ACA insurance costs keep climbing for Ohioans, with another price jump expected

NewsOhioans who buy health insurance through the Affordable Care Act marketplace are facing another double-digit premium increase next year, on top of the steep increase they already faced this year.Getty ImagesCOLUMBUS, Ohio -- Ohioans who buy health insurance through the Affordable Care Act marketplace are facing another double-digit premium increase next year, on top of the steep increase they already faced this year.The 11 insurers remaining in Ohio’s marketplace are proposing to raise premiums by an average of 14.7% for 2027, according to an analysis by the Center for American Progress.“In a normal economic environment, this would be pretty devastating,” CAP director of health policy Natasha Murphy said. “But when people are grappling with higher costs for everything else, this becomes one additional budget pressure.”And Ohioans are already paying substantially more for coverage.The amount the average Ohio marketplace customer paid each month jumped 85% this year, from $126 to $233 per person, according to the Health Policy Institute of Ohio.That increase came from two directions.The price insurers charged for marketplace plans rose by an average of 18%. At the same time, enhanced federal subsidies that had helped people pay those premiums expired at the end of 2025.Now the price of the insurance itself is poised to rise again.If someone paying $233 a month saw the full 14.7% increase proposed for next year, their bill would rise by $34, to $267 a month. That’s $1,692 more annually than the average Ohio marketplace customer paid just two years earlier.Congressional Republicans declined to extend the subsidies last year when they passed a the One Big Beautiful Bill Act that extended President Donald Trump’s 2017 tax cuts worth about $4 trillion. Republicans said the enhanced subsidies were a temporary pandemic-era benefit that had become too expensive and vulnerable to fraud. Extending them permanently would have cost the federal government about $350 billion over 10 years, according to the Congressional Budget Office.They also argued that continuing to spend more federal money subsidizing insurance would do little to address the underlying problem of rising health care costs.But without the extra help, fewer people signed up for coverage, leaving insurers with a smaller and potentially sicker group of customers.Ohio was among the hardest-hit states by this. The Buckeye State saw the largest percentage drop in ACA marketplace enrollment in the country last year. Enrollment fell by 32.4%, which meant more than 161,000 people dropped their coverage. Murphy hoped some of those Ohioans later found health insurance through an employer or qualified for Medicaid. But “the unfortunate reality is that thousands are and will remain uninsured.”That has consequences beyond the people who lose their health coverage.When uninsured patients need medical care they cannot afford, hospitals and other providers are often left with bills that never get paid. That is known as uncompensated care.There are already signs this is happening. Two-thirds of 25 health systems surveyed by the Community Hospital Corporation in May reported their uncompensated care had increased.Murphy said hospitals eventually have to make up for those losses, putting upward pressure on prices for people who do have insurance.Another major change is coming to health coverage in January.The 700,000 Ohioans who receive Medicaid through the state’s expansion program will be subject to new work requirements.Most will have to show they are working, attending school, volunteering or participating in another approved activity for at least 80 hours a month to keep their coverage. People who are pregnant, medically frail or caring for young children or people with disabilities are among those who can qualify for exemptions.Republicans have argued the requirements will encourage more able-bodied adults to work and help reduce government spending on Medicaid.But research on previous Medicaid work requirements has found that many of the people who lose coverage are already working or qualify for exemptions but have trouble proving it.It’s difficult to predict how many more Ohioans will drop coverage in 2027, but Murphy expects the number to reach into the tens of thousands.And she doesn’t expect the double-digit premium increases to end anytime soon.“Until we get to a point where folks in Washington prioritize healthcare access,” she said, “these costs will continue to spiral out of control.”As a statehouse reporter for Cleveland.com, I write about all things Ohio politics with a focus on elections, marijuana policy, social issues, budgets, redistricting, public pensions, immigration in Ohio and...