ACA Marketplace Insurers Are Proposing a Median Premium Increase of About 15% in 2027

Thanks for posting the important news here.

For those of us who follow the issue, it is important to note that there is an issue around whether the ACA, because of its structure, is causing healthcare costs to rise too rapidly. (It's an important technical issue that has been mixed in with horrible propaganda, unfortunately.)

In fact, as I point out here:

https://normspier828307.substack.com/p/senate-republican-leader-john-thune

the claim that ACA costs were rising far more rapidly that employer-based plans was used by both John Thune and Mike Johnson as their justification for not extending the ACA expanded subsidies.

This was done using a graph that I am almost positive is wildly in error, or prepared intentionally to deceive. (Grossly overstating the cost rise of the tracked ACA second lowest cost silver plan.)

Nonetheless, the issue of whether there could be something structural and fixable in the ACA that could cause excessive costs should not be ignored. It should be explored in detail, by organizations like KFF. (For example, perhaps fixing payments, risk-adjusted, like Medicare Advantage could help. Or removing insurers entirely.)

I note the following, ameliorating worries about the 15% and 20% increase consecutive numbers being signs of an ACA-specific problem:

1) Some amount of those numbers is due to increased adverse selection from removal of the expanded subsidies.

2) Health insurance costs are rising fairly rapidly across the board at the moment, owing to GLP-1s and possibly some other factors, such as a lag effect from Covid disruptions

3) If you follow the Charles Gaba posts, he was for a while posting both ACA on-exchange rises for next year and small-group rises. The small groups tended to also to have very high rises.