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).
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.
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.
Rhode Island has around ~42,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have another ~3,000 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.