The Kaiser Family Foundation (KFF) has recently analyzed the proposed premium rates for the Affordable Care Act (ACA) Marketplace in 2025, revealing a median increase of approximately 7%. While this figure might seem concerning for enrollees, most consumers enrolled in Marketplace plans receive financial assistance which increases at the same pace as rates, making rate changes minimal for consumers. Additionally, state regulators often approve lower rate increases than those initially requested by insurers, meaning the final numbers could be more favorable when they are published in September.
The Impact of Rate Increases Across States
It’s important to note that these proposed increases vary significantly from state to state. Some states may see much higher proposed rates, while others might experience minimal changes, or even decreases. This variation underscores the complex nature of health care pricing, influenced by factors like regional health care costs, state-specific regulations, and the competitive landscape among insurers in each state.
The Role of Expanded Subsidies
Despite these potential rate hikes, most ACA Marketplace enrollees may not feel the full impact, thanks to the expanded subsidies introduced under the American Rescue Plan Act and extended through the Inflation Reduction Act. These subsidies help lower out-of-pocket premium costs for eligible enrollees by increasing the Advance Premium Tax Credits (APTC). Since nearly all exchange enrollees currently receive some level of subsidy, the net increase in premiums for most people will be mitigated by higher APTC amounts.
This situation highlights the crucial role of these subsidies in maintaining affordability for and high enrollment in ACA Marketplace plans, even in the face of rising premiums.
Subsidies on the GetInsured Platform
Wherever the final premium costs land, states operating on the GetInsured platform can help enrollees maximize their available APTC. While the platform defaults to leveraging the highest tax credit amount available, it also offers flexibility for users to adjust their applied APTC based on their unique income situation, providing personalized control over how much of their tax credit they apply and their overall health care expenses.
As we move closer to the final rate announcements, we will continue to highlight the tools and resources available to consumers to help them navigate these changes effectively. For a deeper dive into the reasons behind these premium increases and more detailed insights, you can read the full analysis from the Peterson-KFF Health System Tracker here.
