ACA funding shift puts thousands in CT in jeopardy

Could you or someone you love need health care? For most of us, that's an easy yes, and most of us rely on health insurance to cover the sometimes astronomical cost. Every summer, the Connecticut Insurance Department (CID) is responsible for reviewing proposed health insurance rate requests for individual and small group fully insured health plans for the coming year.

It is the department's responsibility under state law to ensure these proposed rates are not excessive, inadequate, or unfairly discriminatory. These decisions affect what individuals and families pay for fully insured health plans sold both on and off the Access Health CT exchange.

This year there is more at stake.

Looming federal changes to the funding, access, and eligibility rules for the Affordable Care Act (ACA) threaten to disrupt health care coverage for millions of Americans, including tens of thousands of Connecticut residents. The expiration of enhanced federal subsidies, known as premium tax credits, could result in major premium increases and coverage losses. These subsidies were expanded during the COVID-19 pandemic and later extended through the Inflation Reduction Act. Unless Congress renews them, they will expire at the end of the 2025 plan year.

Amidst this uncertainty, health insurance rate increase requests nationwide are higher than they have been since 2018 at a median 15% for those states reporting, according to a report issued by the nonprofit health policy organizations KFF and the Peterson Center on Healthcare. CID received 2026 rate filings with average requested increases of 17.8% for individual health plans and 13.1% for small group plans.

The report estimates that without the enhanced subsidies, the average American who buys ACA coverage could see their premiums increase by 75%. The Connecticut Insurance Department has observed a similar trend in the 2026 rate filings, where insurers have cited the possible expiration of these subsidies as a key factor driving an average requested rate increase of 22.6%.

Currently, about 90% of Access Health CT enrollees -- more than 139,000 Connecticut residents -- receive financial assistance. If the enhanced subsidies expire, nearly all of these individuals and families could face unsustainable premium costs that may force the difficult decision to drop health insurance coverage entirely.

The impact of federal changes goes beyond subsidies. The recently passed federal reconciliation bill and finalized Marketplace Integrity Rule impose new restrictions that limit who can enroll, reduce the enrollment period, and introduce more administrative hurdles. These changes include:

A shorter open enrollment window, the removal of assistance for many non-citizen groups including Deferred Action for Childhood Arrivals (DACA) recipients;

The elimination of special enrollment periods for low-income individuals; and

Additional verification and payment requirements that may delay or prevent coverage for many who qualify.

Other provisions could increase costs while reducing plan value, raising out-of-pocket expenses while reducing the scope of covered services. These changes may also have a broader impact on the health care system. If more people lose coverage or forego care due to rising costs, this doesn't mean they won't still get sick. More likely, they will go to expensive emergency rooms which are required by law to treat patients regardless of their ability to pay. As a result, hospitals and providers could see an increase in uncompensated care.

This added financial strain may lead to higher costs across the system, contributing to increased insurance premiums for those who remain insured. In addition, it may threaten the financial stability of some hospitals, affecting the availability of health care.

Health insurance is more than a policy. It is the ability to see a doctor when you are sick, fill a necessary prescription, or get preventive care that may avoid more significant problems later. For thousands of Connecticut families, ACA marketplace plans provide essential access to coverage and financial stability. This is especially true for those with pre-existing conditions or currently under treatment.

The ACA was created to increase access to affordable care. In 2025, a record 24 million people enrolled in ACA marketplace plans nationwide. The progress the ACA has made over the years is at risk.

The decisions being made in Washington will shape access to care and health care costs for years to come.

Most Americans receive their health coverage through employer sponsored plans. But those individuals are not immune from the impacts of these changes to the ACA plans and marketplace. Losing the coverage that comes with employment is a life-changing event. A subsidized ACA plan sold through the Access Health CT marketplace is a safety net any one of us might need someday.

Now is the time to contact your representatives in Congress and urge them to extend the enhanced subsidies and protect the progress we have made.