A new analysis shows that federal policy changes will significantly increase the cost of health insurance for millions of Americans next year. The report finds that residents of rural areas will be hit the hardest.
The non-profit Century Foundation conducted the study. It states that the end of expanded tax credits is the main reason for the price jump. These Biden-era subsidies are set to expire at the end of 2025 unless Congress acts to renew them.
This change will cause average premium costs to rise sharply. People in 32 states that use the federal health insurance marketplace will see a 93% increase.
The impact will not be equal. Rural residents in those states will see their costs jump by 107%. Urban residents will see an 89% increase.
Health insurers have already proposed a median premium increase of 18% for 2026. This is the largest hike since 2018. The expiring tax credits and other policy changes will add to this increase.
About 2.8 million people in those 32 states live in rural counties and use marketplace plans. This group includes 776,000 adults aged 55 to 64.
“Rural residents tend to be older. They may have more chronic illness,” said Jeanne Lambrew of the Century Foundation. “It costs more because they have greater needs and less access to health care.”
Researchers calculated the average annual premium for a rural resident will rise by $760. This is 28% more than the expected increase for city dwellers. States with the highest expected cost increases include Wyoming, Alaska, and Illinois.
The problem is worse in states that did not expand Medicaid under the Affordable Care Act. In those states, people with moderate incomes must use the marketplace for coverage. Of the seven states where over 10% of rural residents use marketplace plans, only two have expanded Medicaid.
State officials are urging consumers to be careful. Pennsylvania’s insurance commissioner advised residents to shop around for the best plan.
Lambrew warns that the high costs will force many to go without insurance. This can harm individual health and strain the healthcare system.
“We know health insurance matters,” Lambrew said. “Having these large potential increases on uninsured Americans is distressing.”
Key improvements made
Inverted Pyramid: The most critical information (who, what, where, when, why) is in the first two paragraphs.
Simplified Language: Complex sentences were broken down into shorter, more direct ones (e.g., “The non-profit Century Foundation conducted the study.”).
Clarity: Terms like “out-of-pocket premiums” were simplified to “costs” or “premium costs” for better understanding.
Logical Flow: Each paragraph builds on the previous one, grouping related ideas together (e.g., explaining why rural residents are more affected).
Neutral Tone: The language remains factual and objective, attributing claims to the report or its author.
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