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Tag: Ohio Health Insurance

  • Ohio Health Insurance to Get Much More Costly Without Action to Renew Federal Credits – Cleveland Scene

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    The federal government shutdown has ended, but Ohioans are still looking down the barrel of significant increases in health insurance costs starting in 2026.

    Insurance rates are expected to increase by double-digit percentages as tax credits on Affordable Care Act premiums are set to expire at the end of the year.

    The tax credits had been a sticking point in the shutdown fight, but the deal reached this week did not extend the credits.

    Open enrollment for the Affordable Care Act began Nov. 1.

    The lack of action on health insurance seems to open the door for changes experts and advocates have been fearing for months, a new health care landscape that includes increased insurance costs and much less governmental support for individuals who may not qualify for Medicaid, but still need help to afford health coverage.

    “As Ohioans begin to consider coverage for 2026, they can expect to pay substantially more for their premiums on the federal marketplace,” the Health Policy Institute of Ohio said in a policy brief released this month.

    An analysis by health research nonprofit KFF showed that since the introduction of the enhanced premium tax credits, enrollment in marketplace plans has “more than doubled” to more than 24 million people nationally.

    Without the tax credits, KFF said annual premium payments in 2024 would have been more than 75% higher than they were.

    “Enrollees with incomes about 400% of the (federal poverty line) will be subject to large increases in premium payments if enhanced premium tax credits expire,” according to KFF research.

    With an annual premium increase of 18%, a 60-year-old couple making $85,000 would see annual premiums rise by an average of more than $22,000 in 2026, the KFF found.

    The Health Policy Institute of Ohio said that states that run their own health marketplace expect to see premium increases of 17%, but individuals in states like Ohio, who use the federal marketplace directly, should expect to see an average jump of 30%.

    The institute said the rates are the largest changes requested by insurers since 2018.

    “Because those previously enrolled in marketplace coverage will likely be ineligible for Medicaid coverage because of their income level and usually do not have insurance coverage offered through their job, most will likely become uninsured,” the policy brief stated.

    A recent study by the Urban Institute estimated an additional 140,000 Ohioans could be uninsured because of the tax credit expiration, pushing the uninsured rate in the state up 29%.

    Those who stick with the Affordable Care Act would could see thousands of dollars in increases without the tax credits.

    A 27-year-old Ohioan with a $35,000 annual income could see their premiums jump from $1,033 to $2,615.

    A 35-year-old couple who makes $30,000 per year would go from paying nothing with the credit, to paying more than $1,100, according to the institute analysis, citing KFF data.

    The insurance cost increases are attributed not only to a fear that with increased premiums, younger Americans will drop coverage, but also to rising hospital costs, bigger demand for “expensive pharmaceuticals” and “economic forces such as potential tariffs on medical supplies, inflation and labor shortages.”

    Medicaid has already seen its share of cuts, including a ban on funding directed toward Planned Parenthood health clinics.

    The cuts have caused Ohio-area affiliates to reduce staff in clinics that provide preventive care along with reproductive health access.

    Planned Parenthood Southwest Ohio Region has even closed facilities due to the loss of Medicaid patients, which make up about 40% of their client population.

    The changes to the Affordable Care Act credits would come despite vast public support for the renewal of the tax credits.

    Originally published by the Ohio Capital Journal. Republished here with permission.

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    Susan Tebben, The Ohio Capital Journal

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  • As Expiration of Tax Credits Loom, Ohio Health Insurers Ask for Big Premium Increases – Cleveland Scene

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    The federal government remains closed for business as Democrats and Republicans battle over health programs for low and middle-income Americans.

    If Republicans get their way on one of those programs, insurance premiums for 427,000 Ohioans could double on average. Insurers in the state are already asking for big increases in premiums.

    The government shut down at midnight Wednesday as Democrats and Republicans failed to agree to a spending plan. Democrats are demanding that the GOP roll back nearly $1 trillion in cuts they made to Medicaid earlier this year as part of President Donald Trump’s One Big Beautiful Bill Act. 

    That bill also gave giant tax cuts to the richest 1% of Americans, largely by extending tax breaks passed in 2017 during the first Trump administration. Even though congressional Republicans were eager to extend those tax breaks, they’re digging in over demands to extend health subsidies for average and low-income Americans.

    Known as the “enhanced premium tax credit,” it was created during the COVID-19 pandemic to subsidize premiums for insurance on the exchanges created under the 2010 Affordable Care Act. The average subsidy they provided was $705 a year in 2024.

    Since they were introduced in 2021, the number of people using the exchanges more than doubled, from 11 million to 24 million, KFF, a health-care analysis nonprofit, reported this week. The subsidies have been credited with helping to push the rate of uninsured Americans to an all-time low.

    In the same report, KFF said that premiums for insurance purchased on the exchanges “will more than double” if the subsidies are allowed to expire at the end of the year. As with the cost of health care, the size of the subsidies has grown annually, so their expiration means bigger losses for recipients going forward, the KFF report said.

    “Based on the earlier federal data and other more recent publicly available information, KFF now estimates that, if Congress extends enhanced premium tax credits, subsidized enrollees would save $1,016 in premium payments over the year in 2026 on average,” it said. “In other words, expiration of the enhanced premium tax credits is estimated to more than double what subsidized enrollees currently pay annually for premiums — a 114% increase from an average of $888 in 2025 to $1,904 in 2026.”

    Individual impacts will vary based on age and income. 

    For example, a 45-year-old making $35,000 a year would see an annual increase of almost $1,600. Meanwhile, a 60-year-old couple making $85,000 would see an $18,000 premium increase, the KFF report said.

    With the credits in jeopardy, insurers who offer plans on the Ohio exchanges are proposing big increases. Open enrollment for 2026 begins on Nov. 1, so insurers and state regulators have to plan without knowing what the fate of the subsidies will be.

    In Ohio, eight companies are offering 17 plans for 2026. All are proposing premium increases ranging from 2.5% to 42%. While increases at the top end of the spectrum are big, it’s not clear they’ll keep pace if the subsidies are allowed to expire.

    Centene, owner of Buckeye Community Health Plan, insures the largest number of Ohioans using the ACA exchanges — 75,ooo in 2023. In an email, a spokesman cited several reasons for proposed increases of 25% to 28% for its 2026 plans.

    “Over the past several months we have been working closely with Ohio regulators and their third-party actuaries to balance rising healthcare costs with the needs of Ohio citizens,” the spokesman said. “Our rate adjustments reflect higher-than-expected care needs than in previous years, including increased hospitalizations, emergency room utilization and behavioral health services.”

    The company is “committed to ensuring affordability of health care coverage” and is urging Congress to extend the enhanced premium tax credits. 

    “These tax credits, which are set to expire at the end of the year, are essential to keeping coverage affordable for Ohioans and working people throughout the country,” the spokesman said.

    Dayton-based CareSource was the state’s second-biggest provider as of 2023. For 2026, it’s proposing to hike premiums by about 17%.

    Asked why the increase was needed, spokesman Joseph Kelley didn’t specifically mention the looming expiration of the subsidies.

    “The ACA Marketplace is facing significant challenges nationwide, driven by a more competitive landscape, rising health care costs and anticipated regulatory shifts,” he said. “These factors led us to adjust our rates to maintain sustainability while continuing to provide quality care.”

    Regulators have until Oct. 15 to finalize next year’s rates.

    America’s Health Insurance Plans, an industry group, goes further than KFF did in its report. It said that millions of American families will face a 75% increase in health premiums if the enhanced subsidies are allowed to expire.

    In a Sept. 22 blog post, the group’s president and CEO cited polls saying that more than 70% of Americans want the insurance subsidies to be renewed.

    “Public opinion is clear, with polls from leading Democratic, Republican, and independent researchers showing overwhelming support for continuing these tax credits,” said CEO Mike Tuffin. “The issue is poised to play a significant role in how millions of Americans vote in the 2026 elections.”

    Originally published by the Ohio Capital Journal. Republished here with permission.

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    Marty Schladen, The Ohio Capital Journal

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  • Huge Numbers of Ohioans to See Big Increases in Insurance Costs

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    Experts are warning that more than 500,000 Ohioans are poised to lose insurance subsidies starting next year. In many cases, the increased costs they’ll face will be so big that more than 100,000 will lose their coverage, they warn.

    However, Ohio U.S. Sens. Jon Husted and Bernie Moreno, both Republicans, won’t say whether they’ll act to renew the program.

    The subsidy is known as the “enhanced premium tax credit.” It was created during the coronavirus pandemic to make insurance purchased on the marketplace created by the Affordable Care Act more affordable. 

    It’s available to people making between 100% and 400% of federal poverty guidelines. For a family of three, that’s between $26,650 and $106,600 a year. Nearly 20 million Americans and 530,000 Ohioans receive it.

    More than 90% of those who get insurance through the Affordable Care Act marketplace receive the subsidies, and they’re set to expire at the end of the year. 

    The average recipient saves about $700 a year because of them, the Center for American Progress reported. But some save much more, meaning they have a lot more to lose.

    “A typical 60-year-old couple making $82,000 … would see monthly marketplace premiums more than triple, from $581 to $2,111 — an annual increase of roughly $18,400,” the group reported late last year.

    The subsidies are credited with helping to push the percentage of uninsured Americans to an all-time low. That might be why, after initially being skeptical of the Affordable Care Act, 66% of Americans had favorable views of the law by June 2025.

    After attempting to repeal the Affordable Care Act in his first term, President Donald Trump has undertaken several other measures that some experts say will push the number of uninsured Americans up — a lot.

    One is by cutting nearly $1 trillion in Medicaid spending over 10 years as part of his One Big Beautiful Bill Act. The law gives roughly the same amount in tax cuts to the richest 1% of Americans, and it adds $3.4 trillion to the deficit.

    The Medicaid cuts are expected to add greatly to the ranks of the uninsured. KFF, an independent nonprofit, in June estimated that 11 million Americans would lose insurance because of them. In Ohio, 310,000 would lose insurance, increasing the rate of uninsured Ohioans by 3%, the organization estimated.

    Emergency physicians have warned that creating huge numbers of newly uninsured people will strain hospital services for all patients — especially in rural areas where hospitals are already struggling.

    ERs have to treat people regardless of their ability to pay. To cover those costs, hospitals will have to cut staff, leading to longer wait times, fewer services and negative health outcomes, the doctors say.

    Expiration of the marketplace subsidies would make the numbers even more dire, experts warn. KFF estimates that between the loss of subsidies and the Trump Medicaid cuts, 16 million Americans will lose insurance, including 440,000 Ohioans.

    If Congress allows the subsidies to expire at the end of 2025, those who receive them will feel the pain before those facing Medicaid cuts do. Medicaid work requirements — the biggest single way cuts to that program will be financed — don’t kick in until after next year’s midterm elections.

    Americans for Healthy Communities, a nonprofit advocacy group, urged Congress to renew the insurance subsidies.

    “By failing to renew the ACA’s premium tax credits, Republicans in Congress are jeopardizing the health of more than 500,000 Ohioans who rely on these credits to receive the care they need,” it said in a written statement. “We urge Congress, especially Ohio’s delegation, to quickly come to the table and work together on passing an extension of these tax credits before it’s too late. Congress still has a chance to renew the tax credits when they return in September — however, if they once again refuse to, millions will lose their coverage and millions more will face unaffordable, high premiums. The time to act is now.”

    The offices of Husted and Moreno didn’t respond when asked whether they believed the insurance subsidies should be allowed to expire.

    Originally published by the Ohio Capital Journal. Republished here with permission.

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    Marty Schladen, The Ohio Capital Journal

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