Oregon Health Insurance Premium Increases Proposed for 2027
Oregon residents purchasing individual health insurance or obtaining coverage through small businesses may face significant premium increases, according to recent filings. Insurers have proposed average rate hikes of approximately 17% for these groups, citing increased medical expenditures, inflationary pressures, federal policy uncertainties, tariffs affecting drug and equipment costs, and a reduction in enrollment.
For those on the individual market utilizing the state's Affordable Care Act exchange, insurers are requesting an average premium rise of 17.5% for the upcoming year, almost double the nearly 10% increase seen last year. The requested increases vary significantly among insurers. Moda Health, covering around 35,000 individuals in Oregon's individual market, proposes the highest average increase at 25%. Should this adjustment be approved, a middle-aged Portlander using Moda’s standard silver plan would see their monthly rate escalate from approximately $540 to about $695. Conversely, BridgeSpan, with a much smaller user base, is seeking a nearly 12% average increase, resulting in a monthly premium of around $690 for similar coverage, a $70 increase.
The marketplace landscape is also changing, with Providence Health Plan and PacificSource Health Plans exiting the individual market. Consequently, the number of participating insurers will fall from six to four. However, state officials assure coverage in every county with at least three options available. Moda, Regence BlueCross BlueShield of Oregon, and BridgeSpan will offer plans throughout the state, while Kaiser Permanente will be available in select counties.
Small businesses face similar challenges, with anticipated premium increases impacting their finances. Even with employer contributions to employee premiums, the overall costs are expected to rise. Six insurers in the small group market, serving companies with up to 50 employees, have requested an average rate increase of 17% for 2027, up from 11.5% the previous year. UnitedHealthcare has proposed the largest increase at nearly 29%, affecting over 7,200 employees and their families. This hike could raise the monthly premium for a UnitedHealthcare silver plan to $800 for a 40-year-old employee. Kaiser Foundation Health Plan of Northwest proposes the smallest rate increase at 9.5%.
The requested increases partly result from fewer enrollees, which spreads rising medical costs across a smaller group, thereby elevating premiums. Enrollment in the individual market fell from around 161,000 last year to approximately 140,000, with the phase-out of pandemic-related subsidies cited as a contributing factor. A similar trend is observed in the small-group market, with enrollees decreasing from 142,000 to 134,000 within a year.
According to TK Keen, Oregon's insurance commissioner, despite the challenges of rising premiums and the withdrawal of two carriers from the market, the state's reinsurance program is mitigating some impacts by keeping premiums about 10% lower than they might otherwise be.
Notably, these rate adjustments are still subject to regulatory review. The Oregon Division of Financial Regulation will evaluate insurers' submissions in the coming months, analyzing the financial data and cost justifications to determine the appropriateness of the requested increases. Large employer-provided health insurance, typically outside the state marketplace, is exempt from this annual review.
The state also plans to hold a virtual public meeting on July 13, inviting each insurer to present and receive public feedback on their proposed rate hikes. Stakeholders can submit comments until that date, with a decision anticipated by September.