{"id":297040,"date":"2025-11-17T12:31:10","date_gmt":"2025-11-17T12:31:10","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/297040\/"},"modified":"2025-11-17T12:31:10","modified_gmt":"2025-11-17T12:31:10","slug":"are-health-insurance-premiums-skyrocketing-where-you-live-in-pa-heres-why","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/297040\/","title":{"rendered":"Are health insurance premiums skyrocketing where you live in Pa.? Here\u2019s why"},"content":{"rendered":"<p class=\"article__paragraph article__paragraph--left\" id=\"SJ3DFXLB4BBM3B7DS23K64ZKBI\">You may well be able to add rising health insurance premiums to the inevitable duo of death and taxes \u2014 especially if you live in central Pennsylvania.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"KNFI4WDNRNHRFNDPBE3GTQ4YKI\">Few Americans will escape the sticker shock of health insurance premiums. The rates are going up, especially for <a href=\"https:\/\/www.pennlive.com\/politics\/2025\/10\/pa-residents-getting-health-insurance-through-the-marketplace-brace-for-huge-premium-increases.html\" target=\"_blank\" rel=\"nofollow noopener\" title=\"https:\/\/www.pennlive.com\/politics\/2025\/10\/pa-residents-getting-health-insurance-through-the-marketplace-brace-for-huge-premium-increases.html\">those who get coverage on the marketplace exchange. <\/a>That\u2019s in large part due to the growing likelihood that enhanced tax credits under the Affordable Care Act are about to expire.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"MT57QJTNSVGT3AZJ4MUJYS2I2M\">Across the central Pennsylvania region, though, the rate of increases outpaces the rest of the commonwealth. That\u2019s true across all income and age brackets, but in particular, high earners in the 60+ age group, according to data from the health advocacy group, <a href=\"https:\/\/www.kff.org\/quick-take\/aca-insurers-are-raising-premiums-by-an-estimated-26-but-most-enrollees-could-see-sharper-increases-in-what-they-pay\/\" target=\"_blank\" rel=\"nofollow noopener\" title=\"https:\/\/www.kff.org\/quick-take\/aca-insurers-are-raising-premiums-by-an-estimated-26-but-most-enrollees-could-see-sharper-increases-in-what-they-pay\/\">the Kaiser Family Foundation. <\/a><\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"CG4HSOA7VVFETCMMEHHVZH73KE\">In some cases the price hike will be staggering.<\/p>\n<p><img fetchpriority=\"low\" loading=\"lazy\" decoding=\"async\" alt=\"Cost of health insurance premiums\" class=\"article__image-content\" src=\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/11\/KWD4UUNRVBG4LGONBKXNVSVRFE.png\"  \/>Parts of central Pennsylvania area poised to see some of the highest rates of increase in the cost of health insurance premiums. The expiration of enhanced premium tax credits have something to do with that, but also other factors.<br \/>\nScreenshot: Pennie websiteScreenshot<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"LPB2DIKLQNCBTOU6BU5ZPXUL3A\">Insurance shoppers in Dauphin County, for instance, would see a nearly a 200% average monthly increase without the enhanced subsidy, <a href=\"https:\/\/pennie.com\/affordability\/\" target=\"_blank\" rel=\"nofollow noopener\" title=\"https:\/\/pennie.com\/affordability\/\">according to Pennie,<\/a> the Commonwealth\u2019s public insurance marketplace.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"DOE5V6VGKFED3L3VN4ETUSZAYI\">Two counties over, residents in Juniata County will see a 485% increase.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"BPTUNTJDANGOHPWK6Q7OBZ5AJU\">KFF, using federal data, gets even more granular: The average 40-year-old who earns $65,000 or more in central Pennsylvania and shops for insurance on the marketplace could see an i<a href=\"https:\/\/www.nytimes.com\/interactive\/2025\/10\/30\/upshot\/obamacare-subsidies-new-prices.html?unlocked_article_code=1.yE8.pNX4.4JEMSb99hS1G&amp;smid=url-share\" target=\"_blank\" rel=\"nofollow noopener\" title=\"https:\/\/www.nytimes.com\/interactive\/2025\/10\/30\/upshot\/obamacare-subsidies-new-prices.html?unlocked_article_code=1.yE8.pNX4.4JEMSb99hS1G&amp;smid=url-share\">ncrease of as much as $500 a month<\/a>. Think small business owners and self-employed people.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"DS3F2DNQGNH5NE6L72EB4HGVRU\">A 60-year-old in that same income bracket would face a staggering $1,000 a month increase for premiums, compared to $500 elsewhere across the state.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"PHLY77HK3ZC2FKZJSOIA44EKMI\">\u201cWe\u2019re trying to figure out what\u2019s going on here in central Pennsylvania because we\u2019ve seen with our payroll groups and group insurance some of the largest increases we\u2019ve seen since I\u2019ve been doing this,\u201d said Fred Reeder, president of Lock Haven-based R&amp;B Insurance Services.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"6HHPM6VWIFFHRA6FJ3CYEVE2XM\">\u201cThe older individuals seem to be the ones taking the largest hit.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"P5ZEUGGAUVDCDIRPM2J3E3BBXU\">For anyone feeling a sense of comfort because they have private or workplace health insurance, brace for the reality check: As Reeder explained, premiums are going up across the board, even for so-called payroll programs, which include small businesses.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"TDE2LHNM25HMLBM4TWTYC2TP2M\">\u201cIt\u2019s widespread,\u201d he said. \u201cIt\u2019s not just the individual market, it\u2019s your groups also.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"G7YZXK3OURBZLEEQRGBK4WSRRQ\">Self-funded companies, Reeder explained, are likely to have some protection because they\u2019re paying the claims and their stop-loss. Everything is based on their claims. <\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"BPEWFQQWHZD43LXGPVYYAZYFIU\">Everyone else seems to be in a panic mode.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"XRBUMTVRGFEEJMP4HPSYOUU3VU\">\u201cWe are the busiest we\u2019ve ever been with our phones ringing off the hooks where folks are just trying to find solutions for affordable health care,\u201d Reeder said. \u201cRight now they may be paying $200 to $300 for a plan, but if the subsidies go away, you\u2019re talking $800 or $1,000 or more that they\u2019d be paying for the same type of insurance.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"PUQL3VAOLJAMZJADEUOTJ5IZYM\">Reeder has in some cases already seen rates increase by as much as 78% for businesses. <\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"IU2BOUY2KNAIVKNW75UMUAB7MQ\">\u201cNo business can absorb a 78% increase,\u201d he said.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"YI4J2VNEB5CNVDWME5DG6TEUTY\">Pennsylvania is divided into nine \u201cgeographic rating areas.\u201d Healthcare across central Pennsylvania tends to cost more than elsewhere, including the Pittsburgh and Philadelphia regions. <\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"H3X2REGH6BERBC7X725COJNQSE\">Factors contributing to that high rate include higher costs charged by hospitals, health systems, and physicians; a continuing post-pandemic surge in people seeking care and the pending expiration of the ACA tax credits in the personal marketplace.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"LBXTNOKWSBEEJKPPPZHHWYQSGE\">Devon Trolley, executive director of Pennsylvania\u2019s health insurance marketplace, Pennie, that serves some 500,000 people, notes that this year insurance customers will be hit with a double punch: the overall sticker price of coverage (the rates that insurance companies charge) and the premium tax credits under ACA, which help reduce the cost so that people don\u2019t pay the full price. <\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"JDERFGB6SVHGRPLS2BRALT3TC4\">The health of the population and the amount of healthcare needed can cause rates to go up, she explained. But when it comes to the subsidies, disparities among insurance plans have a lot to do with spiking rates.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"ALQZZDMBYRFJ7HGJ6CLSEWDT64\">\u201cWhat\u2019s often happening is some plans are going up a lot,\u201d Trolley said. \u201cAnd the benchmark plan, which is the plan that determines how much tax credit you get, is not going up as much. So it\u2019s creating a gap.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"5OXWOKZCNRA3TCVDHU3K6K57YY\">Benchmark plan gaps can help explain the sizeable disparities among Pennsylvania\u2019s regions, on top of lower or non-existent premium subsidies.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"SSD5QGIB6BDLDOOJ2GDVW2RAD4\">\u201cSo normally the tax credits could keep pace,\u201d Trolley said. \u201cAnd sometimes you see those differences that the benchmark plan isn\u2019t keeping pace even in a normal year.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"4FDU65NSS5ELJG3ZVKTTMS3O5E\">This year benchmark plans are not increasing as much as all the other plans and the premium tax credits are coming to a halt.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"BKD5HKNGCZG3JOPFBWHCRB4HLQ\">A region\u2019s rating is dependent on a specific mix of the health plans in that area and the population in that area. An older population, which needs more medical care, can skew the price increase year over year.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"OLIQJNPT2VHP5C4FE2F3NGRWDA\">The data suggests that rates in some areas across central Pennsylvania had been lower than average in prior years, Trolley said. Now they are catching up and getting closer to the average for the rest of Pennsylvania. <\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"6KJ3A67VFREHTDTNLFSRAGYQSM\">\u201cSo it\u2019s more of a question of why were they lower in prior years? Which we have not really dug into,\u201d Trolley said. <\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"47ZEI5YK3NF23OKKX65HO5PKME\">\u201cWhatever has impacted other areas is now kind of impacting (central Pennsylvania regions) this year. But it\u2019s also the year where the tax credits are going down so you have all these factors working together for really significant increases.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"5JRDDT2SMVGM7ACSHEIEX6CHVY\">Last year, for instance, the net monthly premium for people in the Juniata and Fulton counties region was the lowest in Pennsylvania \u2014 the average individual was paying under $100, compared with an expected average of $400 in the coming year.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"SGBZBWW4EZGOFA2POZ62DRXABU\">Another factor is the cost of and demand for weight-loss drugs known as GLP-1s, with some simulations showing increases of 5% to 13% or more depending on factors like eligibility and drug cost, according to research by the AMA and the Centers for Disease Control and Prevention. <\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"BGYY4SFZNJCGRNSFQH4WHHZXAM\">According to the latest KFF Health Tracking Poll, drugs like Ozempic, Wegovy, Mounjaro and others taken by one in eight adults (12%). About half (54%) of all adults who have taken GLP-1 drugs say it was difficult to afford, including one in five (22%) who say it was \u201cvery difficult.\u201d <\/p>\n<p><img fetchpriority=\"low\" loading=\"lazy\" decoding=\"async\" alt=\"Weight-loss medication\" class=\"article__image-content\" src=\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/11\/I42ZRLDTORGWLIAHIR5PEMXALM.jpg\"  \/>The high cost of GLP-1 drugs is contributing to rising health insurance premiums, with some simulations showing increases of 5% to 13% or more depending on factors like eligibility and drug cost, according to research by the AMA and the Centers for Disease Control and Prevention. (Photo by James Manning\/PA Images via Getty Images)PA Images via Getty Images<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"USRHAOEH35FELMAYVXSCC6ZZ3M\">Researchers found that from 2018 to 2023, spending on GLP-1s rose by more than 500%, from $13.7 billion to $71.7 billion.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"LZDSDQHQRBEWLACUSFFJAW5CMM\">\u201cYou\u2019re seeing more GLP-1 drugs being prescribed for things other than diabetes,\u201d Reeder said. \u201cYou\u2019re talking like an Ozempic, which is a $1,200 to $1,500 prescription and somebody\u2019s healthcare is $600 a month. The carrier is losing money on that. So the first thing they\u2019re gonna do is try to recoup their premium dollars. When we\u2019re working with larger groups that are doing self-funded, that is one of the biggest cost factors for larger companies.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"HVOKVOURWBBV5IP5RQ4C2GRJZI\">The idea that premiums are going up has met with pushback, particularly from Republican lawmakers.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"26Q6K5UOFJBXTA4WMLQP2BRWWE\">U.S. Rep. Lloyd Smucker, a Lancaster County Republican, last week refuted what he said were the \u201coverstated\u201d effects of the expiration of enhanced premium tax credits on Pennsylvania consumers.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"GNHDUZD36VAYNAM5Z3GQDUTHKQ\">In a letter to Pennsylvania Insurance Department Commissioner Michael Humphreys, Smucker requested \u201cfull transparency\u201d regarding estimated costs.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"775OEDIFZZHX7GBP6QVEYVQOAU\">\u201cThe department\u2019s claims about \u2018skyrocketing\u2019 premiums are misleading and paint a false picture for consumers,\u201d wrote Smucker, whose 11th congressional district includes parts of York County. <\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"ZC7CKZ3PW5AHHHJ22YQ5TGAWAM\">Smucker argued that most Pennsylvanians will continue to qualify for affordable coverage and the average after-tax premium on HealthCare.gov for 2026 will be just $50 per month. <\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"TYEJMBCSTREZ7FPU66GU3VT2LE\">He claimed that 90% of enrollees will retain \u201ca generous federal tax credit.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"XXLEWFPM2RBUVH7TNYID4ONCEM\">Political rhetoric aside, the impact of all the head-spinning calculations on health insurance premiums is poised to hit hard.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"N36Y2BOCZZDQXHBRAB3PU34XTA\">Already, Pennie is monitoring changes in enrollment. <\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"XLNRFWO2NBFCLNM5QI3AVI7STU\">\u201cDefinitely in those central Pennsylvania areas where the increases are biggest, we\u2019re definitely expecting a lot of sticker shock,\u201d Trolley said. \u201cAnd simply for that reason alone, because the increases are so big, we are anticipating that we\u2019ll see quite a bit of coverage loss in those areas.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"HRWT6IAFM5HDHOUJZJWZ7MXPWU\">Trolley said the public marketplace has already noticed enrollment declines.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"23WQ4VUZ2VAYVJVJ43DRRRE3L4\">\u201cThey might be going without,\u201d she said. \u201cThey might be dropping coverage for now and seeing what happens with federal policy. We are hearing that a lot of people who call in are aware of why their premiums are going up, that it has to do with this federal policy that\u2019s been under discussion. So a lot of people might just be waiting to see what happens. And if it comes more affordable, we\u2019re hoping we can get the folks who dropped back in. If it doesn\u2019t become more affordable, I doubt we\u2019ll be able to do that.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"QKQ7LPKAQBHDFNYKQQ63GJ2AMM\">Reeder offers several pieces of advice to consumers:<\/p>\n<p>Speak to a counselor: Especially a PENNIE certified counselor. They will help you find the proper coverage out of all the plans out there.Consider cost-share health plans: Especially for people who are healthy. Plans like those offered by Christian Health Ministries, for instance, are an option. But he cautioned some of these programs have restrictions on pre-existing conditions.<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"IEC3BU7AFJF45MZCWFBKLRUOTA\">\u201cAnd then this is the big one,\u201d Reeder said. \u201cIf the rates look too good to be true. They probably are.\u201d<\/p>\n<p class=\"article__paragraph article__paragraph--left\" id=\"PAI7QLRT4RDVVA6DB2EDAY5SJY\">\u201cThere are a lot of companies out there that are saying, you can get health insurance for $110 a month or you can get this or that and you\u2019re getting what you\u2019re paying for. A lot of them are scams, A lot of them are so watered down, coverage may cover wellness type visits but then after that it\u2019s not going to cover anything.\u201d<\/p>\n<p>If you purchase a product or register for an account through a link on our site, we may receive compensation. By using this site, you consent to our <a href=\"https:\/\/www.advancelocal.com\/advancelocalUserAgreement\/user-agreement.html\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">User Agreement<\/a> and agree that your clicks, interactions, and personal information may be collected, recorded, and\/or stored by us and social media and other third-party partners in accordance with our <a href=\"https:\/\/www.advancelocal.com\/advancelocalUserAgreement\/privacy-policy.html\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Privacy Policy.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"You may well be able to add rising health insurance premiums to the inevitable duo of death and&hellip;\n","protected":false},"author":2,"featured_media":297041,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[155096,1096,9072,155097,15907,44186,292,25269,83097,8279,14432,97,252,253,68218,1493,9042,11326,25280,14442,18754,19870,80852,83102,25292],"class_list":["post-297040","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-accident-and-insurance-themes","tag-benefits","tag-bill","tag-body-care","tag-care","tag-clinic","tag-close-up","tag-concepts","tag-digital-tablet","tag-doctor","tag-document","tag-health","tag-health-care","tag-healthcare","tag-healthcare-and-medicine","tag-hospital","tag-insurance","tag-medical-exam","tag-mobile-phone","tag-paperwork","tag-patient","tag-protection","tag-solution","tag-stethoscope","tag-telephone"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/297040","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=297040"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/297040\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/297041"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=297040"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=297040"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=297040"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}