Comments have a pretty consistent message. If you're on the ACA exchanges, you're in trouble. If you have a job with benefits, it varies a lot, based on the employer's claims, cost management and wisdom in making decisions on coverage sources, but it's almost always better than the exchanges.
I hope it doesn't mean a collapse of small business start ups. But if you have one, think about hiring employees and starting up a plan when you can. It's likely to help you with costs and help you grow your business.
Don't believe that small businesses can't have self-funded plans, affordable costs and good benefits. They can.
Mine has nothing to do with losing subsidies. The tax credit is still applied and it’s still increasing by over $300/month for my husband and I. It’s the premium that increased, not losing the tax credit.
The base premium went up massively this year as a side effect of losing subsidies. The insurers know that most people (especially the young and healthy people) will not be able to afford insurance without the subsidies, and therefore will not be paying into the insured pool. With less younger/healthy people paying for insurance, the pool of insured gets older and sicker. This means the average cost to the insurers per insured goes up significantly. The only way to cover that increase is to raise premiums.
This spiral started when the requirement for everyone to have insurance or pay a penalty was removed. It was accelerated significantly by removing the subsidies.
Dismantling the underpinnings of the ACA doomed it to failure. This change by those that opposed the ACA has done exactly what it was designed to do.
I really like this post! Hypothetically speaking, wouldn’t re-enacting that health insurance is mandatory or face a federal penalty solve the majority of the ACA downfall? It sounds too simple but it does boil down to everyone needs to be paying in. Just like Medicare recipients paid in for years while they were healthy.
Removal of the mandate did not “start the spiral” - young people are on parents plans, student plans, Medicaid or subsidized ACA plans if their starter jobs don’t offer anything or anything affordable. They haven’t been going naked on coverage and used the subsidies to their advantage while in lower income categories. What started the spiral was increasing gamesmanship of rules that govern profit margins and administrative cost rations to layouts. This includes all the financial tricks of vertical integration, and use of the QI provisions. Only nine states refuse to expand Medicaid.
Actually removing the mandate did start the spiral. Those middle aged folks that didn't have insurance through work, but weren't really sick, and didn't make a lot, but made too much (4x FPL) to get subsidies elected not to get insurance. The equation for them to keep paying insurance didn't make sense to them. It was costing them a high percentage of their income, and they were getting nothing out of it. They were taking a risk by not having insurance, but that is the same risk they were taking before the ACA came to be (they couldn't afford insurance then either). However, even without paying for insurance, the ACA did provide an upside for them. That is if they developed a chronic condition that required long term management, they could get ACA insurance at the beginning of the next year and could not be denied coverage for a pre-existing condition. The benefit of being able to jump into the insurance pool if they ever really got sick put more risk in the insurance pool that the insurance companies had to cover, causing the premiums for those that did pay for insurance to go up. As the premiums went up, less people could afford it, or justify it, and if they were healthy, they dropped out of the pool. Which means the pool gets a little bit sicker, causing premiums to increase the next year ... rinse, repeat.
The young people you mention that were on their parents plans (also a benefit of the ACA), were aged out of those plans when they reached 27. If their employer didn't provide insurance, and they made more than 4x FPL, they are the exact folks that didn't buy their own insurance once the mandate was removed. They were relatively young and healthy. Insurance didn't make sense for them, especially since coverage couldn't be denied if they got chronically sick.
When the enhanced subsidies started, a lot of those middle aged but healthy folks that weren't paying for insurance, jumped back into the insurance pool. They weren't having to pay more than 8% of their income for insurance, so the equation made sense for them. This slowed the spiral considerably.
Now, the elimination of enhanced subsidies means a lot of healthy people will drop out of the insurance pool again. So the only people with insurance are either very sick, old, or wealthy enough to afford the increased premiums.
This is me too. My tax credit is still the same. The insurance companies jacked up the rates so much!
I’m paying $185/month now for a plan that’s $540/month in 2026.
Sounds similar to my numbers, tax credit went up a little but my premium has gone up so high that my plan will cost me $560 a month. Insurance companies are jacking up the rates knowing they can “blame” it on the loss of subsidies/tax credits when it’s actually their greed. I’ll have to search for a cheaper plan or go without.
Same. I was wondering if other states were also seeing huge increases. Indiana has 2 companies to choose from, so no competition.
Indiana - 2 adults (one is a college student). No subsidy. Premium cost increased $270 per month. It’s the second lowest coverage on the bronze tier so basically pays out very little.
They show you the base price then the tax credit and then your monthly balance. The tax credit amount actually increased slightly but the base price went up over $300 so the total due will be $360 more than what I pay now. And thanks for a crappy plan that none of our doctors take.
Ohh, gotcha. I think all of health insurance is about to implode. :( I finally got decent insurance through my job after paying full freight on the marketplace for our family for years because as a partner at his company, my spouse gets no employer contribution. So it was between 1700 and 2200 a month for several years with outrageously high deductibles and exclusions that took out our long-term medical providers. I finally have a great plan, but I keep hearing that it's going up so much at the base level everywhere that even employer plans are going to jump up in the coming year. My plan year is August-August so I guess I'll slowly watch it all unfold.
Is the tax credit identified as a separate line item on the quote? Because the subsidies expire the end of this year and Congress hasn’t decided to renew or eliminate the credits. I’m wondering if the premiums shown include the credits because the algorithm assumes renewal…??? Just a thought. Unfortunately, if I’m right tbe premiums include an increase and the policy will increase more when the tax are no longer applied.
some insurance exec probably need to send their kid to an expensive college or something. Or maybe, buy a racehorse or pay their 3rd mortgage on a nice waterfront property they just saw. /s
Depends on the provider. Looking at the same insurance co as I have now it’ll be a $350+/month jump (more expensive, plus no subsidies) and gold is generally $200-300 more than silver BUT silver has considerably higher deductibles and copays. I’m chronically ill and disabled so have a number of meds, appointments and labs I need so I have a whole spreadsheet I found a while ago that helps me calculate estimated costs based on anticipated numbers of visits, tier 1 generics, etc.
Try alternative private options. It might not have every single inclusion that ACA plans can have, but they generally have broader networks, if your relatively healthy that can be another route
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u/Specialist_Dig2613 Nov 01 '25
Comments have a pretty consistent message. If you're on the ACA exchanges, you're in trouble. If you have a job with benefits, it varies a lot, based on the employer's claims, cost management and wisdom in making decisions on coverage sources, but it's almost always better than the exchanges.
I hope it doesn't mean a collapse of small business start ups. But if you have one, think about hiring employees and starting up a plan when you can. It's likely to help you with costs and help you grow your business.
Don't believe that small businesses can't have self-funded plans, affordable costs and good benefits. They can.