Most Massachusetts residents will see higher insurance bills this year — but for those who get insurance through the Affordable Care Act, or Obamacare, the jump will likely be much bigger unless Congress acts soon. In Massachusetts alone, nearly 400,000 people enrolled in the program for the 2025 year. Nationally, the number is about 24 million enrollees.
The Affordable Care Act open enrollment period started Saturday and runs through Jan. 23, 2026.
David Seltz, executive director of the Massachusetts Health Policy Commission, said the increase in insurance costs will put health care out of reach for many lower-income families.
“They don’t qualify for our state’s Medicaid program because they have a little bit higher income, don’t have insurance through their employer,” he said on GBH’s Morning Edition. “They fall right in this in-between space. And this is really what Obamacare was meant to cover.”
Unless Congress takes action, those subsidies will expire on Dec. 31, making the issue one of the key sticking points in ending the current government shutdown. Congressional Democrats want these subsidies that help pay for people’s health insurance to be part of any deal to reopen the government, while Republicans are demanding the government open first before any negotiations on health care.
This uncertainly, Seltz says, is causing stress for people who will see prices jump in January. If the credits expire, premiums will increase $1,300 annually, on average.
Health care premiums are also rising across the board for both public and private coverage, with data showing costs outpacing inflation.
“We’re looking at 12% to 14% increases in the premiums ... and this comes after big numbers last year,” Seltz said.
Seltz says the increasing costs are due to a variety of factors — but locally, the major driver has been prescription drugs.
“We’re a global hub for innovation, but some of these breakthrough drugs come at a very high price, and that’s causing affordability challenges. One example is these new weight loss drugs, or GLP-1s. The studies show that they’re very effective, but they are causing a really big affordability challenge,” he said.
The Congressional Budget Office is projecting that anestimated 3.8 million Americanswill become uninsured annually over the next eight years. Seltz says that losing access to health care will have significant ripple effects.
“That means that they’re not getting the care that they need when they need it, [or] they’re not filling their prescription, and that can lead to worsening health outcomes,” Seltz said. “That can lead to an exacerbation of health conditions and, oftentimes, that may lead to people using the emergency departments. And we already have a very crowded emergency department situation in Massachusetts.”
“Really, we need the federal government to step up and to continue to help support this coverage,” he said.
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