Pennsylvania Residents Prepare for Future Insurance Costs
As some individuals will still qualify for specific tax credits to reduce their monthly premiums, the removal of additional credits established during the COVID-19 pandemic might leave various Pennsylvanians without health insurance.
The Department of Health indicates that the withdrawal of health care subsidies, alongside anticipated premium hikes in 2026, is likely to hit rural communities, seniors not yet eligible for Medicare, and working middle-income households the hardest.
Lori Cumming, a resident of Havertown, shared her firsthand experience. At 60, she works part-time as both a real estate agent and a bookkeeper at a local church, while her husband runs his own construction business.
Currently, they spend around $1,000 a month on ACA health insurance premiums. However, Cumming noted that without medical subsidies or any financial help, their costs could skyrocket to nearly $1,900 monthly. And that doesn’t even factor in the new rate increases projected for 2026.
“I’m really worried about what next year holds,” she admitted. “I’m scared and just don’t know what will happen… We’ve thought through all the possibilities. Selling our house isn’t realistic.”
Cumming recalled she had previously gone without health insurance—particularly if the premiums were too steep—although that was over 15 years ago.
“I only went to the doctor when I was really unwell,” she explained. “But thankfully, I was younger, so there weren’t any serious issues.”
Now, though, that’s not a feasible option for her and her husband as recent cancer survivors. They will need follow-up appointments and tests in the coming years to ensure their health remains stable.
For small business owners, like Andrea Deutsch, spiraling costs and the loss of financial support might force difficult choices, such as keeping her pet supply store versus obtaining health insurance for her type 1 diabetes and other medical needs.
Deutsch, who also serves as the mayor of Narberth, currently pays about $700 a month for her insurance plan after tax credits but anticipates her costs will exceed $1,400 next year for the same coverage.
“I’m already living a very tight budget. I won’t be able to reinvest in my store, and I’ll have to rethink my retirement plans,” she shared. “If interest rates climb too high, I might not have a choice but to close the business and seek employment somewhere that offers a group plan—if any jobs are available at all, given how many others will be in the same situation.”
Navigating Uncertainty on the ACA Marketplace This Year
Experts suggest that despite the current market instability, it’s crucial for individuals to examine and select health plans during the open enrollment period running from Nov. 1 to Dec. 15.
If Congress acts quickly to extend enhanced tax credits, it could lead to an immediate reduction in premium rates of about 3% to 5% across both individual and group plans. However, state health officials emphasize that time is of the essence.
Insurance providers have pointed out that, aside from potential health benefits cuts, other market dynamics are driving their need to increase premiums—these include escalating overall health care costs, a rise in the use of pricier outpatient services and medications, and a growing number of enrollees dealing with more severe chronic conditions.
Humphreys remarked that the Pennsylvania Department of Insurance has intervened to thwart several excessive increases proposed by insurance firms, amounting to $50.1 million. Nevertheless, some companies are still looking to boost premiums by as much as 38% in the individual market and 22% in the small group market.
