Philly's health insurance costs set to spike
Add Axios as your preferred source to
see more of our stories on Google.
Illustration: Annelise Capossela/Axios
Open enrollment for Pennsylvania's health insurance marketplace begins Saturday, and nearly 500,000 people could see their coverage costs for next year soar as federal aid that kept premiums low is set to expire.
Why it matters: The state estimates that about 150,000 could drop their plans because they're unaffordable, per the Inquirer.
Catch up quick: Affordable Care Act tax credits — federal subsidies that lower monthly costs for people with marketplace coverage — are a key sticking point in the government shutdown.
- Democrats have tied extending those subsidies — which expire at the end of the year — to budget negotiations, a standoff that helped trigger the shutdown when Republicans disagreed.
- GOP leaders have said they won't budge until Democrats back their funding bill.
The big picture: Without the tax credits, Pennie — Pennsylvania's ACA marketplace — estimates the monthly plan costs will soar an average of 102% statewide in 2026.
- That figure factors in next year's 21.5% bump in premiums.
- People living in Pennsylvania's rural counties are expected to be hit the hardest if the tax credits aren't extended.
By the numbers: Philadelphia County will see monthly premium costs rise by $137 on average, per Pennie.
- In Philly's collar counties, average plans are expected to cost between $126 to $140 more each month.
Between the lines: This comes after the uninsured rate for working-age Pennsylvania adults dropped from 13.6% in 2013 to 7.1% in 2023, per an analysis from the Commonwealth Fund, a health care foundation.
- Pennie saw record-breaking enrollment this year.
Pro tip: KFF has a tool to help you calculate how much your rates will increase.
What we're watching: There is still time to extend the tax credits before the deadline. But Republicans have signaled they want to see changes to the subsidies, which makes that possibility murkier, reports Axios' Peter Sullivan.