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Around the nation: ACA premiums face another double-digit spike


According to a new KFF analysis, premiums for Affordable Care Act (ACA) marketplace plans are expected to increase by 14% next year, marking the second straight year of double-digit increases, in today's bite-sized hospital and health industry news from California, Illinois, and Maryland.

  • California: According to a new KFF analysis, premiums for ACA marketplace plans are expected to increase by a median of 14% next year. This is the second straight year of double-digit increases to ACA premiums, with the analysis showing that ACA premiums are increasing by a third between 2025 and 2027. According to 77 insurers who were part of the analysis, some reasons for the increased premiums include growing healthcare costs and healthcare-related inflation. Expired ACA subsidies are also likely contributing to increased premiums. "When there is so much uncertainty, insurers are raising premiums higher than they otherwise would be, and the end result is that consumers are footing a larger bill for their premiums if they're not receiving federal tax credits," said Matthew McGough, a policy analyst at KFF for the Program on the ACA. As premiums continue to rise, ACA enrollment has been declining. Currently, ACA enrollment is down by around 3 million year-over-year, falling to 19.2 million people. (Weixel, The Hill, 7/8; Sullivan, Axios, 7/8)
  • Illinois: According to a new study published in JAMA Internal Medicine, COVID-19 vaccines reduced the risk of major cardiovascular events, such as strokes and heart attacks, related to the virus. For the study, researchers examined data from around 1 million patients who were part of the Department of Veterans Affairs health system between 2024 and 2025. The researchers compared patients who received a seasonal flu vaccine with those who received both a flu vaccine and an updated COVID-19 vaccine. Overall, the researchers found that patients who received a COVID-19 vaccine had a 37.7% lower risk of COVID-associated heart conditions, with the benefit being highest among those over 75 and those with preexisting health conditions. These patients were also around 6% less likely to suffer from severe heart conditions overall and around 7% less likely to experience hospitalizations and deaths from all causes. "It tells us that these vaccines have actually brought beneficial effects even in people who don’t really know that they actually have contracted COVID-19," said Ziyad Al-Aly, a physician-scientist and senior clinical epidemiologist at Washington University in St. Louis and one of the study's authors. (Wu, Washington Post, 6/16)
  • Maryland: FDA has cleared the first over-the-counter integrated continuous glucose monitor (CGM) for children ages two years and older. Dexcom's Stelo Glucose Biosensor System was first cleared for adults two years ago before being recently cleared for children. The device is meant for children with diabetes who manage their condition with oral medication rather than insulin and those without diabetes who want to know how different factors affect their blood sugar levels. "Children deserve access to the best tools available to manage their health," said Michelle Tarver, director of the FDA's Center for Devices and Radiological Health. "Today's clearance reflects the FDA's commitment to fostering innovation for pediatric patients and supporting the safe and effective use of medical devices where children live, learn, and play." (Monaco, MedPage Today, 6/15)

Market outlook for individual and small group health insurance

Stay informed with the latest insights into the individual and small group health insurance markets. This ready-to-use slide deck highlights key developments, market dynamics, plan performance, consumer trends, and actionable strategies to respond to these changing markets.


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