Latest news with #healthcarecosts
Yahoo
a day ago
- Health
- Yahoo
ACA insurers propose biggest premium hikes since 2018 as Trump policies take hold
Affordable Care Act insurers are proposing their steepest premium increases since 2018, driven in part by the looming expiration of Biden-era enhanced premium subsidies and by the Trump administration's tariffs, a new KFF analysis has found. Insurers are asking for a typical rate increase of 15% with more than a quarter proposing hikes of 20% or more. KFF, a nonpartisan health policy research group, looked at 105 Obamacare insurers in 19 states and the District of Columbia that have filed rates so far. Steep rate increases in 2018 were also fueled by Trump administration policies, which were focused on weakening the ACA during the president's first term after Republicans in Congress failed to repeal it in 2017. While rising health care costs account for about half of the coming year's proposed increases, two other forces under the control of President Donald Trump and congressional Republicans are also driving up rates, KFF found. The expiration of the enhanced ACA premium subsidies at the end of this year is prompting many insurers to hike rates by an additional 4%, on average. Insurers are concerned that the disappearance of this beefed-up assistance will prompt many, largely healthier consumers to drop their coverage — leaving sicker, costlier policyholders on the exchanges. Initially created by the Democrats' American Rescue Plan Act in 2021, the enhanced premium subsidies enable lower-income enrollees to sign up for coverage with very low or no monthly premiums. Also, middle-income Americans can qualify for assistance for the first time. The Biden administration repeatedly said the more generous subsidies allow the majority of enrollees to select plans that cost less than $10 a month. The enhanced subsidies helped drive Obamacare signups to a record 24 million people for 2025. Most enrollees qualify for subsidies, which greatly lower their monthly premium payments. But once the beefed-up assistance lapses, those payments are expected to spike by 75%, on average, KFF said. Trump and GOP lawmakers did not include an extension of the subsidies in their 'big, beautiful bill' and it remains to be seen whether they push for it in subsequent legislation. However, the clock is ticking since insurers are currently finalizing their rates, and the Obamacare federal and state exchanges need time to prepare for open enrollment, which starts on November 1. Several states are highlighting the looming loss of the enhanced subsidies as driving up insurers' proposed rates on their exchanges. In Maryland, for instance, carriers have requested an overall average premium change of 17.1%, the highest since 2019. If Congress extends the enhanced subsidies, the rate increases would be 7.9%, on average, according to the Maryland Insurance Administration, which is looking into creating a state-sponsored subsidy to offset some of the premium increases. Also, some insurers are pointing to the tariffs that the Trump administration has promised to impose on pharmaceutical imports, KFF said. Those that cite tariffs say the levies will add 3% to their premium proposals. The rate filings, however, do not mention specific impacts of the 'big, beautiful bill' because insurers generally had to submit their proposals prior to the bill being signed into law on July 4. Those that mention it point to the uncertainty it is causing, said Cynthia Cox, director of KFF's Program on the ACA. 'We're going to be watching over the next few weeks whether insurers come back and say, 'the big, beautiful bill passed, and here's how we think that might affect our premiums,'' she said. The filings also don't take into account the provisions in a rule that the Centers for Medicare and Medicaid Services finalized in late June that will make several changes to Obamacare, including shortening the open enrollment period, increasing verification requirements and limiting the ability of low-income Americans to sign up for coverage year-round. The measures are a 'mixed bag' for insurers in terms of how it might affect premiums, Cox said. One major insurer has already announced its departure from the Affordable Care Act in 2026. Aetna said in May that it would stop selling plans on the individual market because 'it became clear we would not be able to provide the same level of value we've offered in prior years,' the company said on its website. The insurer also left the Obamacare exchanges in 2018 but later returned. Insurers' 2026 rates are preliminary and are subject to change, particularly in states that run their own exchanges, where state regulators have more of a say in setting the final rates. The final rates should be published later this summer, and consumers will be able to view plan premiums shortly before open enrollment starts.
Medscape
a day ago
- Health
- Medscape
Key Drivers of High Costs in Head and Neck Cancer Care
TOPLINE: Advanced disease stage was the strongest predictor of high first-year healthcare costs in Canadian patients with head and neck cancer, a recent analysis found. Patients with stage IV disease had an almost ninefold greater likelihood for high healthcare costs than those with stage I disease. Combination treatments — especially surgery with adjuvant therapy — were also a major driver of high costs. METHODOLOGY: Patients with head and neck cancer experience considerable healthcare burdens due to aggressive and complex multimodal treatments, as well as long-term complications requiring rehabilitation and supportive care. Identifying predictors of high first-year costs can guide strategies to optimize resource use and improve patient outcomes. Researchers conducted a population-based retrospective cohort study using data from 13,795 Ontario, Canada, residents (mean age, 63.2 years; 25% women) who were diagnosed with head and neck cancer between January 2007 and October 2020. Researchers estimated total 1-year healthcare costs using a patient-level algorithm, with values adjusted to 2020 Canadian dollars (CAD), and identified predictors for high healthcare costs. Overall, 25% of patients were classified in the high-cost group (≥ 75th percentile; n = 3448), and 75% were classified in the low- or medium-cost group (< 75th percentile; n = 10,347). Patients in the high-cost vs low- or medium-cost groups were more likely to receive chemoradiotherapy (31.5% vs 19.0%), surgery with radiotherapy (20.0% vs 5.7%), or surgery with chemoradiotherapy (14.4% vs 4.1%), and were less likely to receive surgery alone (11.5% vs 27.4%) or radiotherapy alone (16.7% vs 26.1%). TAKEAWAY: Over 1 year, the biggest costs for patients in the high-cost group were inpatient stays (representing 41.0% of costs or CA$40,796 vs CA$5769 in the lower-cost group), outpatient visits (33.5% or $33,321 vs $16,953), physician services (12.5% or $12,436 vs $4959), complex and home care (8.7% or $8677 vs $1272), and drugs, devices, and lab tests (4.2% or $4208 vs $1576). Stage II (odds ratio [OR], 3.14), stage III (OR, 6.08), and stage IV (OR, 8.94) were associated with progressively greater odds of high healthcare costs than stage I disease. Combination treatment was associated with substantially greater odds of high costs than no treatment or palliative care (OR, 6.94 for surgery and radiotherapy; OR, 5.86 for surgery with chemoradiotherapy). Female sex (OR, 1.26) and older age (per each 10-year increase in age at diagnosis; OR, 1.07) were both associated with increased odds of high costs, as were diagnoses during the COVID pandemic (OR, 1.73) compared with prior years. IN PRACTICE: 'This cohort study found that more advanced disease stage and receiving multiple treatment modalities were the strongest predictors of high-cost care among patients diagnosed with head and neck cancer,' the authors of the study wrote. Potential solutions, they noted, include effective screening programs to promote earlier diagnosis, as well as interventions aimed at treatment de-escalation in appropriately selected patients. SOURCE: This study, led by Noémie Villemure-Poliquin, MD, MSc, Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada, was published online in JAMA Otolaryngology-Head & Neck Surgery. LIMITATIONS: This study included only patients in Ontario, so findings may not be generalizable to other settings. Reliance on administrative data could have led to misclassification of disease severity and treatment types. Additionally, the analysis did not capture direct out-of-pocket costs. DISCLOSURES: This study received support through a grant from the Ontario Ministry of Health and the Ontario Ministry of Long-Term Care. One author reported receiving personal fees from EMD Serono and nonfinancial support from Elekta. Another author reported receiving personal fees from Cancer Care Ontario. No other disclosures were reported. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
CNN
6 days ago
- Health
- CNN
ACA insurers propose biggest premium hikes since 2018 as Trump policies take hold
Affordable Care Act insurers are proposing their steepest premium increases since 2018, driven in part by the looming expiration of Biden-era enhanced premium subsidies and by the Trump administration's tariffs, a new KFF analysis has found. Insurers are asking for a typical rate increase of 15% with more than a quarter proposing hikes of 20% or more. KFF, a nonpartisan health policy research group, looked at 105 Obamacare insurers in 19 states and the District of Columbia that have filed rates so far. Steep rate increases in 2018 were also fueled by Trump administration policies, which were focused on weakening the ACA during the president's first term after Republicans in Congress failed to repeal it in 2017. While rising health care costs account for about half of the coming year's proposed increases, two other forces under the control of President Donald Trump and congressional Republicans are also driving up rates, KFF found. The expiration of the enhanced ACA premium subsidies at the end of this year is prompting many insurers to hike rates by an additional 4%, on average. Insurers are concerned that the disappearance of this beefed-up assistance will prompt many, largely healthier consumers to drop their coverage — leaving sicker, costlier policyholders on the exchanges. Initially created by the Democrats' American Rescue Plan Act in 2021, the enhanced premium subsidies enable lower-income enrollees to sign up for coverage with very low or no monthly premiums. Also, middle-income Americans can qualify for assistance for the first time. The Biden administration repeatedly said the more generous subsidies allow the majority of enrollees to select plans that cost less than $10 a month. The enhanced subsidies helped drive Obamacare signups to a record 24 million people for 2025. Most enrollees qualify for subsidies, which greatly lower their monthly premium payments. But once the beefed-up assistance lapses, those payments are expected to spike by 75%, on average, KFF said. Trump and GOP lawmakers did not include an extension of the subsidies in their 'big, beautiful bill' and it remains to be seen whether they push for it in subsequent legislation. However, the clock is ticking since insurers are currently finalizing their rates, and the Obamacare federal and state exchanges need time to prepare for open enrollment, which starts on November 1. Several states are highlighting the looming loss of the enhanced subsidies as driving up insurers' proposed rates on their exchanges. In Maryland, for instance, carriers have requested an overall average premium change of 17.1%, the highest since 2019. If Congress extends the enhanced subsidies, the rate increases would be 7.9%, on average, according to the Maryland Insurance Administration, which is looking into creating a state-sponsored subsidy to offset some of the premium increases. Also, some insurers are pointing to the tariffs that the Trump administration has promised to impose on pharmaceutical imports, KFF said. Those that cite tariffs say the levies will add 3% to their premium proposals. The rate filings, however, do not mention specific impacts of the 'big, beautiful bill' because insurers generally had to submit their proposals prior to the bill being signed into law on July 4. Those that mention it point to the uncertainty it is causing, said Cynthia Cox, director of KFF's Program on the ACA. 'We're going to be watching over the next few weeks whether insurers come back and say, 'the big, beautiful bill passed, and here's how we think that might affect our premiums,'' she said. The filings also don't take into account the provisions in a rule that the Centers for Medicare and Medicaid Services finalized in late June that will make several changes to Obamacare, including shortening the open enrollment period, increasing verification requirements and limiting the ability of low-income Americans to sign up for coverage year-round. The measures are a 'mixed bag' for insurers in terms of how it might affect premiums, Cox said. One major insurer has already announced its departure from the Affordable Care Act in 2026. Aetna said in May that it would stop selling plans on the individual market because 'it became clear we would not be able to provide the same level of value we've offered in prior years,' the company said on its website. The insurer also left the Obamacare exchanges in 2018 but later returned. Insurers' 2026 rates are preliminary and are subject to change, particularly in states that run their own exchanges, where state regulators have more of a say in setting the final rates. The final rates should be published later this summer, and consumers will be able to view plan premiums shortly before open enrollment starts.
CNN
6 days ago
- Health
- CNN
ACA insurers propose biggest premium hikes since 2018 as Trump policies take hold
Affordable Care Act insurers are proposing their steepest premium increases since 2018, driven in part by the looming expiration of Biden-era enhanced premium subsidies and by the Trump administration's tariffs, a new KFF analysis has found. Insurers are asking for a typical rate increase of 15% with more than a quarter proposing hikes of 20% or more. KFF, a nonpartisan health policy research group, looked at 105 Obamacare insurers in 19 states and the District of Columbia that have filed rates so far. Steep rate increases in 2018 were also fueled by Trump administration policies, which were focused on weakening the ACA during the president's first term after Republicans in Congress failed to repeal it in 2017. While rising health care costs account for about half of the coming year's proposed increases, two other forces under the control of President Donald Trump and congressional Republicans are also driving up rates, KFF found. The expiration of the enhanced ACA premium subsidies at the end of this year is prompting many insurers to hike rates by an additional 4%, on average. Insurers are concerned that the disappearance of this beefed-up assistance will prompt many, largely healthier consumers to drop their coverage — leaving sicker, costlier policyholders on the exchanges. Initially created by the Democrats' American Rescue Plan Act in 2021, the enhanced premium subsidies enable lower-income enrollees to sign up for coverage with very low or no monthly premiums. Also, middle-income Americans can qualify for assistance for the first time. The Biden administration repeatedly said the more generous subsidies allow the majority of enrollees to select plans that cost less than $10 a month. The enhanced subsidies helped drive Obamacare signups to a record 24 million people for 2025. Most enrollees qualify for subsidies, which greatly lower their monthly premium payments. But once the beefed-up assistance lapses, those payments are expected to spike by 75%, on average, KFF said. Trump and GOP lawmakers did not include an extension of the subsidies in their 'big, beautiful bill' and it remains to be seen whether they push for it in subsequent legislation. However, the clock is ticking since insurers are currently finalizing their rates, and the Obamacare federal and state exchanges need time to prepare for open enrollment, which starts on November 1. Several states are highlighting the looming loss of the enhanced subsidies as driving up insurers' proposed rates on their exchanges. In Maryland, for instance, carriers have requested an overall average premium change of 17.1%, the highest since 2019. If Congress extends the enhanced subsidies, the rate increases would be 7.9%, on average, according to the Maryland Insurance Administration, which is looking into creating a state-sponsored subsidy to offset some of the premium increases. Also, some insurers are pointing to the tariffs that the Trump administration has promised to impose on pharmaceutical imports, KFF said. Those that cite tariffs say the levies will add 3% to their premium proposals. The rate filings, however, do not mention specific impacts of the 'big, beautiful bill' because insurers generally had to submit their proposals prior to the bill being signed into law on July 4. Those that mention it point to the uncertainty it is causing, said Cynthia Cox, director of KFF's Program on the ACA. 'We're going to be watching over the next few weeks whether insurers come back and say, 'the big, beautiful bill passed, and here's how we think that might affect our premiums,'' she said. The filings also don't take into account the provisions in a rule that the Centers for Medicare and Medicaid Services finalized in late June that will make several changes to Obamacare, including shortening the open enrollment period, increasing verification requirements and limiting the ability of low-income Americans to sign up for coverage year-round. The measures are a 'mixed bag' for insurers in terms of how it might affect premiums, Cox said. One major insurer has already announced its departure from the Affordable Care Act in 2026. Aetna said in May that it would stop selling plans on the individual market because 'it became clear we would not be able to provide the same level of value we've offered in prior years,' the company said on its website. The insurer also left the Obamacare exchanges in 2018 but later returned. Insurers' 2026 rates are preliminary and are subject to change, particularly in states that run their own exchanges, where state regulators have more of a say in setting the final rates. The final rates should be published later this summer, and consumers will be able to view plan premiums shortly before open enrollment starts.
CNN
6 days ago
- Health
- CNN
ACA insurers propose biggest premium hikes since 2018 as Trump policies take hold
Affordable Care Act insurers are proposing their steepest premium increases since 2018, driven in part by the looming expiration of Biden-era enhanced premium subsidies and by the Trump administration's tariffs, a new KFF analysis has found. Insurers are asking for a typical rate increase of 15% with more than a quarter proposing hikes of 20% or more. KFF, a nonpartisan health policy research group, looked at 105 Obamacare insurers in 19 states and the District of Columbia that have filed rates so far. Steep rate increases in 2018 were also fueled by Trump administration policies, which were focused on weakening the ACA during the president's first term after Republicans in Congress failed to repeal it in 2017. While rising health care costs account for about half of the coming year's proposed increases, two other forces under the control of President Donald Trump and congressional Republicans are also driving up rates, KFF found. The expiration of the enhanced ACA premium subsidies at the end of this year is prompting many insurers to hike rates by an additional 4%, on average. Insurers are concerned that the disappearance of this beefed-up assistance will prompt many, largely healthier consumers to drop their coverage — leaving sicker, costlier policyholders on the exchanges. Initially created by the Democrats' American Rescue Plan Act in 2021, the enhanced premium subsidies enable lower-income enrollees to sign up for coverage with very low or no monthly premiums. Also, middle-income Americans can qualify for assistance for the first time. The Biden administration repeatedly said the more generous subsidies allow the majority of enrollees to select plans that cost less than $10 a month. The enhanced subsidies helped drive Obamacare signups to a record 24 million people for 2025. Most enrollees qualify for subsidies, which greatly lower their monthly premium payments. But once the beefed-up assistance lapses, those payments are expected to spike by 75%, on average, KFF said. Trump and GOP lawmakers did not include an extension of the subsidies in their 'big, beautiful bill' and it remains to be seen whether they push for it in subsequent legislation. However, the clock is ticking since insurers are currently finalizing their rates, and the Obamacare federal and state exchanges need time to prepare for open enrollment, which starts on November 1. Several states are highlighting the looming loss of the enhanced subsidies as driving up insurers' proposed rates on their exchanges. In Maryland, for instance, carriers have requested an overall average premium change of 17.1%, the highest since 2019. If Congress extends the enhanced subsidies, the rate increases would be 7.9%, on average, according to the Maryland Insurance Administration, which is looking into creating a state-sponsored subsidy to offset some of the premium increases. Also, some insurers are pointing to the tariffs that the Trump administration has promised to impose on pharmaceutical imports, KFF said. Those that cite tariffs say the levies will add 3% to their premium proposals. The rate filings, however, do not mention specific impacts of the 'big, beautiful bill' because insurers generally had to submit their proposals prior to the bill being signed into law on July 4. Those that mention it point to the uncertainty it is causing, said Cynthia Cox, director of KFF's Program on the ACA. 'We're going to be watching over the next few weeks whether insurers come back and say, 'the big, beautiful bill passed, and here's how we think that might affect our premiums,'' she said. The filings also don't take into account the provisions in a rule that the Centers for Medicare and Medicaid Services finalized in late June that will make several changes to Obamacare, including shortening the open enrollment period, increasing verification requirements and limiting the ability of low-income Americans to sign up for coverage year-round. The measures are a 'mixed bag' for insurers in terms of how it might affect premiums, Cox said. One major insurer has already announced its departure from the Affordable Care Act in 2026. Aetna said in May that it would stop selling plans on the individual market because 'it became clear we would not be able to provide the same level of value we've offered in prior years,' the company said on its website. The insurer also left the Obamacare exchanges in 2018 but later returned. Insurers' 2026 rates are preliminary and are subject to change, particularly in states that run their own exchanges, where state regulators have more of a say in setting the final rates. The final rates should be published later this summer, and consumers will be able to view plan premiums shortly before open enrollment starts.
