Personal Finance (Not Investing) • ACA premiums 2026

We have ACA plans in my state that are called PPOs, but all of them have very restricted networks and function more like EPOs. PPOs really don't exist anymore. The "best" one from BCBS only covers care at one of the 4 major academic hospital system in my area. At least it is one of the better ones now - it used to be the worst one. And using the Marketplace tool to screen your providers and medications to see which plans cover what are filled with errors every year. It is extremely stressful, and I never really know for sure until the new years starts if I am going to be ok.

Thanks for sharing your experience. This is pretty much what we are seeing and the reason that I'm going to hold off on early retirement for this year at least.

Myself and DW were on an ACA "Elite Gold" "HMO" plan from Ambetter for 2 years ending 25.03, and I was pleased with them (which is something I don't think I've ever said about a Health Insurer in 35-odd years).

Thanks for sharing your experience with Ambetter, good to know. I think this seems to be highly regional. The Ambetter plans in my area don't seem to cover most of the providers we checked and perhaps one single hospital system.

If Bogleheads are feeling this so acutely, I wonder when public uproar will pick up. With this escalation in pricing on premiums, visits and imaging, the average Joe can't keep up. It would seem a decline in public health and mortality is inevitable.

I hope I'm wrong but I'm not (yet) convinced that public uproar will materialize, and even it it did, make much of a difference. A lot of these cascading effects have been predicted for months by health thinktanks like the Kaiser Foundation, and have had zero effect on the outcome.

But as I said in my example above, it’s hard to say my 2026 ACA coverage is affordable when my/spouse’s full 2026 ACA premiums are estimated to be $51k (with $4k in deductibles + OOP vision and dental) if our pretax 2026 ACA MAGI is > $86k (which it will be in a VHCOL area). That is unsustainable for any but the 1%. It will also likely put a damper on long early retirements.

This is really a stunning example. $51K out of a $86K MAGI for probably lousy insurance. Wow.

Statistics: Posted by musicislife — Mon Aug 25, 2025 8:41 am — Replies 98 — Views 10786

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