted 12/05/24

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.

Combined, that's 85,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 80,000 statewide.

Originally posted 1/18/25

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.

Combined, that's ~420,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 392,000 statewide.

Originally posted 8/08/25

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

Blue Cross Blue Shield of OK

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.

Celtic Insurance