Insurers submit filings every year to state regulators detailing their plans to participate in the Affordable Care Act marketplaces (also called exchanges). These filings include information on the premiums insurers plan to charge in the coming year and which areas they plan to serve. Each state or the federal government reviews premiums to ensure they are accurate and justifiable before the rate goes into effect, though regulators have varying types of authority and states make varying amounts of rate review information public.

This analysis looks at lowest-cost bronze, second lowest-cost silver, and lowest-cost gold premiums in the 50 states and the District of Columbia. (Our analyses from 2018, 2017, 2016, 2015, and 2014 examined changes in premiums and participation in these states and major cities since the exchange markets opened nearly four years ago.) The second lowest-cost silver plan serves as the benchmark for premium tax credits (which subsidize premiums for low and modest income exchange enrollees) and is the only plan that offers reduced cost sharing for lower-income enrollees. About 63% of marketplace enrollees are in silver plans this year, and 29% are enrolled in bronze plans.

Rates and plan offerings for 2019 have been finalized, and Open Enrollment is underway. Open Enrollment for ACA-compliant coverage for 2019 runs from November 1st through December 15th in most states.

Premium Changes

The tables below show final 2018 and 2019 premiums for a major city in each of the 50 states and Washington, D.C.

Table 1 below shows monthly premiums before applying a tax credit for the lowest-cost bronze, second lowest-cost silver, and lowest-cost gold plans insurers are offering on the ACA exchanges for 2019.

Table 1: Monthly Unsubsidized Bronze, Benchmark, and Gold Premiums for a 40 Year Old Non-Smoker State Major City Lowest Cost Bronze

Before Tax Credit 2nd Lowest Cost Silver

Before Tax Credit Lowest Cost Gold

Before Tax Credit 2018 2019 % Change from 2018 2018 2019 % Change from 2018 2018 2019 % Change from 2018 Alabama Birmingham $372 $327 -12% $546 $525 -4% $612 $616 1% Alaska Anchorage $526 $461 -12% $709 $696 -2% $759 $655 -14% Arizona Phoenix $405 $333 -18% $513 $426 -17% $621 $574 -8% Arkansas Little Rock $309 $320 4% $378 $381 1% $424 $469 11% California Los Angeles $247 $281 14% $360 $376 4% $398 $405 2% Colorado Denver $338 $336 -1% $413 $466 13% $459 $480 5% Connecticut Hartford $306 $297 -3% $484 $428 -12% $545 $542 -1% Delaware Wilmington $473 $449 -5% $591 $685 16% $706 $672 -5% DC Washington $271 $316 17% $324 $393 21% $385 $426 11% Florida Miami $297 $332 12% $442 $447 1% $456 $476 4% Georgia Atlanta $371 $316 -15% $421 $440 5% $465 $497 7% Hawaii Honolulu $336 $361 7% $456 $503 10% $449 $469 4% Idaho Boise $290 $282 -3% $463 $479 3% $464 $480 3% Illinois Chicago $305 $328 8% $411 $384 -7% $488 $442 -9% Indiana Indianapolis $323 $350 8% $366 $377 3% $501 $498 -1% Iowa Cedar Rapids $570 $429 -25% $702 $724 3% $781 $528 -32% Kansas Wichita $344 $375 9% $484 $529 9% $445 $485 9% Kentucky Louisville $282 $274 -3% $397 $370 -7% $446 $506 13% Louisiana New Orleans $363 $336 -7% $409 $384 -6% $509 $484 -5% Maine Portland $337 $335 -1% $513 $485 -5% $570 $582 2% Maryland Baltimore $314 $298 -5% $456 $419 -8% $449 $408 -9% Massachusetts Boston $233 $251 8% $305 $321 5% $347 $334 -4% Michigan Detroit $219 $225 3% $332 $333 0% $341 $355 4% Minnesota Minneapolis $259 $238 -8% $327 $300 -8% $410 $343 -16% Mississippi Jackson $492 $474 -4% $551 $542 -2% $687 $648 -6% Missouri St. Louis $281 $325 16% $465 $421 -9% $636 $566 -11% Montana Billings $334 $321 -4% $503 $522 4% $561 $499 -11% Nebraska Omaha $532 $473 -11% $752 $821 9% $753 $586 -22% Nevada Las Vegas $291 $292 0% $384 $369 -4% $416 $404 -3% New Hampshire Manchester $391 $303 -23% $475 $402 -15% $524 $444 -15% New Jersey Newark $322 $279 -13% $411 $348 -15% $646 $538 -17% New Mexico Albuquerque $258 $241 -7% $401 $342 -15% $331 $334 1% New York New York $416 $421 1% $510 $587 15% $595 $697 17% North Carolina Charlotte $491 $361 -26% $667 $536 -20% $703 $548 -22% North Dakota Fargo $254 $277 9% $298 $388 30% $382 $392 3% Ohio Cleveland $244 $264 8% $319 $327 3% $376 $400 6% Oklahoma Okla. City $377 $334 -11% $685 $686 0% $690 $486 -30% Oregon Portland $271 $296 9% $380 $414 9% $401 $439 9% Pennsylvania Philadelphia $401 $370 -8% $636 $465 -27% $539 $517 -4% Rhode Island Providence $198 $215 9% $311 $336 8% $300 $323 8% South Carolina Columbia $393 $405 3% $562 $603 7% $590 $607 3% South Dakota Sioux Falls $346 $330 -5% $453 $448 -1% $509 $521 2% Tennessee Nashville $351 $342 -3% $585 $486 -17% $824 $813 -1% Texas Houston $270 $286 6% $399 $393 -2% $426 $476 12% Utah Salt Lake City $283 $271 -4% $517 $510 -1% $578 $584 1% Vermont Burlington $422 $426 1% $505 $622 23% $569 $584 3% Virginia Richmond $327 $379 16% $482 $499 4% $719 $499 -31% Washington Seattle $264 $319 21% $339 $380 12% $406 $436 7% West Virginia Huntington $410 $475 16% $478 $531 11% $623 $683 10% Wisconsin Milwaukee $434 $372 -14% $568 $563 -1% $666 $570 -14% Wyoming Cheyenne $534 $531 -1% $796 $796 0% $657 $660 0% SOURCE: Kaiser Family Foundation analysis of premium data from insurer rate filings to state regulators, healthcare.gov, and state plan finders

Table 2 shows the monthly premium tax credit for a 40-year-old making $30,000 per year living in a major city in each of the 50 states and Washington, D.C.

Table 2: Monthly Advanced Premium Tax Credit Amount for a 40 Year Old Non-Smoker Making $30,000 / Year State Major City 2018 2019 % Change from 2018 Alabama Birmingham $344 $319 -7% Alaska Anchorage $550 $525 -5% Arizona Phoenix $310 $220 -29% Arkansas Little Rock $177 $173 -2% California Los Angeles $158 $170 8% Colorado Denver $214 $260 21% Connecticut Hartford $283 $224 -21% Delaware Wilmington $388 $478 23% DC Washington $117 $181 55% Florida Miami $241 $241 0% Georgia Atlanta $216 $233 8% Hawaii Honolulu $265 $315 19% Idaho Boise $261 $272 4% Illinois Chicago $209 $177 -15% Indiana Indianapolis $163 $171 5% Iowa Cedar Rapids $501 $518 3% Kansas Wichita $283 $322 14% Kentucky Louisville $177 $164 -7% Louisiana New Orleans $207 $177 -14% Maine Portland $311 $278 -11% Maryland Baltimore $250 $215 -14% Massachusetts Boston $104 $115 11% Michigan Detroit $131 $127 -3% Minnesota Minneapolis $126 $94 -25% Mississippi Jackson $349 $336 -4% Missouri St. Louis $263 $214 -19% Montana Billings $302 $316 5% Nebraska Omaha $551 $614 11% Nevada Las Vegas $182 $162 -11% New Hampshire Manchester $273 $196 -28% New Jersey Newark $209 $141 -33% New Mexico Albuquerque $200 $134 -33% New York New York $308 $369 20% North Carolina Charlotte $465 $330 -29% North Dakota Fargo $97 $180 86% Ohio Cleveland $116 $120 3% Oklahoma Okla. City $484 $480 -1% Oregon Portland $174 $205 18% Pennsylvania Philadelphia $434 $259 -40% Rhode Island Providence $109 $129 18% South Carolina Columbia $359 $397 11% South Dakota Sioux Falls $252 $242 -4% Tennessee Nashville $381 $280 -27% Texas Houston $198 $186 -6% Utah Salt Lake City $313 $300 -4% Vermont Burlington $341 $453 33% Virginia Richmond $281 $292 4% Washington Seattle $135 $177 31% West Virginia Huntington $262 $305 16% Wisconsin Milwaukee $366 $356 -3% Wyoming Cheyenne $595 $589 -1% SOURCE: Kaiser Family Foundation analysis of premium data from insurer rate filings to state regulators, healthcare.gov, and state plan finders

Table 3 shows monthly premiums after applying a tax credit for the lowest-cost bronze, second lowest-cost silver, and lowest-cost gold plans insurers are offering for 2019.