ACA funding alterations risk thousands’ welfare in CT

Impending Health Care Funding Changes Place Pressure on Insurance Costs

For many, health care is an unavoidable necessity. The demand for health insurance is high due to the often exorbitant costs associated with medical care. The Connecticut Insurance Department (CID) reviews proposed health insurance rate requests for individual and small group fully insured health plans each summer, ensuring that the proposed rates are reasonable and fair.

CID’s rate review process impacts the cost of fully insured health plans, which are sold both on and off the Access Health CT exchange. However, this year, the stakes are higher.

Potential alterations to the rules for funding, access, and eligibility for the Affordable Care Act (ACA) could disrupt the health coverage of many Americans, including Connecticut residents. The expiration of enhanced federal subsidies, or premium tax credits, might lead to notable increases in premiums and losses in coverage. These subsidies, which were expanded during the COVID-19 pandemic and extended through the Inflation Reduction Act, are set to expire at the end of the 2025 plan year unless renewed by Congress.

Adding to the uncertainty is the fact that health insurance rate increase requests are at their highest level since 2018. According to a report by the nonprofit health policy organizations KFF and the Peterson Center on Healthcare, the median increase in the states that have reported so far is 15%. The CID has received 2026 rate filings with average requested increases of 17.8% for individual health plans and 13.1% for small group plans.

Without the enhanced subsidies, the average ACA coverage could see a premium increase of 75%. The CID has noted a similar trend in the 2026 rate filings, with insurers attributing the potential expiration of subsidies as a significant factor influencing the average requested rate increase of 22.6%.

At present, over 139,000 Connecticut residents, which accounts for approximately 90% of Access Health CT enrollees, receive financial assistance. If the enhanced subsidies expire, these individuals and their families could face impractical premium costs that may lead them to drop their health insurance coverage entirely.

Moreover, the impact of federal changes extends beyond subsidies alone. The recently passed federal reconciliation bill and finalized Marketplace Integrity Rule propose new restrictions that could limit enrollment, reduce the enrollment period, and introduce additional administrative hurdles. These changes range from a shorter open enrollment window to the elimination of special enrollment periods for low-income individuals.

These alterations could lead to increased costs and reduced plan value, possibly raising out-of-pocket expenses while reducing the scope of covered services. In turn, this could have a wider impact on the healthcare system. As more people lose coverage, hospitals and providers could see an increase in uncompensated care, leading to higher costs across the system and potentially threatening the financial stability of some healthcare providers.

Health insurance is more than just a policy. It provides essential access to medical care and financial stability, particularly for those with pre-existing conditions or currently undergoing treatment. The ACA was established to increase access to affordable care. In 2025, a record 24 million people enrolled in ACA marketplace plans nationwide. However, this progress is now at risk.

While most Americans receive their health coverage through employer-sponsored plans, they are not exempt from the effects of these changes to the ACA plans and marketplace. Loss of employment-related coverage can be a life-changing event, and a subsidized ACA plan sold through the Access Health CT marketplace can serve as a critical safety net. Therefore, it is crucial to urge representatives in Congress to extend the enhanced subsidies and safeguard the progress made in healthcare accessibility.

Andrew N. Mais is Commissioner of the Connecticut Insurance Department.