2027 Rate Changes - Delaware: +18.6% indy market; +19.8% sm. group market

ACA exchange enrollment has dropped by 18% in Delaware since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.

Initial signups during Open Enrollment were already down over 15% vs. OEP 2025...and effectuated enrollment has continued to slip to the point that it was 18% lower in February 2026 than a year earlier.

Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:

Looking ahead to 2027, the preliminary rate filings for both the individual and small group markets are now available via the federal Rate Review database:

AMERIHEALTH CARITAS VIP NEXT INC:

Unfortunately, their actuarial summary is not only password-protected from copying & pasting the text (necessitating a screen shot), it also doesn't include the actual number of enrollees as of spring 2026:

HIGHMARK BLUE CROSS BLUE SHIELD OF DE:

Highmark BCBSD Inc. (“Highmark DE”) is requesting an average ACA individual market rate increase of 20.2%, ranging from 17.2% to 23.4%. Products submitted with this filing will have effective dates from January 1, 2027 to December 31, 2027. This rate change is projected to affect 23,790 members.

Historical Financial Experience:

Highmark DE incurred an underwriting loss in its ACA individual market programs in 2025. This loss is net of the expected risk adjustment and state reinsurance programs.

Change in Medical Service Costs:

The projected average cost of medical care for the projected population is expected to increase. The increase will emerge in utilization and average cost per service and is spread across all types of services.

Change in Benefits and Cost Sharing:

Some cost sharing parameters were changed in order to maintain compliance with Federal AV requirements.

Administrative Costs and Anticipated Operating Results:

The anticipated administrative costs and operating results are not excessive or unreasonable. In accordance with regulations, the projected medical loss ratio is over 80%.

Unfortunately, I had to take a guess as to the enrollment for both AmeriHealth Caritas as well as for Celtic (aka Centene) which is leaving the Delaware market at the end of this year. Assuming my guesstimates are fairly accurate (around 8,000 for each), the weighted average rate hikes for 2027 across both AmeriHealth and Highmark BCBS should be around 18.6%.

As for Delaware's small group market, UnitedHealthcare appears to be pulling out of the state, which would leave just a single carrier offering small group coverage: Highmark BCBS, which is seeking increases of nearly 20% next year: