What’s Driving Up ACA Premiums Next Year? Mainly, Macroeconomics

With open enrollment for Affordable Care Act exchange plans now less than a month away, a clearer picture is beginning to emerge regarding which factors are weighing the heaviest on health insurers’ minds when formulating their 2024 premium rates — as well as how much those rates are set to rise.

Based on insurers’ 2024 rate requests and their actuarial justifications, it appears that inflation is one of the biggest drivers of proposed rate increases, which states are now in the process of finalizing. However, due to expanded subsidies that have been in place since pandemic relief legislation passed, most exchange customers won’t feel the effects of rising premiums. And researchers who study the ACA exchanges tell AIS Health, a division of MMIT, that generally the individual insurance marketplace remains on solid ground — a far cry from years like 2017 and 2018 that featured significant regulatory uncertainty and major insurer exits.

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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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