Health insurance cost increases predicted to cut millions from needed protection

Americans can be expected to spend more money on their health care this year, and Cherokee County residents are no exception.

Missing from both the appropriations package and the broader health care deal in Congress is an extension of the enhanced Affordable Care Act premium tax credits, which expired Dec. 31, 2025.

"Allowing the credits to expire will increase premiums, force some patients to drop coverage entirely due to cost, and reverse recent gains in access to care," states the article titled, "Congress advances health care package – but leaves coverage affordability behind," on the California Medical Association website.

The article said loss of insurance delays care, forgoes preventive services, and sends people for treatment to emergency rooms, which drives up costs and worsens outcomes.

Juanita Blair, with Juanita Blair Insurance Agency in Muskogee, answered some questions from Tahlequah Daily Press on the reasons behind the increase in insurance costs overall.

"Health insurance costs have been on the rise for many years now," Blair said. "There are many factors in the costs going up."

One reason is the ACA required health insurers to take anyone, regardless of preexisting health conditions.

"You were given the same age-based premium, whether you were sick and needing treatment from day one or healthy and expected to have little or no treatment," Blair said. "With most types of insurance policies, the premium is based on the risk."

For example, people who have traffic tickets or accidents find their auto insurance will cost more. If they have certain health conditions, a life insurance policy will cost more, Blair said.

"With health insurance, companies are taking on much more risk by not being able to rate-base on health conditions; it drove the costs up," Blair said.

This past year, the additional COVID-19 subsidies expired for those on the Health Insurance Marketplace. This is the exchange program that many people refer to as Obamacare, which caused a sudden rise in cost for those who qualified for subsidy and had been used to paying very little, Blair said.

"Individuals who are not on the Health Insurance Marketplace have been noticing these higher premiums for years," Blair said. "Their policy doesn’t cost any more than the same plan on the Marketplace, but they pay the whole premium instead of part of it being subsidized or paid for them."

Most of Blair's clients on the Marketplace noticed the big increase this year, with not as much subsidy being given, Blair said.

Blair is an independent insurance agent, meaning she is contracted with multiple insurers – not just for health insurance, but also auto, home and business.

"I write individual health insurance policies on and off of the Marketplace, as well as short-term medical, group plans and Medicare supplements," Blair said.

Some of her clients have had to go with higher deductibles and copays, or a plan with a smaller network of doctors, to keep their costs down.

"It’s not always my recommendation that they do that, but in the end, they have to make the decision about what they choose and can afford," Blair said. "My job is to explain the plan well so they understand the difference in what they are getting or not getting."

Blair said she is not aware of anything being considered by lawmakers to help the rising cost of individual health insurance premiums.

"Can the damage really be undone?" Blair said. "We always hear something is being worked on or suggested, but it’s just hard to know how it will be until we actually see it in action."

"Putting the Extraordinary Increase in ACA Premiums in 2026 in Perspective," an article on The Commonwealth Fund website, published Jan. 15, stated the premiums on the Marketplace increased by more than 20%. This is in part because insurers believe they are facing increased risk due to the expiration of the tax credits and other policies.

"A new Urban Institute report finds that marketplace benchmark premiums, i.e., the second-lowest-cost silver plans, have increased by an average 21.7%," states the article.

This increase is significantly larger than the 6%-7% projected increase in the employer-sponsored insurance market.

"This has led to claims that the ACA is a disaster, financially out of control, unsustainably expensive, and wasteful," states the article. "In reality, the 2026 premium increases are an aberration, far above those observed in recent years."

Those working on this report estimate the expiration of premium tax credits will result in 7.3 million fewer marketplace enrollees and an increase of 4.8 million Americans without insurance.

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