You make a good living, you’re healthy, you got a raise, and you’re staring at what looks like a mortgage payment.
Nationwide ACA marketplace rate increase for 2026, with another 15.6% proposed for 2027.
Fewer subsidized plan selections since 2025.
Marketplace plans are guaranteed issue, so everyone is approved. That means the pool includes a lot of moderate-to-high-risk people, and the premium reflects that whether you use it or not. If you’re paying full price and you’re healthy, you’re subsidizing the pool. You can pull yourself out of that high-risk group and insure your insurability.
A private, underwritten plan works like life insurance: it’s based on your health history, and if you qualify as lower risk you can qualify for lower premiums. No enrollment period. PPO networks, max out-of-pocket, financial security, guaranteed renewable to 65. Not everyone qualifies, and some carriers are stricter than others. I shop for the option that’s right for you, to maximize your savings without sacrificing your care.
I’m Nathan Baughman with BIG Benefits. This is the call I get most often since the start of the year. At the end of 2025 the enhanced tax credits expired; marketplace rates increased and are increasing again. If you make $50,000 single, $85,000 as a couple, or $125,000 as a family, you may have other options to consider.
Weigh your options. Are you generally healthy? On generic medications and stable? You may qualify for other plans that suit your lifestyle or age.
Check what you’re actually paying for. Maternity, substance abuse, pediatrics. A lot of people paying full price have a plan with coverages they never use.
Employer plans. Your employer is not required to cover your spouse or family at the same rate as you, the employee. Check whether separate coverage for them would lower your costs.
1. Is there a maximum out-of-pocket? 2. Is it an unlimited contract? 3. Is it major medical?
The phrase “$0 deductible PPO” is a HUGE RED FLAG. You can have a $0 deductible if there is no maximum amount to cover. Deductibles don’t mean you have insurance…these three questions do.
“Nathan was able to help me as a business owner not only increase benefits for my team but also save money in the process. He goes above and beyond to make sure you understand the coverages you have.” — Google review
With just an age and a zip code, I can provide general costs for plans available in your area.
Five minutes, no charge, no pressure.
