- Joined
- Aug 10, 2013
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- 25,684
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- Cambridge, MA
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- Political Leaning
- Slightly Liberal
History repeats itself. In his first term, Trump took office and immediately started taking actions to deliberately jack up insurance premiums in the ACA marketplaces (Trump causing double digit premium increases). The result was by far the largest jump in marketplace premiums (34%) on record in 2018.
Since that last Trump Bump in premiums, ACA marketplace haven't really risen at all. Average benchmark premiums in the ACA marketplaces in 2025 are only about 3% higher (in nominal dollars, meaning they have fallen substantially in inflation-adjusted dollars) than the average post-Trump Bump 2018 benchmark premium. Economy-wide, of course, prices and wages are quite a bit higher this year than they were in 2018. But marketplace premiums have been flat for seven years.
Marketplace Average Benchmark Premiums
Until now. Trump and the GOP have taken a number of steps that have insurers proposing significant (15%) premium increases for next year.
Worse, of course, is that the GOP's reversal of Biden's enhancements to the ACA premium tax credits (better scaling premiums to people's incomes) mean that the impact on what people actually pay next year will be significantly more, making coverage much less affordable.
Years of recovery from the first Trump administration, with flat premiums and insurers streaming into the marketplaces under Biden, substantially increasing the choices available to buyers (actually exceeding under Biden the average number of competing insurers during the competitive early days of Obamacare, after sharp decreases in competition in the first Trump administration) are now in jeopardy and all but certain to be reversed.
Number of Insurers Participating in the Individual Health Insurance Marketplaces
Once again, thanks to Trump's purposefully disastrous (malevolent) mismanagement, premiums are poised to spike, competition is about to wane, and people are about to feel a significantly harsher pinch from health care costs. Like clockwork.
Exchange premiums may rise the most since 2018
Thanks, Trump and the GOP!
Since that last Trump Bump in premiums, ACA marketplace haven't really risen at all. Average benchmark premiums in the ACA marketplaces in 2025 are only about 3% higher (in nominal dollars, meaning they have fallen substantially in inflation-adjusted dollars) than the average post-Trump Bump 2018 benchmark premium. Economy-wide, of course, prices and wages are quite a bit higher this year than they were in 2018. But marketplace premiums have been flat for seven years.
Marketplace Average Benchmark Premiums

Until now. Trump and the GOP have taken a number of steps that have insurers proposing significant (15%) premium increases for next year.
Worse, of course, is that the GOP's reversal of Biden's enhancements to the ACA premium tax credits (better scaling premiums to people's incomes) mean that the impact on what people actually pay next year will be significantly more, making coverage much less affordable.
Years of recovery from the first Trump administration, with flat premiums and insurers streaming into the marketplaces under Biden, substantially increasing the choices available to buyers (actually exceeding under Biden the average number of competing insurers during the competitive early days of Obamacare, after sharp decreases in competition in the first Trump administration) are now in jeopardy and all but certain to be reversed.
Number of Insurers Participating in the Individual Health Insurance Marketplaces

Once again, thanks to Trump's purposefully disastrous (malevolent) mismanagement, premiums are poised to spike, competition is about to wane, and people are about to feel a significantly harsher pinch from health care costs. Like clockwork.
Exchange premiums may rise the most since 2018
That would represent the largest rise in premiums since 2018, and for similar reasons. The year before, President Donald Trump and the majority-Republican Congress came close to repealing the Affordable Care Act of 2010, leading insurers to raise prices amid uncertainty.
Exchange premium hikes in recent years have been much smaller, the KFF study shows. Average rates rose 7% for the 2025 plan year and 6% the year before. Exchange membership reached a record-high 24.3 million in 2025.
During this rate season, exchange insurers anticipate that Trump and the GOP Congress will allow the enhanced premium tax credits in place since 2021 to expire at the end of 2025. The Centers for Medicare and Medicaid Services also tightened enrollment rules starting next year.
The nonpartisan Congressional Budget Office projects these two changes will cause 5.1 million people to become uninsured starting next year. Exchange members who remain are expected to be relatively sicker and costlier to insure.
Rate requests for 2026 also cite the effects of tariffs on pharmaceuticals, medical devices and other products, spending on glucagon-like peptide-1 agonists for weight loss, provider demands for higher reimbursements, and generally rising healthcare costs as justifications for price increases.
Moreover, the health insurance sector expects exchange enrollment to further diminish, and risk pools to worsen, as provisions from Trump’s “One Big Beautiful Bill” begin to take effect, including $200 billion in exchange spending cuts over a decade.
Thanks, Trump and the GOP!
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