This is the best OEP ever for the ACA for several reasons:
The expanded/enhanced premium subsidies first introduced in 2021 via the American Rescue Plan, which make premiums more affordable for those who already qualified while expanding eligibility to millions who weren't previously eligible, are continuing through the end of 2025 via the Inflation Reduction Act;
A dozen states are either launching, continuing or expanding their own state-based subsidy programs to make ACA plans even more affordable for their enrollees;
100,000 or more DACA recipients are finally eligible to enroll in ACA exchange plans & receive financial assistance!
Every year, I spend months painstakingly tracking every insurance carrier rate filing (nearly 400 for 2025!) for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.
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.
I really only need three pieces of information for each carrier:
9/29/25: Welcome Paul Krugman subscribers! I greatly appreciate the shoutout by him but should add the following clarification:
Regarding the chart below which he reposted comparing the original ACA subsidy scale to the current version: You probably think that if the enhanced subsidies expire it will revert back to the original version, which would be bad enough. In fact, however, the Trump Regime has also made THAT version even worse, like so:
North Dakota has around ~43,000 residents enrolled in ACA exchange plans, 91% of whom are currently subsidized. I estimate they also have another ~16,000 unsubsidized off-exchange enrollees.
Wisconsin has around ~293,000 residents enrolled in ACA exchange plans, 98% of whom are currently subsidized. I estimate they also have another ~19,000 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).
The average proposed rate increase of 12.6%, effective January 1, 2026 is expected to impact 13,677 members, based on membership as of March 31, 2025. The rate increase varies by plan, ranging between 4.4% and 20.5%. Rate changes vary by plan due to the impact of changes in benefits and rating adjustments to account for the non-funding of Cost Sharing Reduction (CSR) payments.
(unfortunately, CareSource WV's actuarial memo is heavily redacted)
Highmark BCBS WV:
Highmark West Virgina (“Highmark WV”) is requesting an average ACA individual market rate increase of 17.0%, ranging from 15.2% to 23.3%. Products submitted with this filing will have effective dates from January 1, 2026 to December 31, 2026. This rate change is projected to affect 28,179 members.
Historical Financial Experience:
Highmark WV incurred an underwriting gain in its ACA individual market programs in 2024.
(Unfortunately, BCBSND's actuarial memo is heavily redacted, so I don't know their current enrollment. I've had to make an educated guess on that; see below.)
Congressional failure to extend the enhanced premium tax credits will lead to an estimated 225,000 Coloradans seeing an average 101% increase in health insurance premiums
DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), today released the final approved premium information on private health insurance plans for 2026 for the individual market (for people who don’t get coverage from an employer plan). These filings have been reviewed and updated to reflect the passage of HB25B-1006, which blunted some of the premium increases.
