Pa. Obamacare enrollees could see double-digit premium increases for 2027
Affordable Care Act rate requests for health insurance in 16 states have a median premium increase of 14% for 2027, indicating the second consecutive year of double-digit increases for individual coverage, according to a new health policy group analysis.
The proposed rate increases could be a harbinger for what's in store for the nearly half million Pennsylvanians who rely on the ACA to cover medical bills.
According to one Pittsburgh broker, Obamacare enrollees will see a 13% premium increase in 2027.
An analysis by KFF, a nonprofit San Francisco-based health policy research group, found that rate filing requests across 77 ACA marketplace insurers in 16 states and D.C. had requested premium increases ranging between 10% and 20% for 2027, with 20 insurers asking for premium increases exceeding 20%. The rising cost of hospitalizations, doctor's visits and prescription drugs were among the reasons cited for the double-digit increases.
The median increase in the medical cost trend this year was 10%, which compares to an 8% average for each of the past few years, according to KFF.
Pennsylvanians with ACA coverage can expect an average 13% increase in monthly premiums next year, about the same percentage insurers propose, according to Dan DeStefano, broker and senior executive vice president at Mt. Lebanon-based Liberty Insurance Agency. He blamed the increase on expanded use of artificial intelligence by health care providers.
"The providers are using AI to learn how to more efficiently and effectively bill the insurance company," he said.
Shelley Bloom, director of compliance at Emerson Rogers LLC, a Valhalla, N.Y.-based wholesale employee benefit agency, declined to forecast the rate hike for Obamacare enrollees in Pennsylvania next year, but she predicted that it will be substantial.
"Generally, I think we're going to see another big increase," she said. "I don't think the carriers are done. Health care is a bit of a mess right now."
In Pennsylvania, the Insurance Department is evaluating the requested rates from insurers and will decide whether to accept them as proposed. The state is expected to issue the rate increases sought by insurers by the end of July.
In Pennsylvania, the average premium increase for ACA members was 21.5% last year.
"I don't think things are going to get better any time soon," Michael Berman, Pennsylvania office director of the nonprofit Protect Our Care social welfare group, said during a media briefing Wednesday. "This is not a good time for health care in America."
Premium increases last year were blamed for more than 160,000 Pennsylvania enrollees canceling coverage since open enrollment ended for most people in January. As of June 1, enrollment in ACA plans was 443,024.
Beaver and Greene counties in Western Pennsylvania had among the highest decreases in ACA enrollment in the state, down 20% and 22% respectively, according to Pennie, the state's online marketplace for health insurance. Washington and Lawrence counties each had enrollment declines of 18%.
Nationally, the expiration of enhanced tax credits in December, federal government subsidies that shielded consumers from high premiums, drove average marketplace deductibles up 37% - or over $1,000 - to $3,786 this year, according to KFF. Faced with sharply higher premiums, consumers dropped health insurance by the thousands or switched to lower-cost plans.
Although the enhanced tax credits ran out last year, Antoinette Kraus, founding executive director of Philadelphia-based nonprofit Pennsylvania Health Access Network, said people with Obamacare were still eligible for lower government subsidies that can make premiums affordable. For that reason, she encouraged enrollees to shop around.
"We're seeing the uncertainty created by the enhanced tax credits, so that's contributing to some of these large increases," she said. "But we have a robust market, which helps, and every county has multiple plan choices.
"Financial assistance still does exist. Don't panic."
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