Potential Changes in Health Insurance Costs Ahead
PORTLAND, Ore. — A number of Americans, including those with private insurance from their jobs, may see shifts in their benefit costs as insurance companies prepare for possible changes in Affordable Care Act (ACA) subsidies and ongoing inflation.
Rising insurance premiums are quite common. To keep up with inflation and increasing hospital and medication costs, insurance providers are hiking up monthly plan prices.
Experts anticipate that these premium increases could reach new levels this year. For companies that cover part of the premiums, they might consider contributing less.
A survey of 711 U.S. employers showed that over half—51%—of companies surveyed plan to pass these premium hikes onto their employees.
According to the Keizer Family Foundation (KFF), insurers attribute the pronounced premium increases to the costs associated with prescriptions and hospitalizations, along with a growing demand for new GLP-1 weight loss medications.
While some individuals may see their premiums unchanged from 2025 to 2026, they might face higher deductibles. Insurers might also alter which services count before the deductible kicks in, and some might adjust which types of care are excluded from benefits.
Employers are required to provide a benefits information booklet if asked. Comparing the 2025 and 2026 booklets could reveal significant changes to the plans. Many employers and benefits administrators put these booklets and summary tools online.
The greatest increases in premiums have been noticed by those enrolled in the Affordable Care Act, also referred to as Marketplace insurance in Oregon. About 3.3% of Oregonians participate in the Marketplace, with nearly 80% benefiting from subsidies provided under the Rescue Plan Act of 2021.
These subsidies, which mitigate insurance costs for numerous middle-income Americans, are due to expire at the end of 2025. However, there has been no indication from Congress regarding their renewal.
A KFF report states that insurers are already bracing for the impact of potential non-renewal, predicting an average premium increase of around 26% for ACA members. They worry that losing subsidies might lead to policyholders dropping their health insurance, consequently affecting profits.
Additionally, some insurers may be adjusting to their financial losses by driving up premiums for group insurance plans provided by employers.
The premium rises are already in effect and are not expected to change. However, if Marketplace users lose their subsidies, they might find themselves paying more than double the amount by 2025.
