BCN is filing a year-over-year average rate increase for 2026 for all individual products that were offered in 2025 of 16.3%. Significant contributors to rate change are outlined in the table below:
Experience Restate 4.0%
Medical and pharmaceutical price and utilization trend 5.4%
ARPA Subsidy Expiration Impact 4.6%
Benefit Change and CSR -2.6%
Margin Impact 1.2%
...Incorporated in the above, BCN assumed an additional pharmacy price trend due to tariffs, as follows:
Generic +2.5%
Brand +10%
Specialty 0%
Total Impact +2.5%
...Consistent with the 2025 filing, BCN has assumed no CSR payments will be made by the federal government for 2026. Therefore, rates for Silver plans offered on exchange are 20.5% higher than if the federal government funded CSR subsidies.
Last month, in response to House Republicans passing their version of the budget resolution bill, I broke out total enrollment in Medicaid via ACA expansion, ACA exchange Qualified Health Plan (QHP) enrollment and ACA-based Basic Health Plan (BHP) enrollment by Congressional District in order to try and get a sense of just how many Americans healthcare coverage is at risk from the bill...and how that breaks out along partisan lines at the House District level.
As I noted at the time, Republicans seem to be under the impression that it will mostly be Democrats who get screwed by their bill, since 9 of the 10 non-expansion states are Republican strongholds...while some Democrats seem to be under the impression that it will mostly be rural MAGA republicans who get screwed.
Senate GOP tax bill would hit politically explosive Medicaid provision
The Finance Committee is due to brief members on its megabill draft text Monday night.
Senate Republicans are seeking to ratchet up savings from a politically explosive policy within Medicaid to pay for their megabill, and it’s already setting off shockwaves through Capitol Hill.
The Senate Finance Committee’s forthcoming portion of the party-line tax and spending package would lower the Medicaid provider tax to 3.5 percent, according to three people with direct knowledge of the legislation who were granted anonymity to discuss it.
The 4,000 California National Guard soldiers who President Donald Trump surged into Los Angeles remain unpaid due to delays in issuing official activation orders, leaving compensation and benefits in limbo.
According to more than a dozen Guardsmen across four units who spoke to Military.com, none has received formal activation orders, the critical paperwork that not only authorizes their duty status, but also unlocks pay, Tricare health benefits and eligibility for Department of Veterans Affairs services. Without those orders, troops remain in a legal and administrative limbo.
Multiple defense officials with direct knowledge of the situation told Military.com the chaotic and sudden activation of troops has effectively clogged up the flow of administrative work.
16 Million Americans Would Become Uninsured Due to Reconciliation Bill and Loss of Tax Credits; 8.2 Million in Marketplaces Alone
Leaders from State-based Health Insurance Marketplaces, Enrollees, Providers, and Small Business Highlight Potential, Devastating Impacts
(Washington, DC) The Congressional Reconciliation bill and loss of federal tax credits would result in 16 million Americans losing health coverage, including 8.2 million enrolled in Health Insurance Marketplaces. By stripping millions of lives from the Marketplaces, health care will be more expensive, harder to access, create a strain on health care systems, and hurt small businesses.
Governor Kathy Hochul today released new data showing the massive impact the GOP’s ‘Big Ugly’ Reconciliation Bill would have on New York families. The latest bill threatens to severely disrupt health coverage for millions of New Yorkers. In addition to increasing the number of uninsured by 1.5 million and stripping $13.5 billion in annual funding from New York’s healthcare system, the bill would trigger steep increases in private health insurance premiums for vulnerable New Yorkers and impose excessive burdens on consumers enrolling through NY State of Health, the State’s official health plan marketplace.
But the plans were on display…”
“On display? I eventually had to go down to the cellar to find them.”
“That’s the display department.”
“With a flashlight.”
“Ah, well, the lights had probably gone.”
“So had the stairs.”
“But look, you found the notice, didn’t you?”
“Yes,” said Arthur, “yes I did. It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard.”
There was a lot to unpack there, all of it pretty horrible...but I felt one provision in particular was worth its own separate post:
Funding Cost-Sharing Reductions.
Enacting section 44202 would affect the cost-sharing reductions that the ACA requires insurers to offer to eligible people who purchase silver plans through the marketplaces. Those reductions increase the actuarial value—the average share of covered medical expenses paid by the insurer—above the amount in other silver plans, resulting in lower out-of-pocket costs for eligible enrollees. To be eligible for cost-sharing reductions an enrollee’s income must generally fall between 100 percent and 250 percent of the FPL; the subsidy varies with income.
BALTIMORE (June 3, 2025) – The federal budget reconciliation bill passed by the House earlier this month will have significant consequences for the Affordable Care Act in Maryland, if it becomes law as is. For the nearly 250,000 Marylanders who buy health insurance through Maryland Health Connection this bill will increase premium costs, and create unnecessary, inefficient barriers to enrollment.
“For many of those enrolled in Maryland Health Connection, this proposed bill will drive up prices and increase the barriers to quality health insurance,” said Michele Eberle, executive director of Maryland Health Benefit Exchange. “Maryland Health Connection has increased enrollment by 40% in the last four years, because people who know how important health insurance is have found it affordable.”
The Congressional Budget Office has published several projections about how many people would lose healthcare coverage and/or become uninsured (these aren't the same thing) under various versions of the #OneBigUglyBill Act passed by House Republicans, which is currently beginning its next phase over on the Senate side of the Capitol.
Their most recent projection put the total at around 11.7 million when you include some technical weirdness which I'm a little vague about...plus another 3.8 million if you include their projection from December 2024 regarding the impact of the upgraded ACA subsidies included in the Inflation Reduction Act being allowed to expire at the end of this year. This placed the grand total at around 15.5 million...except they more recently sent a letter to the House Energy & Commerce Committee which bumped this estimate up a bit more, putting the combined total at 15.9 million.
