In North Carolina, health insurance companies are planning to raise average premiums between 11 and 26 percent next year on the Affordable Care Act exchange or marketplace.
The state's dominant insurance company, BlueCross BlueShield, wants to raise average premiums about 26 percent – almost twice as much as last year's increase.
The rates are supposed to fit the population they cover. For example, an insurance pool with a lot of older, sicker people will have higher premiums because their care costs more.
On a conference call with reporters, Blue Cross Chief Actuary Patrick Getzen says its customers this year were about the same age, but "we're finding that the 2015 customers are sicker than what we had in 2014."
"This is an indication that this pool is still volatile and uncertain," he said.
Almost two years into the Obamacare exchanges, that's the message from many insurance companies in North Carolina.
Aetna and Coventry want to raise average premiums between 17 and 26 percent. (Aetna bought Coventry two years ago.) United Healthcare is aiming for a 13 percent increase. And Humana, which would be new to the exchange in North Carolina next year, wants an 11 percent increase compared to its similar plans off the exchange.
Larry Levitt tracks premium trends nationally for the Kaiser Family Foundation.
"In general, premium increases are looking higher in 2016, and certainly North Carolina looks to be on the high side of what we've seen in some other states," he said.
Levitt says premium proposals are still coming in across the country, so the picture could change. State and federal regulators still have to sign off, too.
But Levitt says the trend of higher prices shows that many insurance companies weren't very good at projecting how sick their new Obamacare customers would be.
"In the first couple years of Obamacare, insurers were simply making guesses at how much health care enrollees were going to use,"he says. "Now they have real data that they can use to set the premiums, and that's producing some swings up and some swings down in how much they're charging."
Those swings won't hit the wallets of many North Carolinians though. More than 90 percent of people covered through the exchange here received federal subsidies, which provide a huge cushion against rising premiums.
