The Affordable Care Act (ACA) transformed states’ individual health insurance markets in 2014 with new consumer protections and benefit standards and the establishment of health insurance marketplaces offering subsidized coverage. We use 2013 and 2014 data reported by insurers to the National Association of Insurance Commissioners (NAIC) to examine changes by state and market in average claims, premiums and medical loss ratios (MLRs) (i.e., medical claims and quality improvement expenses as a percentage of premiums). We discuss how findings shed light on where 2016 premiums are likely headed, and how this varies widely across states.