2025 ACA Rate Changes Discussion

[PaunchyPirate]

It's that time of year again! Insurance companies and States are starting to reveal the coming rate changes for health insurance plans for 2025. I thought I'd start a thread to hold posts about what you're seeing in your locations and with your insurers.

Pennsylvania reviews and approves insurance rates prior to them going live on our ACA website, pennie.com. The state just released the PROPOSED rates that the various insurance companies have asked for in the coming year. These requests are posted for public review and comment. However, it pretty much takes an Excel expert to decipher the individual plan numbers (but it can be done!).

Statewide, across all insurance companies and all plans, they are requesting an average 7.9% rate increase. My insurer, Highmark (the local BC/BS company), is requesting 8.76% more on average across its plans.

The state typically approves a rate increase that is slightly less than what the insurance companies ask for. But not always. Final rates will not be known until just prior to Open Enrollment on November 1st.

For my fellow Pennsylvanians, here is a link to the page showing the rate change requests. You can drill into the spreadsheets in the last column to see the dirty details of your own insurance company, if you wish.

https://www.insurance.pa.gov/Consumers/HealthInsuranceFilings/Pages/ACA-Health-Rate-Filings.aspx

 

[SecondCor521]

Idaho's requested rates average a 6% increase in 2025. Rates are finalized 10/1. Apparently the state approves the increase unless the increase isn't adequately justified.

DOI publishes preliminary health insurance rates for 2025 • Press Release • Idaho Department of Insurance

The Idaho Department of Insurance (DOI) has received preliminary premium rates from health insurance carriers for plans sold starting January 2025. The DOI is seeking public comments before final rates are published.

doi.idaho.gov

My insurer and metal level is averaging a 9% increase. I'll look and see at Open Enrollment what the actual situation is.

 

[petfer]

WASHINGTON: “Thirteen health insurers filed an average requested rate increase of 11.3% for Washington's individual health insurance market.” You can read more details about various providers at 2025 WA ACA proposal

 

[Tuirc]

Seriously, what are people doing during their gap years retiring before Medicare? Do people pay themselves less so they can squeeze into some sort of ACA plan with having to remove arms legs or substantial parts of their future retirement? Or, do they just suck it up and pay the ACA $23,000 + per year? Or, get something like Medishare?

 

[NewEnglander]

In Connecticut there are three Insurance companies providing ACA plans but two are Connecticare divisions so it's really just two companies. Here are the increases they have asked for in 2025.

Anthem BC/BS 9%
Connecticare Benefits 7.4%
Connecticare Insurance 12.5%

 

[Surewhitey]

Seriously, what are people doing during their gap years retiring before Medicare? Do people pay themselves less so they can squeeze into some sort of ACA plan with having to remove arms legs or substantial parts of their future retirement? Or, do they just suck it up and pay the ACA $23,000 + per year? Or, get something like Medishare?

Not there yet, but we have a chunk in after tax to keep our MAGI at a reasonable level. Our interest income and dividends are around the "sweet spot".

Can choose to do Roth rollovers or ACA subsidies, or a combination.

 

[RetiredHappy]

Seriously, what are people doing during their gap years retiring before Medicare? Do people pay themselves less so they can squeeze into some sort of ACA plan with having to remove arms legs or substantial parts of their future retirement? Or, do they just suck it up and pay the ACA $23,000 + per year? Or, get something like Medishare?

It depends. We make too much money to even have a chance for me to get any sort of ACA subsidies beyond the first year of retirement. I have been paying full freight since 2018 when I was 55 yo. Since I get no subsidies I buy the best private health insurance that money can buy and those are not available in ACA. My premiums this year is $16K for a Silver plan at 61 yo. I still have deductibles and max out of pocket. I had an accident 2 years ago and was hospitalized and hit my max Out of Pocket, and my medical cost was another $7K above my premiums.

If you can manage your income, you can pay next to nothing. We can't and we are at 24% IRS tax bracket and we are not even doing ROTH conversions. Our problem is that my husband is on SS and subject to RMD.

 

[jim584672]

Seriously, what are people doing during their gap years retiring before Medicare? Do people pay themselves less so they can squeeze into some sort of ACA plan with having to remove arms legs or substantial parts of their future retirement? Or, do they just suck it up and pay the ACA $23,000 + per year? Or, get something like Medishare?

If you keep in the subsidy zone the price is capped to a set percentage of income for the Silver benchmark (SLCSP) plan. This stops age related increases and inflation from impacting you.

SLCSP = second lowest cost Silver plan in your county

 

[NewEnglander]

The last time I checked last year even a couple(MFJ) with an income of $250K would receive over $500/month subsidy in CT for ACA plans.

 

[jim584672]

The last time I checked last year even a couple(MFJ) with an income of $250K would receive over $500/month subsidy in CT for ACA plans.

The 400% FPL income cap for subsidies will come back in 2026 if nothing is done.

 

[wearefinishedworking]

We are getting great subsidized ACA by keeping income below 60K. Of course we are pulling some from cash stockpile we set up prior to retirement. DH hits 65 next year!

 

[Aerides]

There's not much of a squeeze to keep taxable income in the range for some amount of subsidy


That aside, I never look at these proposals until the dust settles and enrollment begins
No point for me!

 

[FLSUnFIRE]

How much and why ACA Marketplace premiums are going up in 2025 - Peterson-KFF Health System Tracker

Health insurers submit rate filings annually to state regulators detailing expectations and rate changes for Affordable Care Act (ACA)-regulated health plans for the coming year. A relatively small, but growing, share of the population is enrolled in these plans (compared to the number in...

www.healthsystemtracker.org

This article has a table by state/plan with insurer proposed 2025 increases. I'm in a BCBS plan but there are a few so not sure what the 9.9% means for me. Not worried about it.

 

[Gallaher]

Seriously, what are people doing during their gap years retiring before Medicare? Do people pay themselves less so they can squeeze into some sort of ACA plan with having to remove arms legs or substantial parts of their future retirement? Or, do they just suck it up and pay the ACA $23,000 + per year? Or, get something like Medishare?

We became very creative ar managing our income down.
Sold some real estate, sold some toys, cashed in Roth’s, used our cash.
We’ve been on ACA four years, $25 monthly premiums for bronze. So AGI is 65-70k year actual spend about $120k year.

 

[SecondCor521]

Seriously, what are people doing during their gap years retiring before Medicare? Do people pay themselves less so they can squeeze into some sort of ACA plan with having to remove arms legs or substantial parts of their future retirement? Or, do they just suck it up and pay the ACA $23,000 + per year? Or, get something like Medishare?

I manage my taxable income to maintain eligibility for an ACA subsidy. I am able to do that because I have a paid off home and car and live in a low to medium COL area. Since I don't require much cash flow, I can maintain a relatively moderate AGI and qualify for some ACA subsidies.

I do tax planning every December and look at my marginal rate including ACA effects. Generally this ends up in me finding a target AGI which balances my marginal rate now with what I expect it to be later, then Roth converting just beyond that number, then contributing to my HSA to get my AGI down to $1 below that exact target AGI. My target AGI usually lines up with a "breakpoint" in the tax law - either a bracket change or one of the several ACA FPL percentages.

Another thing that I do is choose a Bronze HSA eligible HDHP plan. This in general has lower premiums and lower benefits. I take the risk because I (knock wood) am relatively healthy, and I also contribute to my HSA annually - if I have a bad medical year I could use my HSA to cover it, or use other funds and leave the HSA invested and growing.

I did a quick check and for my circumstances, my worst case scenario would be age 64, max OOP, and that would be about $17K - about $9K of premium and $8K of OOP. But I'm single, so for a married couple both on ACA plans I suppose the worst case could be more. And again, I'm sort of banking on banking more good years than bad so that on average I'm ahead of the game. We'll see.

I know one can't guarantee health outcomes, but I will also add that I have been trying to take care of my health. Even though there's no guarantees, I do think it does help tilt the odds more in my favor.

Eating well, exercising (strength and cardio), maintaining a proper weight, avoiding potentially unhealthy levels of alcohol or dangerous drugs, getting immunizations and screenings done on time, and meeting the doctor once a year, are all things I try to do. If you go and read what the top few risk factors are for the top five or ten things that people die from in their 60s/70s/80s/90s and how to avoid those risks or minimize them, it generally boils down to those common sense things that I just listed.

 

[Trailwalker]

We had several years to plan before retirement, putting away enough post-tax money to take maximum advantage of the ACA rules. Next year is our final year of ACA, and I will breathe a sigh of relief when we can start Medicare and start drawing from the pre-tax accounts.

 

[Texas Proud]

Seriously, what are people doing during their gap years retiring before Medicare? Do people pay themselves less so they can squeeze into some sort of ACA plan with having to remove arms legs or substantial parts of their future retirement? Or, do they just suck it up and pay the ACA $23,000 + per year? Or, get something like Medishare?

I managed my taxable income... used savings in taxable accounts at first when I could sell for small cap gain... then have been using ROTH for the last few years...

Last year had to pay full freight as I did a stock conversion on my mega that cost me a bundle in taxes... but I was already off so it was not as expensive...

 

[PaunchyPirate]

I also manage my taxable income so that I can get some ACA subsidy to lower my insurance premium. At the expense of NOT doing Roth Conversions when I would like to be doing them. I fund my spending with cash reserves so that I don't have to realize capital gains from selling investments.

 

[Alex The Great]

I keep MAGI ~$23K to max the subsidy, which is in fact a taxable income ~$31K with the deduction of HSA contribution and capital loss carry-over. Of course no Roth conversions in this scenario. Still, I pay $435/mo premium for Blue Shield of CA PPO plan which is the only ACA plan accepted by provider I use for years in my area.

 

[SecondCor521]

Idaho's requested rates average a 6% increase in 2025. Rates are finalized 10/1. Apparently the state approves the increase unless the increase isn't adequately justified.

DOI publishes preliminary health insurance rates for 2025 • Press Release • Idaho Department of Insurance

The Idaho Department of Insurance (DOI) has received preliminary premium rates from health insurance carriers for plans sold starting January 2025. The DOI is seeking public comments before final rates are published.

doi.idaho.gov

My insurer and metal level is averaging a 9% increase. I'll look and see at Open Enrollment what the actual situation is.

My state plans are now available to preview.

The 2025 version of my plan is a bit over a 10% premium increase compared to 2024. Part of that increase is that I'm one year older - if I had managed to magically stay the same age the increase would only be 5.5%. I also am aware that I'm getting to the age where medical expenses start creeping up. All in all, it feels reasonable.

 

[PaunchyPirate]

My state plans are now available to preview.

The 2025 version of my plan is a bit over a 10% premium increase compared to 2024. Part of that increase is that I'm one year older - if I had managed to magically stay the same age the increase would only be 5.5%. I also am aware that I'm getting to the age where medical expenses start creeping up. All in all, it feels reasonable.

I agree that’s not a bad increase. I expect about the same for my results.

 

[FLSUnFIRE]

12.5% Increase for my BCBS HDHP here in FL. Part of that is due to me getting older... not sure the break out as it's not on the marketplace yet but I got the renewal notice.

 

[scrabbler1]

Seriously, what are people doing during their gap years retiring before Medicare? Do people pay themselves less so they can squeeze into some sort of ACA plan with having to remove arms legs or substantial parts of their future retirement? Or, do they just suck it up and pay the ACA $23,000 + per year? Or, get something like Medishare?

I have had an uneven history obtaining HI in the individual market after I retired in late 2008 at age 45, before the ACA.

In 2010 and 2011, I faced rate increases of nearly 50% in those 2 years, making me wonder if my whole ER plan was going to work. But after the ACA got passed in 2010, with the exchanges becoming available in 2014, I knew I had to hang in there until the end of 2013. In early 2011, I switched to a bare-bones, hospital-only plan to get me through the next 2 1/2 years.

I made it through 2013 and signed up for an exchange (Silver) plan in 2014. I barely qualified for a premium subsidy of about $500 per year. That worked out well until one of my funds, an actively-managed stock fund, began spewing out huge cap gain distributions in 2017. This pushed my MAGI over the cliff so the small subsidy disappeared. It was also in those years that my premiums were increasing a lot, from 9%-18% in the next 3 years. [I also had health issues including a hospital stay in 2015, some of which continue to today although nothing terribly costly.]

When this happened again at the end of 2019, I quickly dumped the stock fund for a similar index fund, something I probably should have done a few years earlier. In 2020, without the cap gain distributions and with a small dividend in the index fund, my MAGI dropped a lot and I got back on the subsidy train, reducing my premium to below what it was in 2014. In 2021, the ARP further reduced my premium by increasing the subsidy about $110 a month.

In late 2023, through this forum, I was alerted to my home state being allowed to increase the income cutoff to become eligible for its Essential Plan, one which had lower copays and had no monthly premiums. My income was in that small range to become eligible for that plan. I did some research to see which insurers I could switch to because my current insurer did not offer the Essential Plan. So, back in April, I switched to the new plan with a new insurer and have seen my premiums drop to zero and my copays get reduced. [This is also why I stopped creating a thread for others to post their 2025 premium increases - I didn't receive such a notice from my old insurer.]

At 61, I still have another 4 years on the ACA. But it is good to have greatly reduced my medical costs, partly due to luck, partly due to better income management.

 

[JohnC12]

I just received my renewal notice from BCBS here in Florida (FloridaBlue HMO plan). 40.1% increase for our Silver plan. Yikes! In reviewing the 2025 plan vs. current plan, everything is exactly the same except for a slightly decreased Individual/Family deductible. Individual dedcutible went from $5,900 to $5,000.

 

[SecondCor521]

I just received my renewal notice from BCBS here in Florida (FloridaBlue HMO plan). 40.1% increase for our Silver plan. Yikes! In reviewing the 2025 plan vs. current plan, everything is exactly the same except for a slightly decreased Individual/Family deductible. Individual dedcutible went from $5,900 to $5,000.

Is that the increase in the subsidized or unsubsidized premium?