08/04/2025
FOR IMMEDIATE RELEASE
Montana State Auditor James Brown Issues Statement on Anticipated Affordable Care Act Rate Increases
Helena, Mont. — The Montana Commissioner of Securities and Insurance (CSI), Montana State Auditor’s Office, is alerting small businesses and individual consumers to expect rate increases for Affordable Care Act (ACA) health insurance plans. New rates from several major carriers — including Blue Cross and Blue Shield of Montana, PacificSource, Mountain Health Co-op, and UnitedHealthcare — will become public between August 1–14, ahead of the open enrollment period for 2026 coverage.
“This increase will affect small group health insurance plans offered both on and off the federally facilitated marketplace (HealthCare.gov), as well as individual marketplace health plans - the plans used by many Montana small employers, independent workers, and families,” said Montana State Auditor James Brown. “We want Montanans to be informed and prepared.”
CSI’S ROLE IN REGULATING HEALTH INSURANCE AND ACA RATES
The CSI regulates all insurance companies doing business in Montana. While CSI has oversight of rate transparency and compliance under both state and federal laws, the agency does not have the authority to approve or deny rates in the ACA small group and individual markets — a limitation imposed by federal law and state statute.
THE CSI’S RESPONSIBILITIES INCLUDE:
Licensure and Regulation of insurance companies by enforcing compliance with all applicable state insurance laws and rules through the performance of market conduct examinations, financial reviews, and licensing oversight.
Review of rate filings to ensure that the rate submissions are complete, actuarially justified, and in accordance with federal and state statutes.
Consumer outreach and education to help Montanans understand what factors are driving premium increases.
Protecting policyholders through education, enforcement, and advocacy.
WHY ARE ACA RATES INCREASING NATIONWIDE IN 2025?
Montana is not alone. ACA rate filings across the country are reflecting increases. Several key factors are contributing to the upward trend:
Medical inflation and rising hospital and physician costs across the nation.
Prescription drug inflation, especially driven by high-demand specialty medications.
Post-pandemic workforce pressures and hospital consolidations, which reduce competition and increase operating costs.
Ongoing uncertainty about federal subsidies and reinsurance policies, which affects how insurers price future risk. Enhanced premium tax credits, made available during the COVID-19 pandemic, will expire at the end of 2025.
Fraud and abuse, leading to increased costs, reduced quality of care and even patient harm.
AUDITOR BROWN ENCOURAGES CONSUMERS TO SHOP AROUND
“The rising cost of health insurance is one of the most urgent issues facing Montana families and small businesses,” said Auditor Brown. “My agency is committed to ensuring maximum transparency and advocates strongly for consumers. The CSI’s rate review is limited to ensuring that all filings are justified, transparent, non-excessive, and not unfairly discriminatory; however, under state and federal law, the Commissioner does not have the authority to approve or deny ACA rates. Instead, the CSI serves as a reviewer—not an approver—for ACA small group and individual market rate filings. As always, I encourage every Montanan to carefully review their coverage options each year and reach out to your agent with any questions or concerns. Our mission is to protect consumers, promote competition, and ensure access to quality coverage across the state.”
WHAT CONSUMERS AND EMPLOYERS CAN DO
Looking ahead to open enrollment this fall, the State Auditor’s Office recommends:
Shop and Compare: Use Healthcare.gov or a licensed health insurance broker to compare all available plans and carriers.
Check for Updated Subsidies: Many Montanans still qualify for generous federal subsidies that can drastically lower monthly premiums.
Get Help: Talk to a certified enrollment specialist, insurance broker, or call the CSI for guidance on plan options.
Know the Timeline: Marketplace open enrollment begins November 1, 2025, but certain qualifying life events allow people to enroll or change coverage sooner.
Reach Out: Contact the CSI with questions or complaints.
Call now to connect with business.
