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riversedge

(82,443 posts)
Wed Jul 8, 2026, 07:15 AM 8 hrs ago

Affordable Care Act Insurers Want More Premium Increases as Enrollment Sags

Source: KFF


By Rachel Spears July 8, 2026


For the second year in a row, many Affordable Care Act insurers are proposing double-digit premium increases, driven by rising medical costs as well as policy changes by Congress and the Trump administration.

In preliminary filings with state regulators, insurers are seeking a median rate increase of 14% for 2027, according to an analysis of filings in 16 states and the District of Columbia by the Peterson-KFF Health System Tracker.


If those rates are ultimately approved, it would be the second-highest increase since 2018.

That would be a “triple whammy“ for consumers, said Cynthia Cox, a senior vice president and the director of the Program on the ACA at KFF, because they have already had to pay higher premiums in 2026 and saw the expiration of more generous tax credits to offset their premiums at the end of last year.

President Joe Biden sought to bolster the program known as Obamacare by enacting more generous tax subsidies, driving down out-of-pocket costs for consumers and increasing enrollment to more than 20 million Americans. But under President Donald Trump, Republicans have sought to scale back taxpayer support for ACA coverage, allowing the Biden-era enhanced subsidies to expire.

As of February, ACA enrollment had fallen by about 3 million people compared with the same time last year. ...................

Read more: https://kffhealthnews.org/insurance/priced-out-obamacare-affordable-care-act-aca-premium-increases-peterson-kff/?utm_source=firefox-newtab-en-us






Priced Out
Affordable Care Act Insurers Want More Premium Increases as Enrollment Sags 🤑

By Rachel Spears July 8, 2026

kffhealthnews.org/insurance/pr...

(@oceancalm.bsky.social) 2026-07-08T11:06:10.979Z
16 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
Affordable Care Act Insurers Want More Premium Increases as Enrollment Sags (Original Post) riversedge 8 hrs ago OP
Of course they do,not a surprise. Keep gutting the ACA slowly and it will DIE Bengus81 8 hrs ago #1
Yes, well that makes sense. Biophilic 8 hrs ago #2
Why do they even call it insurance? It is just robbery without a mask. twodogsbarking 8 hrs ago #3
Look, it costs a lot of money to plaster their names on stadiums and flvegan 8 hrs ago #4
Gee no one saw this coming. mdbl 8 hrs ago #5
The expiration date of the temporary additional covid era subsidies was written into it when it was passed in 2021. MichMan 3 hrs ago #13
Um... lonely bird 7 hrs ago #6
As premiums rise, healthier people tend to drop their coverage, leaving the insurance pool sicker on average progree 7 hrs ago #7
In its current form, the ACA is a very expensive program that mainlines money to insurance companies. Intractable 7 hrs ago #8
But, it is called the "Affordable" Care Act MichMan 7 hrs ago #9
We are the ONLY country with private health insurance RainCaster 5 hrs ago #10
We are not the only country with private health insurance. ihaveaquestion 4 hrs ago #11
My retirement job (age 65 to 73) was at a call center rhiannon55 3 hrs ago #12
Cut out the bookies. Universal Medicare for all. Max out the risk pool. Marcuse 54 min ago #14
Thereby defeating the entire point of the AFFORDABLE Care Act. It never should have thrown a lifeline to private Karasu 51 min ago #15
It's already dead in Montana. MontanaMama 50 min ago #16

Bengus81

(10,678 posts)
1. Of course they do,not a surprise. Keep gutting the ACA slowly and it will DIE
Wed Jul 8, 2026, 07:22 AM
8 hrs ago

Mission almost accomplished Republicans. Now on to Social Security,Medicare and Medicaid

Biophilic

(6,841 posts)
2. Yes, well that makes sense.
Wed Jul 8, 2026, 07:24 AM
8 hrs ago

People can’t afford the rates now so they are dropping their coverage. The answer is to increase those rates higher. I must be missing something important. Obviously I’m not insurance CEO material.

flvegan

(66,740 posts)
4. Look, it costs a lot of money to plaster their names on stadiums and
Wed Jul 8, 2026, 07:37 AM
8 hrs ago

pay CEOs *checks notes* (shit, that's a lot of money) that much. Plus, do you know how much it costs to train AI to deny your claims?

Won't someone PLEASE think of the poor health insurance companies.

MichMan

(17,746 posts)
13. The expiration date of the temporary additional covid era subsidies was written into it when it was passed in 2021.
Wed Jul 8, 2026, 12:42 PM
3 hrs ago

Everyone knew when it was passed when they were going to expire. I believe the original subsidies are still in place.

progree

(13,125 posts)
7. As premiums rise, healthier people tend to drop their coverage, leaving the insurance pool sicker on average
Wed Jul 8, 2026, 08:41 AM
7 hrs ago

From the OP's link, repeated for convenience of reference
https://kffhealthnews.org/insurance/priced-out-obamacare-affordable-care-act-aca-premium-increases-peterson-kff/?utm_source=firefox-newtab-en-us

Insurers expect that with young and healthy people leaving the program rather than paying higher premiums, their remaining customers will be older, sicker, and therefore costlier on average.

 “It’s likely that the people who dropped their coverage were also the healthier people, because sicker people were probably going to try to make it work however they could, to stretch their budget to keep their health insurance,” said Cox, of KFF, a health information nonprofit that includes KFF Health News.


Just so people are aware of this death spiral dynamic. This has been much discussed as part of the reason for the large 2026 increases.

Another driver of higher premiums cited by several insurers is that claims submitted on behalf of patients have tended to be for more intense — and costly — levels of care than in the past. Such increased severity may be because patients are actually sicker, or it may reflect that hospitals or doctors are using artificial intelligence to find billing codes that can maximize their payments, the report noted.


With or without AI, this has long concerned me -- doctors upping the diagnosis and billing code to get a larger reimbursement. Doesn't that result in a person's medical record looking a lot worse than their true medical condition? I've seen a lot of discussion about the upcoding, but I haven't seen any of how it might result in a false impression of the person's condition that can mislead future providers into prescribing wrong treatments.

Intractable

(2,643 posts)
8. In its current form, the ACA is a very expensive program that mainlines money to insurance companies.
Wed Jul 8, 2026, 08:56 AM
7 hrs ago

The ACA solidifies the hold insurance companies have over our healthcare. (It would have been much better with a public option.)

I have an ACA plan. It's fairly good for me, but expensive to administrate.

The total monthly premium for my middle-of-the-road "silver" plan for one person is about $1500.

I pay about $180 for the premium. The ACA pays more than $1300.

On top of that, for me, there are ample deductibles and co-pays. The prescription plan is so bad, I buy my scripts without it at costplusdrugs.com.

There's got to be a better way -- one that actually lowers the cost of providing medical care. The way it all works now, we need the ACA to help pay for our premiums. But, it's just throwing money at the problem.

MichMan

(17,746 posts)
9. But, it is called the "Affordable" Care Act
Wed Jul 8, 2026, 09:00 AM
7 hrs ago

It's literally right in the name. I remember when it was enacted that it was going to be so affordable that the young and uninsured couldn't wait to sign up for it. How it was going to lower costs annually by $2500 for the average person.

RainCaster

(13,960 posts)
10. We are the ONLY country with private health insurance
Wed Jul 8, 2026, 10:29 AM
5 hrs ago

Also, we are the only country where people go bankrupt because of healthcare debt.

Is there a relationship between these? I think so...

The solution IMO is to enact single payer healthcare. Just like the rest of the world.

ihaveaquestion

(4,917 posts)
11. We are not the only country with private health insurance.
Wed Jul 8, 2026, 11:16 AM
4 hrs ago

Many other countries have private insurance companies, but regulate them, subsidize them and generally use them to their people's advantage instead of letting the companies dictate the terms of their people's health.

rhiannon55

(2,799 posts)
12. My retirement job (age 65 to 73) was at a call center
Wed Jul 8, 2026, 12:13 PM
3 hrs ago

helping callers sign up for the ACA. I liked it. I worked four hours a day, five days a week, and got to work from home after Covid hit. I have always had social worker type jobs, and this was a good one. I retired when my sister’s cancer returned and I wanted to be with her while she went through treatment. She died anyway, a week after she got home, in March 2024. 😢

I really need another retirement job, because I was not financially ready to live on my small retirement income. I felt like I was helping people in that job, but after fuckface and his cronies started messing with the subsidies, I couldn’t bring myself to go back. I knew I’d spend most of my time talking to angry, disappointed people this time around.

How I hate repukes. They are the reason we can’t have nice things.

Karasu

(2,427 posts)
15. Thereby defeating the entire point of the AFFORDABLE Care Act. It never should have thrown a lifeline to private
Wed Jul 8, 2026, 03:12 PM
51 min ago

insurance in the first place, but Americans have been too brainwashed for too long into believing the patchwork system we have is both normal and desirable.

MontanaMama

(24,786 posts)
16. It's already dead in Montana.
Wed Jul 8, 2026, 03:14 PM
50 min ago

For years now, we’ve only had two companies offering health plans on the marketplace. Blue Cross of MT and Pacific Source. BC didn’t want to small business or individual market and they priced their plans accordingly. Pacific Source is ending their marketplace plans at the end of this year leaving only BC. Essentially, we’ve gone from zero competition to a monopoly. BC won’t reduce the price of their plans for marketplace customers, why would they? Pacific currently has 14,000 groups in Montana. GROUPS, not customers. Thousands of Montanans will not have insurance at the end of the year. This will be an unmitigated disaster.

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