August 2025

via Vermont's Green Mountain Care Board:

May 13, 2025

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, South Dakota Insurance Dept. and/or the federal Rate Review database.

Avera Health Plans:

(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)

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

Blue Cross Blue Shield NM

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.

Hoo boy. Via the Delaware Insurance Dept:

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

Summary

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.

Originally posted 1/30/25

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.

Originally posted 12/17/24

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.

Combined, that's ~438,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 410,000 statewide.

Originally posted 1/26/25

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.

Combined, that's ~523,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 488,000 statewide.

Originally posted 12/20/24

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.

Combined, that's ~315,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 300,000 statewide.

Originally posted 1/15/25

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.

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 12/06/24

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.

Combined, that's 320,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 300,000 statewide.

How did we get here?

Originally posted 12/03/24

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.

Combined, that's ~213,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 200,000 statewide.

Originally posted 12/09/24

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

Combined, that's 5.3% of their total population.

Assuming the national average 6.6% net enrollment attrition rate thru April reported by the Centers for Medicare & Medicaid Services applies to Indiana, however, that would knock the current enrollment down to more like 341,000 statewide.

Originally posted 12/31/24

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.

Combined, that's 1.8% of their total population.

Assuming the national average 6.6% net enrollment attrition rate thru April reported by the Centers for Medicare & Medicaid Services applies to Hawaii, however, that would knock the current enrollment down to more like 24,000 statewide.

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.

via the NJ Dept. of Banking & Insurance:

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.

Originally posted 12/23/24

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.

Combined, that's 158,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 150,000 statewide.