Oregon: *Final* avg unsubsidized 2025 ACA rate changes: +8.3%

Via the Oregon Division of Financial Regulation:

The Oregon Division of Financial Regulation (DFR) has finalized the rate decisions for 2025 health insurance for the individual and small group markets. The division reviews and approves rates for these markets through a detailed and transparent public process before they can be charged to policyholders.

This transparent process includes actuarial analysis provided to the public, public hearings, and a public comment period. Annually, insurance companies submit rate filings for the upcoming plan year. These filings are rigorously reviewed by division actuaries during a monthslong public review process. That process is now final and Oregonians will see an average rate increase of 8.3 percent in the individual market and a 12.2 percent increase in the small group markets.

The final rates in the individual market came in 1 percent lower than the original rate requests from companies and the small group market came in one-tenth of 1 percent lower than originally requested. The lowered rate averages were driven by an actuarial review by the division that found several components of the company rate filings to be above division actuarial parameters. DFR has the authority to review and revise rates to ensure they are “reasonable and not excessive, inadequate or unfairly discriminatory," under ORS 743.018 (4).

“We work hard to find any way we can to save Oregonians money throughout this process," said Andrew R. Stolfi, Oregon insurance commissioner and director of the Department of Consumer and Business Services. “The health insurance market is competitive with five carriers offering plans in every Oregon county 2025, which gives Oregonians more options to shop for plans to fit their budget."

Moda became the fifth company to offer health insurance in every county in Oregon after expanding into Benton, Linn, and Lincoln counties. Moda joins BridgeSpan, PacificSource, Providence, and Regence as health insurance companies who provide coverage in all parts of Oregon. It will be the first time that five insurers have offered plans in every county.

In the small group market, which serves small businesses with one to 50 employees, eight insurance companies submitted health insurance rates with a weighted final average increase of 12.2 percent. The average increase range is now 5.7 percent to 16.3 percent, for a weighted average increase of 12.2 percent. The increase was due in large part to medical costs and inflation.

DFR's review also showed that the Oregon Reinsurance Program continues to help stabilize the health insurance market and keep rates lower. This program works to offset risk experienced by insurers, ultimately lowering premiums. Reinsurance lowered rates by at least 6 percent for the seventh straight year. In fact, this year it saved consumers 8.4 percent.

See the attached chart for the full list of rate change requests.

The division has created a Consumer Guide to 2025 Health Insurance Rate Filings to explain how rates were arrived at and the adjustments made. This guide provides comprehensive detail as to the key components of the 2025 rates and an explanation to adjustments made by the division.

The division has also created a general Consumer Guide to Health Insurance Rate Review to help explain how rates are determined each year.