Individual Market Rates Increase by an Average of 13 Percent in 2025

New Yorkers anticipating health insurance premiums in the individual market will face
disappointing developments in 2025. The latest data shows that individual market rates
are expected to increase by an average of 13 percent next year. Insurance carriers initially
requested a 17 percent average rate surge for 2025, but through New York’s prior approval
process, the Department of Financial Services has marginally trimmed this figure down. The table below compares health plans’ initial rate requests with rates that were ultimately approved, providing insight into how this process impacts your healthcare costs (you can also review our detailed comments on each carrier’s rate request).


The prior approval process acts as an important safeguard; and while expanded advanced premium tax credits—enacted through the American Rescue Plan during the COVID-19 pandemic—have helped make health insurance more affordable, these tax credits are set to expire in 2025. This 13 percent increase will be a financial burden for many New Yorkers. New York should consider additional strategies to protect consumers from steep premium increases beyond the rate review process. States—such as Connecticut, Delaware, Massachusetts, Nevada, New Jersey, Oregon, Rhode Island, and Washington—have already taken steps in this direction, setting up Health Care Cost Containment task forces or agencies.


If you’re concerned about health insurance costs, there’s good news. Most New Yorkers
purchasing their own health coverage are eligible for subsidies that can help. To explore
your options and learn more about available subsidies, visit the NY State of Health
enrollment site. If you need help switching plans or finding affordable health insurance, the
Navigators program offers free, unbiased guidance and can help you understand your
premium assistance and coverage options. You can contact Navigators through the CSS
Navigator Network at 888-614-5400 or email enroll@cssny.org. Additionally, you can reach out to NY State of Health assistors online or by calling 855-355-5777.

New York’s individual market premiums might increase by up to 17 percent in 2025. New York’s twelve individual market carriers are requesting increases ranging from 9 percent by MVP to a shocking 51 percent by Emblem. These requested increases far surpass requests from carriers in other states.

In our comments, HCFANY breaks down why DFS should curb each carrier’s specific rate requests to protect patients from another unaffordable increase in health care costs. Find your carrier in the list below to see what we had to say: 

The NY State of Health (NYSOH) is New York’s Marketplace, an online portal created to help peopel shop for health insurance through the Affordable Care Act. New York has worked hard to make NYSOH easy to use. While there have been hiccups here and there, the Department of Health announced today that a record breaking 4.9 million people used NYSOH to enroll in health coverage during this year’s open enrollment! That’s more than 25 percent of New Yorkers, and it includes 150,000 people who used NYSOH for the first time.

New Yorkers can use NYSOH to enroll in the following programs:

  • Medicaid – This is New York’s public insurance program for low-income people. Enrollment into Medicaid can happen year round. This year 3.4 million New Yorkers enrolled in Medicaid using NYSOH.
  • Essential Plan – This is another public plan for people who earn a bit too much for Medicaid but not enough to purchase private insurance. Almost 800,000 New Yorkers enrolled this year.
  • Child Health Plus – This covers children up to age 19 whose families make too much for public programs but who cannot easily afford full coverage. About 450,000 kids enrolled in CHP this year!
  • Qualified Health Plans – These are private plans that follow the ACA’s rules (such as accepting people with pre-existing conditions and covering the ten essential benefits). About 273,000 New Yorkers purchased a QHP this year. Many (58 percent) did so with help from federal subsidies they qualify for based on income. But a large number (114,000) still found plans they liked without help – a good sign that New York’s individual market is becoming more and more stable over time.

The new 2018 census data numbers are out this this morning. 

The bad news is that uninsurance numbers increased across the country by 1.9 million in 2018, despite the positive economy. This was the first increase in uninsured since the Affordable Care Act was fully implemented in 2014. Here’s a New York Times article with more details.

BUT, there’s great news in New York, which was one of just three states in the country to have a decline in our uninsurance numbers, from 1,113,000 in 2017 to 1,041,000 in 2018 (our uninsurance rate declined from 5.7% to 5.4%). 

New York’s continued decline in uninsured residents is inextricably linked to its adoption of the high quality, affordable, Essential Plan, which saw an increase in enrollment from 665,000 in 2017 to 739,000 in 2018.  Other important factors include:

  • One-stop shopping: you can apply for the full spectrum of coverage, including Medicaid, Emergency Medicaid, Child Health Plus, the Essential Plan, Qualified Health Plans and tax credits, all through the same NY State of Health application
  • Robust Navigator funding of $27 million a year

Congratulations New Yorkers! And let’s keep up the good work!