{"id":12890,"date":"2024-09-09T06:41:27","date_gmt":"2024-09-09T06:41:27","guid":{"rendered":"https:\/\/distilinfo.com\/healthplan\/?p=12890"},"modified":"2024-09-09T06:41:27","modified_gmt":"2024-09-09T06:41:27","slug":"top-20-payers-aca-premiums-for-2025","status":"publish","type":"post","link":"https:\/\/distilinfo.com\/healthplan\/top-20-payers-aca-premiums-for-2025\/","title":{"rendered":"Top 20 Payers Significantly Boosting ACA Premiums for 2025"},"content":{"rendered":"\r\n<div id=\"rank-math-toc\" class=\"wp-block-rank-math-toc-block has-pale-ocean-gradient-background has-background\"><nav>\r\n<ul>\r\n<li><a href=\"#introduction\">Introduction<\/a><\/li>\r\n<li><a href=\"#aca-marketplace-in-2025\">ACA Marketplace in 2025<\/a><\/li>\r\n<li><a href=\"#factors-contributing-to-premium-increases\">Factors Contributing to Premium Increases<\/a>\r\n<ul>\r\n<li><a href=\"#1-inflation\">1. Inflation<\/a><\/li>\r\n<li><a href=\"#2-increased-usage-of-specialty-drugs\">2. Increased Usage of Specialty Drugs<\/a><\/li>\r\n<li><a href=\"#3-covid-19-costs-and-medicaid-redeterminations\">3. COVID-19 Costs and Medicaid Redeterminations<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#top-20-payers-raising-aca-premiums-in-2025\">Top 20 Payers Raising ACA Premiums in 2025<\/a>\r\n<ul>\r\n<li><a href=\"#1-emblem-health-new-york-51-1\">1. EmblemHealth (New York) &#8211; 51.1%<\/a><\/li>\r\n<li><a href=\"#2-highmark-western-and-northeastern-new-york-30-7\">2. Highmark Western and Northeastern New York &#8211; 30.7%<\/a><\/li>\r\n<li><a href=\"#3-metro-plus-new-york-28-3\">3. MetroPlus (New York) &#8211; 28.3%<\/a><\/li>\r\n<li><a href=\"#4-independent-health-new-york-27-7\">4. Independent Health (New York) &#8211; 27.7%<\/a><\/li>\r\n<li><a href=\"#5-aetna-utah-26-6\">5. Aetna Utah &#8211; 26.6%<\/a><\/li>\r\n<li><a href=\"#6-oscar-new-york-25-5\">6. Oscar (New York) &#8211; 25.5%<\/a><\/li>\r\n<li><a href=\"#7-bcbs-kansas-city-kansas-24-4\">7. BCBS Kansas City (Kansas) &#8211; 24.4%<\/a><\/li>\r\n<li><a href=\"#8-bcbs-vermont-23-8\">8. BCBS Vermont &#8211; 23.8%<\/a><\/li>\r\n<li><a href=\"#9-regence-blue-shield-washington-23-6\">9. Regence BlueShield (Washington) &#8211; 23.6%<\/a><\/li>\r\n<li><a href=\"#10-united-healthcare-oregon-23-3\">10. UnitedHealthcare Oregon &#8211; 23.3%<\/a><\/li>\r\n<li><a href=\"#11-cambia-bridge-span-health-washington-20\">11. Cambia BridgeSpan Health (Washington) &#8211; 20%<\/a><\/li>\r\n<li><a href=\"#12-capital-district-physicians-health-plan-new-york-19-8\">12. Capital District Physicians Health Plan (New York) &#8211; 19.8%<\/a><\/li>\r\n<li><a href=\"#13-moda-health-plan-alaska-19-6\">13. Moda Health Plan (Alaska) &#8211; 19.6%<\/a><\/li>\r\n<li><a href=\"#14-mvp-health-plan-new-york-19-6\">14. MVP Health Plan (New York) &#8211; 19.6%<\/a><\/li>\r\n<li><a href=\"#15-excellus-bcbs-new-york-19-5\">15. Excellus BCBS (New York) &#8211; 19.5%<\/a><\/li>\r\n<li><a href=\"#16-priority-health-michigan-18-9\">16. Priority Health (Michigan) &#8211; 18.9%<\/a><\/li>\r\n<li><a href=\"#17-regence-bcbs-of-utah-18-5\">17. Regence BCBS of Utah &#8211; 18.5%<\/a><\/li>\r\n<li><a href=\"#18-cambia-bridge-span-health-utah-18-4\">18. Cambia BridgeSpan Health (Utah) &#8211; 18.4%<\/a><\/li>\r\n<li><a href=\"#19-sanford-health-plan-north-dakota-18-2\">19. Sanford Health Plan (North Dakota) &#8211; 18.2%<\/a><\/li>\r\n<li><a href=\"#20-mvp-health-plan-vermont-17-8\">20. MVP Health Plan (Vermont) &#8211; 17.8%<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#conclusion\">Conclusion<\/a><\/li>\r\n<li><a href=\"#fa-qs\">FAQs<\/a>\r\n<ul>\r\n<li><a href=\"#1-why-are-aca-premiums-rising-in-2025\">1. Why are ACA premiums rising in 2025?<\/a><\/li>\r\n<li><a href=\"#2-will-covid-19-costs-affect-aca-premiums-in-2025\">2. Will COVID-19 costs affect ACA premiums in 2025?<\/a><\/li>\r\n<li><a href=\"#3-are-these-premium-increases-final\">3. Are these premium increases final?<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/nav><\/div>\r\n\r\n\r\n\r\n<h2 id=\"introduction\" class=\"wp-block-heading\">Introduction<\/h2>\r\n\r\n\r\n\r\n<p>The Affordable Care Act (ACA) marketplace plays a critical role in providing millions of Americans with health insurance coverage. However, with the changing economic landscape, premium rates are expected to rise significantly in 2025. Among the 324 insurers offering ACA coverage, some are increasing their premiums more than others, with <a href=\"https:\/\/abc7ny.com\/post\/health-insurance-costs-ny-new-york-state-approves-rate-hikes-health-insurance-premiums\/15252451\/\" target=\"_blank\" rel=\"noopener\">New York residents<\/a> facing the largest hikes. This blog will explore the factors behind these increases and highlight the 20 payers raising ACA premiums the most in 2025.<\/p>\r\n\r\n\r\n\r\n<h2 id=\"aca-marketplace-in-2025\" class=\"wp-block-heading\">ACA Marketplace in 2025<\/h2>\r\n\r\n\r\n\r\n<p>In 2025, the <a href=\"https:\/\/www.healthsystemtracker.org\/brief\/how-much-and-why-aca-marketplace-premiums-are-going-up-in-2025\/\" target=\"_blank\" rel=\"noopener\">ACA marketplace<\/a> will feature 324 insurers across all 50 states and Washington, D.C. The median proposed premium increase is projected at 7%, closely mirroring the rates observed in 2024. While this number may seem moderate, many payers are proposing significant hikes, with some as high as 51%.<\/p>\r\n\r\n\r\n\r\n<p>It&#8217;s essential to understand that these proposed rates are still in preliminary stages and could be adjusted during the rate review process before states finalize them. However, the trends emerging from rate filings shed light on the driving forces behind these increases.<\/p>\r\n\r\n\r\n\r\n<h2 id=\"factors-contributing-to-premium-increases\" class=\"wp-block-heading\">Factors Contributing to Premium Increases<\/h2>\r\n\r\n\r\n\r\n<p>Several key factors are influencing premium rates for 2025:<\/p>\r\n\r\n\r\n\r\n<h3 id=\"1-inflation\" class=\"wp-block-heading\">1. Inflation<\/h3>\r\n\r\n\r\n\r\n<p>Inflation continues to affect the healthcare industry, leading to rising operational costs for insurers. As the cost of medical services, technology, and pharmaceuticals increase, insurers are forced to adjust their premiums to maintain profitability.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"2-increased-usage-of-specialty-drugs\" class=\"wp-block-heading\">2. Increased Usage of Specialty Drugs<\/h3>\r\n\r\n\r\n\r\n<p>The increased use of specialty drugs, including weight loss medications, is a significant factor driving premium increases. These medications often come with high costs, and their growing popularity means insurers must account for the added expenses.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"3-covid-19-costs-and-medicaid-redeterminations\" class=\"wp-block-heading\">3. COVID-19 Costs and Medicaid Redeterminations<\/h3>\r\n\r\n\r\n\r\n<p>Interestingly, lingering COVID-19 costs and Medicaid redeterminations are having minimal effects on premium increases. While these factors were more influential in previous years, their impact has lessened as the pandemic becomes more manageable.<\/p>\r\n\r\n\r\n\r\n<h2 id=\"top-20-payers-raising-aca-premiums-in-2025\" class=\"wp-block-heading\">Top 20 Payers Raising ACA Premiums in 2025<\/h2>\r\n\r\n\r\n\r\n<p>Let\u2019s dive into the 20 payers that are raising their ACA premiums the most in 2025, starting with EmblemHealth, which leads the list with an enormous 51.1% increase.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"1-emblem-health-new-york-51-1\" class=\"wp-block-heading\">1. EmblemHealth (New York) &#8211; 51.1%<\/h3>\r\n\r\n\r\n\r\n<p>New York residents insured by EmblemHealth will face a staggering 51.1% increase in their ACA premiums. This is the highest proposed hike among all payers, driven primarily by inflation and the increased usage of high-cost specialty medications.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"2-highmark-western-and-northeastern-new-york-30-7\" class=\"wp-block-heading\">2. Highmark Western and Northeastern New York &#8211; 30.7%<\/h3>\r\n\r\n\r\n\r\n<p>Highmark plans to raise premiums by 30.7% in New York. This increase is attributed to rising healthcare costs and the need to cover expensive treatments for chronic conditions.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"3-metro-plus-new-york-28-3\" class=\"wp-block-heading\">3. MetroPlus (New York) &#8211; 28.3%<\/h3>\r\n\r\n\r\n\r\n<p>MetroPlus, a popular ACA marketplace insurer in New York, will see a 28.3% rise in premiums for 2025. This increase is partly due to inflation and the high demand for specialty drugs.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"4-independent-health-new-york-27-7\" class=\"wp-block-heading\">4. Independent Health (New York) &#8211; 27.7%<\/h3>\r\n\r\n\r\n\r\n<p>Another New York-based insurer, Independent Health, will implement a 27.7% increase, influenced by rising medical costs and the expanding utilization of advanced therapies.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"5-aetna-utah-26-6\" class=\"wp-block-heading\">5. Aetna Utah &#8211; 26.6%<\/h3>\r\n\r\n\r\n\r\n<p>Aetna&#8217;s Utah members will see a premium hike of 26.6%. Similar to other insurers, this increase is driven by inflation and the use of costly medications.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"6-oscar-new-york-25-5\" class=\"wp-block-heading\">6. Oscar (New York) &#8211; 25.5%<\/h3>\r\n\r\n\r\n\r\n<p>Oscar Health, known for its innovative approach to insurance, is raising premiums by 25.5% in New York. This increase reflects rising healthcare service demands and inflationary pressures.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"7-bcbs-kansas-city-kansas-24-4\" class=\"wp-block-heading\">7. BCBS Kansas City (Kansas) &#8211; 24.4%<\/h3>\r\n\r\n\r\n\r\n<p>Blue Cross Blue Shield (BCBS) of Kansas City will implement a 24.4% increase, mainly driven by higher costs of care and inflation.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"8-bcbs-vermont-23-8\" class=\"wp-block-heading\">8. BCBS Vermont &#8211; 23.8%<\/h3>\r\n\r\n\r\n\r\n<p>BCBS Vermont will see a 23.8% increase, attributed to rising healthcare expenses and the increased use of expensive treatments.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"9-regence-blue-shield-washington-23-6\" class=\"wp-block-heading\">9. Regence BlueShield (Washington) &#8211; 23.6%<\/h3>\r\n\r\n\r\n\r\n<p>Regence BlueShield in Washington is set to increase premiums by 23.6%, influenced by inflation and rising drug costs.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"10-united-healthcare-oregon-23-3\" class=\"wp-block-heading\">10. UnitedHealthcare Oregon &#8211; 23.3%<\/h3>\r\n\r\n\r\n\r\n<p>Oregon residents insured by UnitedHealthcare will experience a 23.3% premium increase, driven by the costs of providing comprehensive care.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"11-cambia-bridge-span-health-washington-20\" class=\"wp-block-heading\">11. Cambia BridgeSpan Health (Washington) &#8211; 20%<\/h3>\r\n\r\n\r\n\r\n<p>Cambia BridgeSpan Health in Washington is proposing a 20% increase, citing inflation and higher usage of medical services as primary factors.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"12-capital-district-physicians-health-plan-new-york-19-8\" class=\"wp-block-heading\">12. Capital District Physicians Health Plan (New York) &#8211; 19.8%<\/h3>\r\n\r\n\r\n\r\n<p>New York&#8217;s Capital District Physicians Health Plan will raise premiums by 19.8%, driven by increasing medical service costs.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"13-moda-health-plan-alaska-19-6\" class=\"wp-block-heading\">13. Moda Health Plan (Alaska) &#8211; 19.6%<\/h3>\r\n\r\n\r\n\r\n<p>Moda Health Plan members in Alaska will see a 19.6% increase, due to higher healthcare costs in the state.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"14-mvp-health-plan-new-york-19-6\" class=\"wp-block-heading\">14. MVP Health Plan (New York) &#8211; 19.6%<\/h3>\r\n\r\n\r\n\r\n<p>MVP Health Plan, another New York insurer, will also increase premiums by 19.6% in 2025.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"15-excellus-bcbs-new-york-19-5\" class=\"wp-block-heading\">15. Excellus BCBS (New York) &#8211; 19.5%<\/h3>\r\n\r\n\r\n\r\n<p>Excellus BCBS is planning a 19.5% premium hike, driven by inflation and healthcare service costs.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"16-priority-health-michigan-18-9\" class=\"wp-block-heading\">16. Priority Health (Michigan) &#8211; 18.9%<\/h3>\r\n\r\n\r\n\r\n<p>Michigan&#8217;s Priority Health will raise premiums by 18.9%, reflecting rising costs in healthcare services.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"17-regence-bcbs-of-utah-18-5\" class=\"wp-block-heading\">17. Regence BCBS of Utah &#8211; 18.5%<\/h3>\r\n\r\n\r\n\r\n<p>Regence BCBS members in Utah will experience an 18.5% increase in premiums, driven by inflation and higher medical service utilization.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"18-cambia-bridge-span-health-utah-18-4\" class=\"wp-block-heading\">18. Cambia BridgeSpan Health (Utah) &#8211; 18.4%<\/h3>\r\n\r\n\r\n\r\n<p>Cambia BridgeSpan Health in Utah will raise premiums by 18.4%, due to similar factors of rising medical costs and inflation.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"19-sanford-health-plan-north-dakota-18-2\" class=\"wp-block-heading\">19. Sanford Health Plan (North Dakota) &#8211; 18.2%<\/h3>\r\n\r\n\r\n\r\n<p>Sanford Health Plan in North Dakota will increase premiums by 18.2%, influenced by healthcare service demands.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"20-mvp-health-plan-vermont-17-8\" class=\"wp-block-heading\">20. MVP Health Plan (Vermont) &#8211; 17.8%<\/h3>\r\n\r\n\r\n\r\n<p>MVP Health Plan members in Vermont will see a 17.8% premium increase in 2025.<\/p>\r\n\r\n\r\n\r\n<h2 id=\"conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\r\n\r\n\r\n\r\n<p>Premium increases in the ACA marketplace for 2025 reflect broader trends in the healthcare industry, including rising medical costs, inflation, and the increased use of specialty medications. While the median increase is 7%, many insurers are raising premiums by significantly larger margins. Consumers should stay informed about these changes to make the best healthcare decisions for themselves and their families.<\/p>\r\n\r\n\r\n\r\n<p><span data-teams=\"true\"><span class=\"ui-provider a b c d e f g h i j k l m n o p q r s t u v w x y z ab ac ae af ag ah ai aj ak\" dir=\"ltr\">Discover the latest <a id=\"menurn6\" class=\"fui-Link ___1rxvrpe f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1hu3pq6 f11qmguv f19f4twv f1tyq0we f1g0x7ka fhxju0i f1qch9an f1cnd47f fqv5qza f1vmzxwi f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn\" title=\"https:\/\/distilinfo.com\/healthplan\/\" href=\"https:\/\/distilinfo.com\/healthplan\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Link payers&#039; news updates\"><strong>payers&#8217; news updates<\/strong><\/a> with a single click. Follow <a id=\"menurn8\" class=\"fui-Link ___1rxvrpe f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1hu3pq6 f11qmguv f19f4twv f1tyq0we f1g0x7ka fhxju0i f1qch9an f1cnd47f fqv5qza f1vmzxwi f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn\" title=\"https:\/\/distilinfo.com\/healthplan\/\" href=\"https:\/\/distilinfo.com\/healthplan\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Link DistilINFO HealthPlan\">DistilINFO HealthPlan<\/a> and stay ahead with updates. Join our community today!<\/span><\/span><\/p>\r\n\r\n\r\n\r\n<h2 id=\"fa-qs\" class=\"wp-block-heading\">FAQs<\/h2>\r\n\r\n\r\n\r\n<h3 id=\"1-why-are-aca-premiums-rising-in-2025\" class=\"wp-block-heading\">1. Why are ACA premiums rising in 2025?<\/h3>\r\n\r\n\r\n\r\n<p>A. Premium increases are primarily due to inflation, rising medical costs, and the increased use of expensive specialty drugs.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"2-will-covid-19-costs-affect-aca-premiums-in-2025\" class=\"wp-block-heading\">2. Will COVID-19 costs affect ACA premiums in 2025?<\/h3>\r\n\r\n\r\n\r\n<p>A. COVID-19 costs are having little impact on 2025 premiums compared to previous years.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"3-are-these-premium-increases-final\" class=\"wp-block-heading\">3. Are these premium increases final?<\/h3>\r\n\r\n\r\n\r\n<p>A. No, these rates are preliminary and could change during the rate review process.<\/p>\r\n","protected":false},"excerpt":{"rendered":"<p>Introduction The Affordable Care Act (ACA) marketplace plays a critical role in providing millions of Americans with health insurance coverage&#8230;. <a href=\"https:\/\/distilinfo.com\/healthplan\/top-20-payers-aca-premiums-for-2025\/\" style=\"white-space: nowrap;\">Continue Reading <i class=\"fas fa-long-arrow-alt-right\" style=\"vertical-align: middle;\"><\/i><\/a><\/p>\n","protected":false},"author":1,"featured_media":12892,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rank_math_lock_modified_date":false,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[1],"tags":[284],"class_list":{"0":"post-12890","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-distilinfo-originals","8":"tag-payers","9":"entry"},"_links":{"self":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/12890"}],"collection":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/comments?post=12890"}],"version-history":[{"count":3,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/12890\/revisions"}],"predecessor-version":[{"id":12962,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/12890\/revisions\/12962"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media\/12892"}],"wp:attachment":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media?parent=12890"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/categories?post=12890"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/tags?post=12890"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}