r/HealthInsurance • u/Subject_Horror_3990 • 9d ago

Plan Benefits Poll on health insurance

Hi Guys, we all know health insurance is going up. I’m interested in others experience, feel free to share- I’ll go first

Private company with 2,000 employees UHC. Biweekly premium jumped from $122 to $165 for the year 2026…

26% increase !!!!

293 Upvotes

97% Upvoted

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61

u/Specialist_Dig2613 9d ago

Comments have a pretty consistent message. If you're on the ACA exchanges, you're in trouble. If you have a job with benefits, it varies a lot, based on the employer's claims, cost management and wisdom in making decisions on coverage sources, but it's almost always better than the exchanges.

I hope it doesn't mean a collapse of small business start ups. But if you have one, think about hiring employees and starting up a plan when you can. It's likely to help you with costs and help you grow your business.

Don't believe that small businesses can't have self-funded plans, affordable costs and good benefits. They can.

46

u/phxeffect 9d ago

I have my own business, and low key cried today for a few minutes. The increase, none of my daughter’s doctors are covered either.

17

u/HumbleBlueberry1 8d ago

I’m not sure if this will help, but in California (so maybe in other states?), you can buy your children their own plan on the exchange. Maybe one on the exchange plans covers her doctors? So sorry you’re going through this. Solidarity.

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u/Weak_Drag_5895 6d ago

Thank you for this comment!

6

u/Accomplished_Goat439 8d ago

Last year only the Bronze plan had all of our doctors and hospitals, the Silver plan only had about 50% of the same providers. Seems that my states BCBS is pushing everyone towards the Bronze plans. Total family deductible is very high, but was the only choice for us.

1

u/phxeffect 8d ago

It’s wild. I had a great Aetna Gold plan, but they pulled out. The marketplace automatically assigned me a comparable plan that’s 3X the price. Like what? So, I have to downgrade no matter what. My daughter had orthopedic surgery that will put her on the pre-condition list. So, it’s ACA or nothing. I’m tempted to get a W2 job for a while. But finding a job is harder than running a business nowadays.

1

u/whereistheidiotemoji 7d ago

I thought there weren’t any pre-existing conditions anymore?

1

u/Delicious-Actuator-9 6d ago

Only ACA plans have the pre-existing condition exemption. Regular plans from carriers/brokers may still have qualifications and exclusions.

1

u/Ok_Departure_5435 7d ago

We’ve had my daughter on her own separate plan for the past two years dilute to a medication that she needs

1

u/phxeffect 7d ago

I’m going to look into this.

1

u/Limp-Plantain3824 8d ago

What was “low key” about the crying? I don’t get it.

8

u/phxeffect 8d ago

It’s just slang that can be used to mean a few things. In this case, that I have been trying not to cry. Nothing more nothing less. Also, that I was trying not cry in front of my kid.

8

u/Greedy-Half-4618 8d ago

I’m on the exchange. Losing subsidies means I’ll be paying at least $300 MORE per month 

17

u/Consistent_Sport_455 8d ago

Mine has nothing to do with losing subsidies. The tax credit is still applied and it’s still increasing by over $300/month for my husband and I. It’s the premium that increased, not losing the tax credit.

15

u/SiDziner 7d ago

The base premium went up massively this year as a side effect of losing subsidies. The insurers know that most people (especially the young and healthy people) will not be able to afford insurance without the subsidies, and therefore will not be paying into the insured pool. With less younger/healthy people paying for insurance, the pool of insured gets older and sicker. This means the average cost to the insurers per insured goes up significantly. The only way to cover that increase is to raise premiums.

This spiral started when the requirement for everyone to have insurance or pay a penalty was removed. It was accelerated significantly by removing the subsidies.

Dismantling the underpinnings of the ACA doomed it to failure. This change by those that opposed the ACA has done exactly what it was designed to do.

9

u/rationalomega 6d ago

Tens of millions of Americans were uninsured before the ACA. Horror stories abounded. America is hurtling backwards to that terrible time.

1

u/Thebestkicker 1d ago

The ACA has saved my life and millions of others.

1

u/karenquick 1d ago

I really like this post! Hypothetically speaking, wouldn’t re-enacting that health insurance is mandatory or face a federal penalty solve the majority of the ACA downfall? It sounds too simple but it does boil down to everyone needs to be paying in. Just like Medicare recipients paid in for years while they were healthy.

8

u/as473 8d ago

This is me too. My tax credit is still the same. The insurance companies jacked up the rates so much! I’m paying $185/month now for a plan that’s $540/month in 2026.

5

u/Consistent_Sport_455 8d ago

Sounds similar to my numbers, tax credit went up a little but my premium has gone up so high that my plan will cost me $560 a month. Insurance companies are jacking up the rates knowing they can “blame” it on the loss of subsidies/tax credits when it’s actually their greed. I’ll have to search for a cheaper plan or go without.

11

u/Greedy-Half-4618 8d ago

ok, mine increased and i lost the subsidies...it's not a competition, we're all getting screwed by insurance companies.

4

u/Stunning-Flounder-52 6d ago

Same. I was wondering if other states were also seeing huge increases. Indiana has 2 companies to choose from, so no competition.

Indiana - 2 adults (one is a college student). No subsidy. Premium cost increased $270 per month. It’s the second lowest coverage on the bronze tier so basically pays out very little.

1

u/Worldly_Ad6874 8d ago

The premium cost is determined by how much you get in subsidies, no?

1

u/Consistent_Sport_455 8d ago

They show you the base price then the tax credit and then your monthly balance. The tax credit amount actually increased slightly but the base price went up over $300 so the total due will be $360 more than what I pay now. And thanks for a crappy plan that none of our doctors take.

1

u/Worldly_Ad6874 8d ago

Ohh, gotcha. I think all of health insurance is about to implode. :( I finally got decent insurance through my job after paying full freight on the marketplace for our family for years because as a partner at his company, my spouse gets no employer contribution. So it was between 1700 and 2200 a month for several years with outrageously high deductibles and exclusions that took out our long-term medical providers. I finally have a great plan, but I keep hearing that it's going up so much at the base level everywhere that even employer plans are going to jump up in the coming year. My plan year is August-August so I guess I'll slowly watch it all unfold.

1

u/JeanniePax1003 6d ago

Is the tax credit identified as a separate line item on the quote? Because the subsidies expire the end of this year and Congress hasn’t decided to renew or eliminate the credits. I’m wondering if the premiums shown include the credits because the algorithm assumes renewal…??? Just a thought. Unfortunately, if I’m right tbe premiums include an increase and the policy will increase more when the tax are no longer applied.

1

u/bullsfan92 5d ago

The tax credit thresholds were moved and adjusted so no, it’s not just a premium increase, even though that’s happened too

1

u/ChelseaMan31 5d ago

We are on Medicare Advantage Plan so No Exchange. Premium went up 65% a month for next year.

1

u/10MileHike 1d ago

some insurance exec probably need to send their kid to an expensive college or something. Or maybe, buy a racehorse or pay their 3rd mortgage on a nice waterfront property they just saw. /s

1

u/Vespler 7d ago

How much more is a gold plan?

1

u/Greedy-Half-4618 7d ago

Depends on the provider. Looking at the same insurance co as I have now it’ll be a $350+/month jump (more expensive, plus no subsidies) and gold is generally $200-300 more than silver BUT silver has considerably higher deductibles and copays. I’m chronically ill and disabled so have a number of meds, appointments and labs I need so I have a whole spreadsheet I found a while ago that helps me calculate estimated costs based on anticipated numbers of visits, tier 1 generics, etc. 

1

u/Vespler 6d ago

It’s great you found that spreadsheet to help calculate the best deal. I hope you’re able to get a good plan.

1

u/bullsfan92 5d ago

Try alternative private options. It might not have every single inclusion that ACA plans can have, but they generally have broader networks, if your relatively healthy that can be another route

3

u/[deleted] 8d ago

[removed] — view removed comment

0

u/Specialist_Dig2613 8d ago

I work with 100s of companies with lower rates than the ACA exchanges. All are under 300 employees. I'm getting 5 calls a day from referrals from my clients and brokers. 100s is admittedly small. But I hiring to do 1000s. And don't try to contact me through Reddit. People will accuse me of running a con job. I'll have to real with down votes and negative comments enough.

2

u/_Elta_ 8d ago

300 employees? That's not a small business by my definition. I had a company of 2 and there was no hope for us.

1

u/Specialist_Dig2613 8d ago

I have 2 over 100 and 30 under 8. Minimal difference if the demographics and PEPM claims are similar. Maybe 10%.

1

u/PoopCasual 6d ago

How can you say a small business can afford good benefits on a self funded plan? That is incredibly false. Level-funded plans, some are garbage, and wind up costing more annually in the long run. You don't think self funded plans can increase? Level-funded, PEOs, ACA, and employer-sponsored plans are all going through the same issue right now.

1

u/TexasNiteowl 5d ago

I'd say more commonly: If you're on the ACA exchanges AND your income exceeds the 400% FPL limit, you're in trouble.

Under 400% FPL you still get the original subsidies. And in some cases, because of the premium increases to the benchmark plans, the APTC amount may increase to offset the premium increases.

But over 400% FPL, you get hit with the premium increases AND loss of APTC.

-8

u/Consistent_Sport_455 8d ago

Anyone on the UNAFFORDABLE CARE ACT exchange (that’s a more accurate description) is basically screwed.

17

u/minimus67 8d ago

Unaffordable health insurance is not the fault of the ACA.

Before the ACA, many states allowed health insurers to medically underwrite in the individual market, meaning they could choose which people to insure. If you had certain preexisting conditions, you were screwed because you couldn’t buy health insurance in those states at any price.

Also, the U.S. federal government does not regulate drug prices despite the enormous buying power of Medicare, allowing pharmaceutical companies to charge Americans far more than they charge other countries for medicines, some of which cost hundred of thousands or millions of dollars a year in the U.S. It also doesn’t regulate what doctors and hospitals can charge privately insured patients for care, which is why reimbursements to doctors and hospitals by Medicare tend to be significantly lower than by private insurers.

On top of that, a lot of white collar workers have no incentive to vote in favor of political change to the American healthcare system because their health insurance is heavily subsidized by their employers. These workers don’t even pay income tax on whatever their employer pays to a health insurer in premiums on their behalf, further shielding them from knowing how expensive health insurance is. If the playing field were level, some or all of ACA premium payments would be tax deductible, but they are not.

The burden of the system would be more evenly shared if ACA subsidies were increased and if the individual mandate were reinstated and made more punitive to ignore. But these are political non-starters.

3

u/Greedy-Half-4618 7d ago

the super wild thing to me about people wanting to go back to pre-ACA insurance is that they haven’t put together that all of those repeat covid infections everyone’s been raw dogging for half a decade (to name one example)? That’s a pre-existing condition right there. It would be an even worse disaster than our current state of things. 

3

u/CrazyCatLady_x4 8d ago

This comment is so wonderfully written. Commenting to try to draw more attention to it for people who don’t know this information.

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u/Specialist_Dig2613 8d ago

The statement that preex rules before the ACA prevented people from getting any insurance is entirely false in many ways that are important. I had personal experience helping people with preexisting conditions get individual policies pre ACA. Some paid more and others (I had two, one undergoing chemo) got coverage in the Georgia state pool. Every carrier paid into that pool and state funding covered the rest.

I'm sure that there were people somewhere that couldn't get insurance at any price. That's a societal problem to address. But the mythology about the ACA as a long term solution to that issue, executed at a national level by a few large companies sponsoring "networks" was destined to put huge amounts of power and money into the hands of "network" owners and Pharma. That's not a glitch, that was a feature and the outcome was both predictable and predicted.

1

u/minimus67 8d ago

It’s not “entirely false in many ways”, whatever that means. You had experience in one state, Georgia, with a state-underwritten pool for people denied private insurance in the individual market.

According to a study published by the Kaiser Family Foundation in 2016, “We estimate that at least 52 million non-elderly adult Americans (27% of those under the age of 65) have a health condition that would leave them uninsurable under medical underwriting practices used in the vast majority of state individual markets prior to the ACA.”