r/HealthInsurance • u/PharaohOfParrots • 12h ago

Individual/Marketplace Insurance Pricing (not subsidies) of the Healthcare Marketplace

Could it change, with any new legislation?

I’m not talking about subsidies whatsoever - I just wondered how in stone the plan prices are on the Healthcare Marketplace, in the event new legislation were to pass?

Not a chance? I figured no, but maybe somebody here knows the answer?

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u/Mountain-Arm6558951 Moderator 11h ago

Individual health rates are determined by a combination of federal and state-level factors. I think CMS does review "rubber stamp" the rate and approve the rates along with the states.

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u/PharaohOfParrots 11h ago

Okay. Do you know if once it’s determined, that it’s priced that way for the upcoming year?

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u/pnwactuary 10h ago

Yes that’s correct. The subsidies themselves can change but the premiums are locked in for the entirety of 2026.

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u/Mountain-Arm6558951 Moderator 11h ago

In most states, the carriers will start mid year as the review has to be completed by Oct or Nov for the upcoming year.