Why Brokers Need to Prepare for a Wave of ACA Premium Increases
Members of Congress and the White House failed to reach a new deal to extend the Affordable Care Act (ACA) premium subsidies beyond the end of 2025. As a result, millions of Americans are expected to drop their ACA plans in 2026.
Some may go without health insurance altogether. Many may consider joining their employer’s group health plan, if any. Others may be on the hunt for alternative Individual & Family Plan (IFP) coverage, outside of the Covered California or Nevada Health Link exchanges.
As a Word & Brown broker, you need to be ready to help them.
What the Expiration of Enhanced APTC Means for Your Clients
According to an analysis by KFF, most enrolled in ACA coverage through a state or federal exchange received an enhanced premium. With the expiration of the enhanced tax credits, many could still qualify for a smaller tax credit. However, others will lose their eligibility and face a much higher premium.
KFF says with the enhanced tax credits, an individual earning $28,000 paid around 1% ($325) of their annual income for a benchmark plan last year. With the enhanced tax credit expiration, this same individual will likely pay around 6% of their income ($1,562 annually) toward a similar plan in 2026.
Those with incomes above 400% of the Federal Poverty Level (FPL) are seeing significant increases in exchange coverage premiums. For example, for a 60-year-old couple making $85,000 (402% FPL), the premium increase exceeds $22,600. That’s more than a quarter of the couple’s annual income.
How Brokers Can Pivot Clients to More Stable Small Group Options
If you’re a California broker, you can partner with Word & Brown’s Duncan Shader to help your clients shop for alternatives. Duncan is W&B’s IFP Sales Representative. He focuses exclusively on IFP and has 30+ years of experience at Word & Brown. He can help you find the right coverage at the right price for your clients. If you want IFP help in California, send an email to dshader@wordandbrown.com or give him a call at 714.567.4657.
Nevada Brokers: Alternative Solutions to Explore
At this time, W&B does not offer IFP in Nevada. However, the Nevada Sales Team may be able to discuss other ways to respond to Nevada clients seeking alternative ACA options. For example, some of your clients may be eligible for Association Health Plan (AHP) coverage through Anthem Blue Cross Blue Shield or Prominence Health Plan. Anthem offers AHP coverage to members of multiple Chambers of Commerce. Prominence Health offers AHP coverage to Nevada members of CAWA (the California Automotive Wholesalers’ Association), the Clark County Bar Association, the Nevada Builders Alliance, the Nevada Landscape Association, the Reno + Sparks Chamber of Commerce, and the Washoe County Bar Association. Reach out to Mona Hannah or Josh Carle to learn more.
