Community Rating & Age Rating
Definition current for the 2026 plan year · Last reviewed July 2026
In one sentence: How states let insurers vary premiums by age: most allow 3:1 (64-year-olds pay 3× 21-year-olds); NY and VT ban age rating entirely.
Age rating is why the same plan costs a 60-year-old about 2.7× what it costs a 25-year-old. Federal rules cap the spread at 3:1 — a 64-year-old pays at most three times a 21-year-old — using a standard curve (1.000 at 21, 1.278 at 40, 3.000 at 64) that most states adopt.
The exceptions rewrite the math entirely. New York and Vermont use pure community rating: age doesn't affect premiums at all — a 64-year-old and a 26-year-old pay identical prices. That makes NY/VT relatively expensive for the young and a relative bargain for older enrollees (a real factor in early-retirement relocation decisions). Massachusetts compresses the spread to 2:1.
Remember that subsidies are age-blind in the other direction: the required contribution depends only on income, so older subsidized enrollees simply receive bigger credits. Age rating truly bites only above the subsidy cliff. Explore actual prices at any age in the cost-by-age tool.