Fall Is Here — And So Are Health Plan Price Increases
- Jason Price
- 2 hours ago
- 3 min read
🌬 Change Is in the Air
As the leaves fall and the year winds down, fall is always a season of transition. But this year, there’s another change ahead — one that could hit your wallet harder than you expect.
Starting in 2026, Marketplace/ACA health plans are projected to rise dramatically as federal subsidies phase out. According to recent reports, average premiums could increase by 18% nationwide, with some states already projecting hikes of 25%–30%. And if enhanced federal subsidies shrink or expire altogether, families could see their out-of-pocket costs jump by 75% or more.
To put it in perspective: a household paying $300–$400 per month in 2024 could easily be looking at $600–$900 per month in 2026 for the exact same coverage. That’s not a minor budget change — that’s the kind of increase that forces families and self-employed individuals to make tough choices about healthcare, savings, and daily living expenses.
The drivers behind these steep increases are multi-layered:
Rising hospital and provider costs that continue to outpace general inflation
New, high-cost prescription drugs and advanced therapies hitting the market every year
Overall economic inflation pushing up everything from medical supplies to staffing costs
The possible rollback of enhanced subsidies, which have temporarily masked the true cost of ACA plans
All of this adds up to one conclusion: what felt “manageable” under today’s ACA rates may not be sustainable in the near future. Many families will soon realize that the security they thought they had in their coverage is slipping away, replaced by premiums and deductibles that grow faster than their income.
This fall is more than just a change of seasons — it’s a wake-up call. The decisions you make now about your health coverage will determine whether you face these 2026 increases head-on or get ahead of them with a smarter alternative.
📈 Why Private PPOs Are Winning Going Into 2026
Unlike Marketplace plans, private PPO coverage is designed to give families and self-employed individuals real value at lower costs, especially as we step into 2025 and prepare for 2026.
Here’s what sets them apart:
First-Dollar Benefits → With many ACA plans, you face deductibles of $5,000–$7,500 before coverage even begins. With private PPOs, there’s no deductible to satisfy first. Doctor visits, labs, and outpatient care are covered immediately, saving you thousands out of pocket.
Nationwide PPO Network → ACA networks can be restrictive, often limiting you to local providers or HMO-style setups. Private PPOs, by contrast, give you access to the UnitedHealthcare Choice Plus PPO — one of the largest networks in the country. That means freedom to see top doctors and hospitals nationwide without penalty.
Telemedicine 24/7 → Instead of waiting weeks for an appointment or paying $150+ out of pocket, private PPOs offer access to U.S. board-certified doctors any time of day — often with $0 consult fees.
Rollover Visits → Unlike ACA plans where unused visits are lost, private PPOs let you roll over unused doctor visits into the next year — so your benefits never go to waste.
Accident & Critical Illness Protection → ACA plans often leave you with big deductibles in emergencies. Private PPOs build in protection for accidents and critical illnesses, covering costs that would normally drain savings.
Tax Savings for the Self-Employed → Marketplace plans may offer subsidies, but if your income is too high, you don’t qualify. Private PPO premiums are often fully tax-deductible, turning a personal expense into a business write-off.
At the end of the day, private PPOs are about more than just “insurance.” They’re about predictability, stability, and control — three things that ACA plans simply don’t offer as we head into a year of major price hikes.