Medicare Advantage 2026 Spotlight: A First Look at Plan Premiums and Benefits
This brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2026 and key trends over time.
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This brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2026 and key trends over time.
In a new column, President and CEO Dr. Drew Altman forecasts eight things to look for in health policy in 2026. “First and foremost,” he writes, “is the role health care affordability will play in the midterms.” And, he notes: “The average cost of a family policy for employers could approach $30,000 and cost sharing and deductibles will rise again after plateauing for several years.”
This survey explores how ACA Marketplace enrollees expect to respond if their premium payments doubled as expected in 2026 when enhanced premium tax credits are set to expire. About a third would very likely look for a lower-cost plan, even if it had higher deductibles, and about a quarter would very likely end up uninsured. The survey also examines how increased health care costs may affect their finances and the potential impact in next year's elections.
If the amount they pay in premiums doubled, about one in three enrollees in Affordable Care Act Marketplace health plans say they would be “very likely” to look for a lower-premium Marketplace plan (with higher deductibles and co-pays) and one in four would “very likely” go without insurance next year, finds a new survey of…
Proposals from some Republicans in Congress would effectively repeal some or all of the ACA premium tax credits and replace them with contributions to Health Savings Accounts (HSAs) or something similar. Senator Rick Scott proposes “Trump Health Freedom Accounts” and Senator Bill Cassidy proposes HSA contributions available only for people who enroll in bronze level ACA plans to pay for out-of-pocket health care costs.
Prior authorization review frustrates patients and physicians, but we likely can’t just eliminate it. In his new column, President and CEO Dr. Drew Altman discusses why, and why the focus is now instead on “doing it smarter.” Altman writes: “A proposal to eliminate prior authorization altogether could be the single most tangible and popular health reform idea a candidate could make. But, in our fragmented health system, with no great way to control costs or limit unnecessary care, we seem to be stuck with prior authorization review…and most payers are now trying to ‘do prior authorization review smarter.’”
The survey provides an in-depth look at trends in employer-sponsored coverage in California, including premiums, cost sharing, offer rates, and employer strategies to manage costs and access to care, including comparisons to the nation overall.
This analysis compares ACA Marketplace costs to employer-sponsored health insurance costs and finds that individual market premiums have become more similar to employer-sponsored premiums over time. In 2024, individual market insurance premiums averaged $540 per member per month, slightly below the average $587 per member per month premium for fully-insured employer coverage.
The ACA's enhanced premium tax credits are set to expire at the end of 2025. This calculator estimates how much out-of-pocket premiums would increase for families if Congress does not extend the credits. The projected premium increases are estimated based on family income, zip code, size, ages, and 2026 ACA Marketplace premiums.
The amount health insurers charge for coverage on the ACA Marketplaces is rising 26%, on average, in 2026.... Most enrollees would face even sharper increases in what they pay if they ACA’s enhanced premium tax credits expire.
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