Insurers propose an average 15% premium increase for 19 million ACA marketplace enrollees.

Americans with job-based plans, Affordable Care Act marketplaces and Medicare face higher bills next year from rising premiums, deductibles and copays. The cost drivers. Insurers' filings cite higher hospital prices, more doctor visits and costly GLP-1 drugs (injectable weight-loss medications) as the forces pushing healthcare spending up. For individual buyers, that pressure lands as enhanced Affordable Care Act (ACA) tax credits (federal subsidies that discount monthly premiums) expire at the end of 2025, leaving families to pay the full rate hike. The Medicare shift. Stand-alone drug plans face extra pressure because a federal pilot that capped monthly premiums is ending, forcing plans to set rates on their own. What next. State regulators will review and approve final rates before open enrollment starts this fall.

What the expiring Medicare drug pilot had been holding down:

• The Medicare drug pilot cut monthly base premiums by $15 in 2025 and capped plan hikes at $35; for 2026 it cut $10 and allowed hikes up to $50.
• A separate federal law caps annual growth in base drug plan premiums at 6% through 2029.