N.J. insurance shoppers will see a nearly 20% premium hike next year for ACA plans
GetCoveredNJ's Affordable Care Act plans are raising premiums on average by nearly 20% next year, higher than in Pennsylvania and the national average. Open enrollment begins Nov. 1.
Hundreds of thousands of New Jerseyans who buy health insurance through the state’s Affordable Care Act marketplace, GetCoveredNJ, will face double-digit premium increases next year.
The average premium increase for individuals and families will be 19.8%, which insurance carriers attributed to rising medical and specialty drug costs, Acting Banking and Insurance Commissioner Susan Ochs said in a statement Thursday.
Some of the plans offered by the state’s five carriers raise rates far higher than the average increase. UnitedHealthcare will charge 35.7% more, Oscar rates will rise by 29.3%, and Ambetter from Wellcare New Jersey is 20.8% more.
AmeriHealth and Horizon’s rate increases are below the state average, at 17% and 15.3%, respectively.
The Pennsylvania Insurance Department announced last month an average rate increase of 16% for health plans sold to individuals and families through Pennie, its ACA marketplace.
These increases follow a difficult year for people who buy their own insurance.
Last year, many lost subsidies that dramatically lowered their costs when Congress declined to renew pandemic-era subsidies for people with higher incomes who were insured through the ACA.
Nearly 70,000 people in New Jersey dropped their coverage as a result, according to the state. Ochs said the loss of subsidies drove away all but the sickest people who couldn’t find coverage elsewhere, creating a sicker and more expensive pool of consumers.
State marketplace plans enrolled 440,362 people this year.
“These health insurance rate increases will place extraordinary pressure on household budgets and drive more New Jerseyans to make the heartbreaking choice to drop coverage altogether,” Ochs said. “While this is a challenging environment for many, our GetCoveredNJ team is here to help consumers find plans that may work for them.”
The average premium increase for individual marketplaces nationwide is 15%, lower than New Jersey, according to a recent Kaiser Family Foundation analysis.
Members of the Small Employer Market will pay an average of 18.8% more. Horizon is raising premiums by 19.5% and both Oxford and AmeriHealth by 17.6%, the department said.
Linda Schwimmer, president of the New Jersey Health Care Quality Institute, a research and advocacy nonprofit, expressed dismay on consumers’ behalf.
“Given the loss of the extra premium supports and the increase in prices of healthcare services and medication, the insurance premium rate increases are unsurprising but unsustainable. The small employer market increases are also skyrocketing at about 19%,” Schwimmer said.
The open enrollment period in New Jersey runs from Nov. 1 through Jan. 31, 2027.
