Insurers estimate that they will pay more than $759 million in medical loss ratio rebates across commercial markets in 2026. KFF’s preliminary analysis is based on insurer-reported financial data from market database Health Coverage Portal TM. The ACA established an…
ACA
CMS lacks adequate safeguards to stop agents and brokers from enrolling individuals into ACA coverage or switching their plans without consent, according to a report from the Government Accountability Office published July 13. More than 19 million people were enrolled…
The traditional group health plan is in crisis, with commercial insurance costs reaching record highs as factors like specialty medication spend, stop-loss insurance and behavioral health utilization continue to compound. Naturally, employers nationwide have been turning to an array of…
Eight insurers have announced they will stop offering individual ACA marketplace plans, either nationally or in specific states, after the 2026 plan year. The withdrawals come amid declining enrollment nationwide, rising premiums and the expiration of enhanced premium tax credits…
Payers owe a combined $11.2 billion in ACA risk-adjustment charges for 2025, CMS said at the end of June. Risk adjustment transfers funds within a state’s individual or small group market from insurers whose members have lower risk to insurers…
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ACA insurers are pitching a median rate increase of 14% for 2027, the second year in a row of double-digit premium hikes, according to a July 8 Peterson-KFF Health System Tracker analysis. The tracker reviewed 77 insurers in marketplaces across…
Enrollment in ACA marketplace plans fell in 49 of the 50 states plus D.C. between February 2025 and February 2026, according to CMS data published in late June. Ohio, Oklahoma and Arizona posted the steepest year-over-year declines, each shedding roughly…
Three federal lawsuits are forming a tapestry of litigation related to the future of the ACA marketplace. In recent years, CMS has pitched rules focused on promoting marketplace “integrity” by tightening eligibility, altering enrollment periods and narrowing subsidy access, to…
Blue Cross and Blue Shield of Vermont dropped its proposed Vermont Basic offering from consideration for the qualified health plan market in 2027. BCBS Vermont had pitched the product line, offering more affordable HSA-compatible plans, in May. The company said,…
Medica will no longer offer individual marketplace plans in Iowa, Kansas and Oklahoma, effective January 1, 2027. The decision affects about 4,000 members in Iowa, 600 members in the Kansas City area in Kansas, and 8,400 members in Oklahoma, the…