The Supreme Court seemed likely to uphold a key preventive-care provision of the Affordable Care Act in a case heard Monday.
Conservative justices Brett Kavanaugh and Amy Coney Barrett, along with the court’s three liberals, appeared skeptical of arguments that Obamacare’s process for deciding which services must be fully covered by private insurance is unconstitutional.
If this happens, it would mean the ACA exchange market would drop by more than 1/3 from the ~24.2 million currently enrolled (myself & my own family included).
However, I've repeatedly stated that even this is likely a low estimate--the remaining ~16 million exchange enrollees would still be hit with MASSIVE (and in some cases eye-poppingly huge) premium hikes which would force them to drop to far worse plans (meaning much higher deductibles & co-pays; worse provider networks and so on).
The good news is, the Illinois Insurance Dept. now provides a handy, simple table with the actual average rate changes as well as direct links to the actuarial memos & other filing forms for every carrier, which made it easy for me to plug in the effectuated enrollment & calculate the weighted average rate hikes for every carrier in both the individual and small group markets.
The bad news is, the actuarial memos themselves are heavily redacted, meaning I'm unable to see how much of the rate hikes are due to the IRA subsidies expiring, CSR payments being reinstated or Trump's tariffs.
More than 400,000 Washingtonians will lose health insurance if ‘Big Beautiful Bill’ passes
Washington Health Benefit Exchange warns of looming rise in uninsured Washingtonians if Senate passes Reconciliation Bill
OLYMPIA, Wash. - The Congressional Reconciliation bill and loss of enhanced federal tax credits would result in 16 million Americans losing coverage, according to the Congressional Budget Office, with more than 400,000 predicted to lose coverage in Washington state.
“The reconciliation bill now headed to the Senate would make it much harder for Washingtonians to get and stay covered,” said Ingrid Ulrey, CEO of Washington Health Benefit Exchange. “While there has been much attention on the bill’s effects on Medicaid — which will be devastating — it is important to understand that it would also create a massive new layer of red tape and higher costs for people who purchase private health insurance on the Exchange.”
Back in March, the Health & Human Services (HHS) Dept. and the Centers for Medicare & Medicaid Services (CMS) proposed a so-called "Marketplace Integrity & Affordability Rule" which would include sweeping changes to how the ACA exchanges (both the federal one (HealthCare.Gov) and the 20-odd state-based ones (Covered California, MNsure, etc) operate, as well as who is or isn't eligible to enroll in ACA exchange coverage, restrictions on subsidy eligibility and so forth.
Many of these changes are simply repeals/reversals of improvements put into place during the Biden Administration; others are completely new ones being put into place by the Trump Regime under RFK Jr. & Dr. Oz.
However, until today, these were still technically only proposed changes. Now they're official. The final version isn't quite as bad as it could have been, and there's one or two items on the list which I'm not that upset about, but overall...yeah, it's pretty ugly.
Secretary Kennedy, Administrator Oz to Host Press Conference to Discuss Groundbreaking Health Insurance Reform
WASHINGTON, DC—FRIDAY, JUNE 20, 2025—U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. and Centers for Medicare and Medicaid Services Administrator Mehmet Oz will host a press conference to discuss a breakthrough in health insurance that will improve access to care for millions of Americans.
WHEN: Monday, June 23 at 2:45 PM ET
Press should arrive by 1:45 PM for priority placement
Press must have REAL ID to enter the building
WHERE:
Hubert H. Humphrey Building Auditorium
200 Independence Ave SW
Washington, D.C. 20009
PARTICIPANTS:
HHS Secretary Robert F. Kennedy, Jr.
CMS Administrator Mehmet Oz, M.D.
Federal policy shifts drive higher 2026 rates for individual and small group health plans
State actions blunt increases tied to the reconciliation bills and policy direction of the federal government
St. Paul, MN: Health insurers have submitted their proposed increased rates to the Minnesota Department of Commerce for 2026 plans available to Minnesotans who buy individual or small group health insurance through MNsure or directly through insurers. These proposed rates apply to coverage starting Jan. 1, 2026, with open enrollment beginning Nov. 1, 2025.
BCN is filing a year-over-year average rate increase for 2026 for all individual products that were offered in 2025 of 16.3%. Significant contributors to rate change are outlined in the table below:
Experience Restate 4.0%
Medical and pharmaceutical price and utilization trend 5.4%
ARPA Subsidy Expiration Impact 4.6%
Benefit Change and CSR -2.6%
Margin Impact 1.2%
...Incorporated in the above, BCN assumed an additional pharmacy price trend due to tariffs, as follows:
Generic +2.5%
Brand +10%
Specialty 0%
Total Impact +2.5%
...Consistent with the 2025 filing, BCN has assumed no CSR payments will be made by the federal government for 2026. Therefore, rates for Silver plans offered on exchange are 20.5% higher than if the federal government funded CSR subsidies.
Last month, in response to House Republicans passing their version of the budget resolution bill, I broke out total enrollment in Medicaid via ACA expansion, ACA exchange Qualified Health Plan (QHP) enrollment and ACA-based Basic Health Plan (BHP) enrollment by Congressional District in order to try and get a sense of just how many Americans healthcare coverage is at risk from the bill...and how that breaks out along partisan lines at the House District level.
As I noted at the time, Republicans seem to be under the impression that it will mostly be Democrats who get screwed by their bill, since 9 of the 10 non-expansion states are Republican strongholds...while some Democrats seem to be under the impression that it will mostly be rural MAGA republicans who get screwed.
Senate GOP tax bill would hit politically explosive Medicaid provision
The Finance Committee is due to brief members on its megabill draft text Monday night.
Senate Republicans are seeking to ratchet up savings from a politically explosive policy within Medicaid to pay for their megabill, and it’s already setting off shockwaves through Capitol Hill.
The Senate Finance Committee’s forthcoming portion of the party-line tax and spending package would lower the Medicaid provider tax to 3.5 percent, according to three people with direct knowledge of the legislation who were granted anonymity to discuss it.
