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ACA premiums set to spike 

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August 7, 2025
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The Big Story 

ACA premiums set to spike 

People who buy health insurance through the Affordable Care Act (ACA) are set to see a median premium increase of 18 percent, more than double last year’s 7 percent median proposed increase, according to an analysis of preliminary filings by KFF. 

© Andrew Harrer, Bloomberg via Getty Images

The proposed rates are preliminary and could change before being finalized in late summer. The analysis includes proposed rate changes from 312 insurers in all 50 states and DC. 

 

It’s the largest rate change insurers have requested since 2018, the last time that policy uncertainty contributed to sharp premium increases. On average, ACA marketplace insurers are raising premiums by about 20 percent in 2026, KFF found. 

 

Insurers said they wanted higher premiums to cover rising health care costs, like hospitalizations and physician care, as well as prescription drug costs. Tariffs on imported goods could play a role in rising medical costs, but insurers said there was a lot of uncertainty around implementation, and not many insurers were citing tariffs as a reason for higher rates. 

 

But they are adding in higher increases due to changes being made by the Trump administration and Republicans in Congress. For instance, the majority of insurers said they are taking into account the potential expiration of enhanced premium tax credits. 

 

Those subsidies, put in place during the COVID-19 pandemic, are set to expire at the end of the year, and there are few signs that Republicans are interested in tackling the issue at all.    

 

If Congress takes no action, premiums for subsidized enrollees are projected to increase by over 75 percent starting in January 2026, according to KFF. 

 

But some states are pushing back.  

 

Arkansas Gov. Sarah Huckabee Sanders (R) on Wednesday called on the state’s insurance commissioner to disapprove the proposed increases from Centene and Blue Cross Blue Shield. The companies filed increases of up to 54 percent and 25.5 percent, respectively, she said.  

 

“Arkansas’ Insurance Commissioner is required to disapprove of proposed rate increases if they are excessive or discriminatory, and these are both,” Huckabee Sanders said in a statement.

 

“I’m calling on my Commissioner to follow the law, reject these insane rate increases, and protect Arkansans.”  

 

 

Welcome to The Hill’s Health Care newsletter, we’re Nathaniel Weixel, Joseph Choi and Alejandra O’Connell-Domenech — every week we follow the latest moves on how Washington impacts your health.

 

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Essential Reads 

How policy will be impacting the health care sector this week and beyond:

 

Appeals court upholds dismissal of US Chamber challenge to Medicare negotiation

The U.S. 6th Circuit Court of Appeals on Wednesday upheld a lower court’s ruling to dismiss a challenge to the Medicare Drug Price Negotiation Program brought by the U.S. Chamber of Commerce, finding once again that the parties involved did not have standing to sue. Almost exactly one year ago, a federal judge dismissed the Chamber’s lawsuit challenging the Medicare negotiation program established through the Inflation …

 Full Story

 

Huge cuts to mRNA research spark fears about future pandemics

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.’s decision this week to cancel hundreds of millions of dollars in mRNA vaccine funding will leave the United States unprepared for the next pandemic and other public health emergencies, public health experts warned.   “I’ve tried to be objective & non-alarmist in response to current HHS actions—but quite frankly this move is going to cost lives,” President …

 Full Story

 

Legionnaires’ outbreak grows: What are the disease’s first symptoms?

(NEXSTAR) – Three people have died and at least 67 have been infected as a cluster of Legionnaires’ disease cases in New York City continues to spread. The case count has ballooned since the bacteria that causes Legionnaires’ started sickening people in late July. City health officials link the outbreak in Central Harlem to cooling towers, structures containing water and a fan that are used to cool buildings. They …

 Full Story

 
 

In Other News 

Branch out with a different read:

Ex-Trump surgeon general: RFK Jr. vaccine move ‘going to cost lives’

President Trump’s first-term surgeon general, Jerome Adams, sharply criticized the decision by Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. on Tuesday to pare back investments in mRNA vaccine projects, including those underway to help fight bird flu and COVID-19. “I’ve tried to be objective & non-alarmist in response to current HHS actions – but quite frankly this move is going to cost lives,” Adams said …

Full Story

 

Around the Nation 

Local and state headlines on health care:

Idaho lost one in three OB/gyns after its abortion ban (Mother Jones) 
Third person has died from Legionnaires’ disease cluster in New York (NBC) 
As California’s behavioral health workforce buckles, help is years away (KFF Health News) 
 

What We’re Reading 

Health news we’ve flagged from other outlets:

Sarepta hired a Trump-connected firm to lobby on Duchenne treatment (Stat) Congress looks to ease restrictions on veterans’ use of non-VA clinics and hospitals (KFF Health News) 
Excessive screen time linked to heart health risks in kids, new research shows (CBS)
 

What People Think 

Opinions related to health submitted to The Hill:

RFK made a massive mistake by ending global vaccine fundingSomething both sides agree on: A bill to prevent late-stage cancer
 
 

You’re all caught up. See you tomorrow! 

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