2026 Rate Changes - Kansas: 30.5%; ~206,000 Kansans facing MASSIVE rate hikes starting in January

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.

...The 2025 rate is a weighted average of current per member per month premiums for the current plans using the current distribution of membership by plan with an area factor of 1.0. As of May 2025, 1,426 lives are covered under the plans included in this rate filing. The 2026 rate is illustrative of the application of the listed factors.

Blue Cross Blue Shield of Kansas:

The proposed rates will apply to policies that start or renew during the period beginning January 1, 2026 and ending December 31, 2026.

As of May 1, 2025, 19,772 members are enrolled in BCBSKS Individual plans affected by this rate increase for period beginning January 1, 2026 and ending December 31, 2026.

The proposed increase of 16.66 percent is an average. The actual premium increase a member of one of these plans will receive depends on such things as the member's choice of plan, the member's age, the member's location in the state, and any changes in federal government tax subsidies. The lowest rate increase for a given plan is 8.90 percent and the highest is 20.83 percent.

The key drivers for this filing are:

• Projected claims per member per month came in higher than anticipated compared to a year ago.
• Increased morbidity as a result of discontinued enhanced APTC.

Celtic Insurance Co:

The proposed rate change of 40.0% applies to approximately 110,780 individuals. Celtic Insurance Company’s projected administrative expenses for 2026 are $84.40 PMPM. Administrative expense does not include $40.21 for taxes and fees. The historical administrative expenses for 2025 were $74.05 PMPM, which excludes taxes and fees. The projected loss ratio is 85.4% which satisfies the federal minimum loss ratio requirement of 80.0%.

Medica Insurance Co:

Medica Insurance Company (MIC) is requesting a rate change for its Affordable Care Act (ACA) individual market business in Kansas. The rate change will take effect on January 1, 2026 and will impact an estimated 417 members. The average rate change will be 29.3% and will result in rate changes that vary across plan designs. This includes changes to the costs of care.

MIC uses 2024 data from Kansas in addition to additional regional data that has been adjusted to reflect Kansas cost characteristics to develop premium rates. This data includes estimates of changes to the below through 2026:

• Population Medica expects to insure
• Cost of medical services
• Cost of pharmacy services
• Taxes and fees

The significant factors that impact the rate change include those listed above. Claim costs per member per month are expected to change from $589.04 in 2024 to $637.85 in 2026.

Oscar Insurance Co:

‬‭ 1.‭ Scope and Range of Rate Increase

‭ The purpose of this document is to present rate change justification for Oscar Insurance Company's Individual Affordable ‭ Care Act (ACA) products, with an effective date of January 1, 2026, and to comply with the requirements of Section 2794 ‭ of the Public Health Service Act as added by Section 1003 of the Patient Protection and Affordable Care Act (ACA).

‭ Using in-force business as of April 2025, the proposed average rate increase for renewing plans is 14.4%. Rate increases‬ ‭ vary by plan due to a combination of factors including shifts in benefit leveraging and cost-sharing modifications. This‬ ‭ rate increase is absent of rate changes due to attained age.‬ ‭ The rate increase impacts an estimated 13,036 members.‬

‭ The significant factors driving the proposed rate change include the following:‬

‭ Medical and Prescription Drug Inflation and Utilization Trends‬

‭ The‬‭ projected‬‭ premium‬‭ rates‬‭ reflect‬‭ the‬‭ most‬‭ recent‬‭ emerging‬‭ experience‬‭ which‬‭ was‬‭ trended‬‭ for‬‭ anticipated‬‭ changes‬‭ due to medical and prescription drug inflation and utilization.‬

‭ Prospective Benefit Changes‬

‭ Plan‬‭ benefits‬‭ have‬‭ been‬‭ revised‬‭ as‬‭ a‬‭ result‬‭ of‬‭ changes‬‭ in‬‭ the‬‭ Center‬‭ for‬‭ Medicare‬‭ and‬‭ Medicaid‬‭ Services‬‭ (CMS)‬‭ Actuarial‬ ‭ Value Calculator and state requirements, as well as for strategic product considerations.‬

‭ Anticipated Changes in the Average Morbidity of the Covered Population‬‬

‭ Changes‬‭ to‬‭ the‬‭ overall‬‭ premium‬‭ level‬‭ are‬‭ needed‬‭ because‬‭ of‬‭ anticipated‬‭ changes‬‭ in‬‭ the‬‭ underlying‬‭ morbidity‬‭ of‬‭ the‬ ‭ projected marketplace.‬

UnitedHealthcare Insurance Co:

HIC is filing 2026 rates for individual products. The proposed rate change is 10.11% and will affect 25,308 individuals. The rate changes vary between 5.60% and 16.16%. Given that the rate changes are based on the same single risk pool, the rate changes vary by plan due to plan design changes.

The premium collected in plan year 2024 was $203,562,245. Incurred claims during this period were $126,221,047 and UHC expects payments of $54,757,591 for risk adjustment. The benefit cost ratio, or portion of premium required to pay risk adjusted medical claims, for plan year 2024

is 88.91%.

There are many different healthcare cost trends that contribute to increases in the overall U.S. healthcare spending each year. These trend factors affect health insurance premiums, which can mean a premium rate increase to cover costs. Some of the key healthcare cost trends that have affected this year’s rate actions include:

• Increasing cost of medical services: Annual increases in reimbursement rates to healthcare providers, such as hospitals, doctors, and pharmaceutical companies.
• Increased utilization: The number of office visits and other services continues to grow. In addition, total healthcare spending will vary by the intensity of care and use of different types of health services. The price of care can be affected using expensive procedures such as surgery versus simply monitoring or providing medications.
• Higher costs from deductible leveraging: Healthcare costs continue to rise every year. If deductibles and copayments remain the same, a higher percentage of healthcare costs need to be covered by health insurance premiums each year.
• Impact of new technology: Improvements to medical technology and clinical practice often result in the use of more expensive services, leading to increased healthcare spending and utilization.
• Expiration of enhanced premium tax credits: Expanded and enhanced federal premium tax credits for consumers will expire at the end of 2025. As a result, post-tax credit premiums will increase for calendar year 2026.
• Changes in market morbidity: Premiums reflect the expected increase in the average cost per member due to healthier members leaving the market if enhanced ATPCs are allowed to expire.

Overall, the weighted average rate hike being requested by individual market carriers in Kansas is 30.5%.

It's important to remember that this is for unsubsidized enrollees only; for subsidized enrollees, ACTUAL net rate hikes will likely be MUCH HIGHER for most enrollees due to the expiration of the improved ACA subsidies & the Trump CMS "Affordability & Integrity" rule changes.

Meanwhile, I have no enrollment data at all for most of the small group carriers; the unweighted average 2026 rate hike there is around 9.0%