(Aetna/CVS is pulling out of the entire individual market nationally; I've estimated their current enrollment, see below for methodology)
AmeriHealth HMO:
AmeriHealth HMO, Inc. ("AHNJ”) is revising premium rates for the New Jersey Individual Health ACA compliant products, effective from January 1, 2026. Rate increases average 16.8%, ranging from 16.8% to 16.8%. The proposed revisions to each plan are shown on the last page of this exhibit. About 35 members will be affected.
The proposed rate change of 39.0% applies to approximately 142,324 individuals. Ambetter of Magnolia Inc.’s projected administrative expenses for 2026 are $89.76 PMPM. Administrative expense does not include $34.22 for taxes and fees. The historical administrative expenses for 2025 were $73.84 PMPM, which excludes taxes and fees. The projected loss ratio is 84.4% which satisfies the federal minimum loss ratio requirement of 80.0%.
Blue Cross Blue Shield of MS:
The 2026 monthly health insurance premium is made up of four pieces: estimated claim costs, administrative costs, taxes and fees, and risk/profit margin.
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 projected average rate change for plans effective January 1, 2026 is 16.0% which is an average rate change of about $87 per member per month (pmpm). Because 16.0% (or about $87) is an average, it is possible to have a different rate change. Factors affecting a member's premium are age, tobacco use, family composition, plan, and geographic area. Expected cost differences by product are updated every year to ensure premium differences are appropriate. BridgeSpan has approximately 200 members enrolled in this line of business as of March 2025.
...The rate change described above is driven by the following factors:
Medical Trend : 9.1%
Change in Benefits, Age, Area, and Network : -1.5%
Change in Market Morbidity : 5.0%
Exchange User Fees : 1.0%
Other : 2.0%
Other includes: actual results vs. expected, changes to admin expenses, and rx rebates. Actual results vs. expected reflect differences between actual results and past assumptions, including a true-up of market morbidity estimates
Healthy Alliance Life Insurance Company (HALIC) has filed for premium rate changes for its Affordable Care Act (ACA) compliant Individual health insurance plans. This filing includes an average rate change of 21.23%, effective January 1, 2026, with plan prices changing between 18.75% and 24.73%. The price changes will impact about 52,000 people that have HALIC plans now and will keep HALIC plans next year. An insured person’s actual rate increase could be higher or lower depending on their benefit, where they live, how old they are, number of children, and if they use tobacco.
The Department of Insurance receives preliminary health plan information for the following year from insurance carriers by June 1 and reviews the proposed plan documents and rates for compliance with Idaho and federal regulations.The Department of Insurance does not have the authority to set or establish insurance rates, but it does have the authority to deem rate increases submitted by insurance companies as reasonable or unreasonable. After the review and negotiation process, the carriers submit their final rate increase information. The public is invited to provide comments on the rate changes. Please send any comments to Idaho Department of Insurance.
Last winter, I initiated an ambitious project in which I generated graphics to illustrate just how much net ACA premiums are likely to increase starting on January 1st, 2026 (slightly over 5 months from today) assuming the enhanced premium subsidies provided by the Inflation Reduction Act over the past several years are allowed to expire.
This project took several months to complete, as I had to generate both tables and bar graphs for all 50 states (+DC), using 4 different households at multiple income brackets for each. All told, that's over 1,600 different examples.
I made sure to include various caveats for these projections. For instance, each of these examples assumes...
Neighborhood Health Plan of Rhode Island (if IRA subsidies are extended):
Weighted Average Rate Increase: This represents the average rate increase, including modifications to prior year benefits and other pricing adjustments. The average premium increase to consumers, before reflecting changes in age is expected to be 16.3%.
The range of rate changes, before reflecting changes in age, which consumers will experience, is approximately 15.0% to 17.5%.
Neighborhood Health Plan of Rhode Island (if IRA subsidies AREN'T extended):
Weighted Average Rate Increase: This represents the average rate increase, including modifications to prior year benefits and other pricing adjustments. The average premium increase to consumers, before reflecting changes in age is expected to be 21.2%.
The range of rate changes, before reflecting changes in age, which consumers will experience, is approximately 20.1% to 22.2%.
Blue Cross Blue Shield of RI (if IRA subsidies are extended):
This page contains proposed health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2026.
The District of Columbia Department of Insurance, Securities and Banking (DISB) received 188 proposed health insurance plan rates for review from CareFirst BlueCross BlueShield, Kaiser Permanente and United Healthcare in advance of open enrollment for plan year 2026 on DC Health Link, the District of Columbia’s health insurance marketplace.
The three insurance companies filed proposed rates for individuals, families and small businesses for the 2026 plan year. Overall, 188 plans were filed, compared to 198 last year. The number of small group plans decreased from 171 to 161, and the number of individual plans remained at 27.
Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Arkansas Insurance Department for review and approval before plans can be sold to consumers.
The Department reviews rates to ensure that the plans are priced appropriately. Under Arkansas Law (Ark. Code Ann. § 23-79-110), the Commissioner shall disapprove a rate filing if he/she finds that the rate is not actuarially sound, is excessive, is inadequate, or is unfairly discriminatory.
The Department relies on outside actuarial analysis by a member of the American Academy of Actuaries to help determine whether a rate filing is sound.
Below, you can review information on the proposed rate filings for Plan Year 2026 individual and small group products that comply with the reforms of the Affordable Care Act.
