With the 2026 ACA Open Enrollment Period officially starting on November 1st, and with millions of ACA enrollees being bombarded with scary letters from their insurance carriers and headlines warning of massive premium hikes, residents of six states* (as of this writing) can already enter their own household information to find out how much their net health insurance premiums are going to increase starting January 1st, 2026:
Twelve years ago, the Wall St. Journal ran a story about the impact of the American Taxpayer Relief Act of 2012, a sweeping tax bill signed into law by President Obama which locked in the Bush tax cuts for lower & middle-class households while allowing them to expire on schedule for wealthier Americans:
A compromise measure, the Act gives permanence to the lower rate of much of the Bush tax cuts, while retaining the higher tax rate at upper income levels that became effective on January 1 due to the expiration of the Bush tax cuts. It also establishes caps on tax deductions and credits for those at upper income levels. It does not tackle federal spending levels to a great extent, rather leaving that for further negotiations and legislation. The American Taxpayer Relief Act passed by a wide majority in the Senate, with both Democrats and Republicans supporting it, while most of the House Republicans opposed it.
...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.
Virginia has ~388,000 residents enrolled in ACA exchange plans, 86% of whom are currently subsidized. They also have over 22,000 off-exchange enrollees. Combined, that's 411,000 people with ACA market coverage, or 4.6% of the total population.
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.
For over a decade, State-Based Marketplaces have provided private health coverage to tens of millions of Americans, ensuring their health, well-being, and economic security. The Americans who depend on the Marketplaces include working parents, small business owners, farmers, gig workers, early retirees, and lower and middle-class individuals of all ages, political views, and backgrounds who drive our local economies and make both our rural and urban communities thrive.
The legislation under consideration in the House will severely impact the ability of these millions of Americans to continue to access this coverage and the health and financial security they depend on today. This will make for a sicker, less financially secure American public and strain hospitals and health care providers by increasing uncompensated care.
Every year around this time I start my annual individual & small group market rate filing analysis project. This involves spending months painstakingly tracking every insurance carrier rate filing for the upcoming year to determine just how much average insurance policy premiums on the individual market are projected to change.
Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need.
The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier: How many effectuated enrollees they have in ACA-compliant policies this year; the average projected rate change for those policies; and, ideally, a breakout of the rationale behind the changes.
Usually the reasons given are fairly vague things like "increased morbidity" (ie, a sicker risk pool) or the like. Sometimes, however, there's a very specific reason given for some or all of the premium changes. Major examples of this include:
Virginia’s Insurance Marketplace is proud to announce that more than 388,000 Virginians successfully enrolled in health care coverage during the Marketplace’s Open Enrollment Period, which ran from November 1, 2024, to January 22, 2025.
Among the 388,856 Virginians who secured health insurance plans through Virginia’s Insurance Marketplace, 69,000 were new enrollees. This is a 21% increase in new enrollments from last year’s Open Enrollment Period, marking a significant milestone for the Marketplace.
New enrollments may be up 21%, but overall enrollments are down 2.8% vs. last year, which is a bit of a head-scratcher since there doesn't seem to be any specific reason for enrollment to drop in VA this year (as opposed to NY, OR & NC which each had cannibalization of exchange enrollees by their Medicaid or Basic Health Plan programs this year).
After last year's near-chaos on Virginia's individual market, things seem to be much calmer & less interesting this year. The premium increases for 2025 being requested by individual market carriers have a weighted average of 4.0%, while small group market carriers are asking for 6.8% increases on average.
The most noteworthy news for 2025 is that Aetna Life Insurance (their EPO division) is exiting the Virginia market, although Aetna Health (HMOs) is sticking around.
UPDATE: I thought Piedmont was also pulling out in 2025, but it turns out they left Virginia's individual market last fall at the very last minute.
In addition, it looks like Aetna is pulling completely out of the small group market, as is Innovation Health and, again, Piedmont Community.
Friday is the last day for Virginia residents to apply for health care coverage that starts on January 1, 2024.
Any healthcare coveragesecured after December 15 and before Open Enrollment ends on January 15 will begin on February 1, 2024.
The Virginia Insurance Marketplace reminds Virginians to apply now for 2024.
After the Open Enrollment period ends January 15, Virginians experiencing a Qualifying Life Event such as having a baby or losing health insurance coverage may be eligible to enroll during a Special Enrollment Period.
Virginia’s Insurance Marketplace replaced HealthCare.gov for all Virginians and launched on November 1, 2023. Marketplace provides a wealth of resources for residents to find affordable health care coverage. Hundreds of thousands of Virginians have accessed the Marketplace this Open Enrollment Period to find coverage that meets their needs.
