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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