Rep. Lloyd Smucker from Pennsylvania isn’t buying the state insurance department’s story about “skyrocketing” Affordable Care Act premiums.
In a letter to Insurance Commissioner Michael Humphreys, the Republican congressman from District 11 said the department’s Oct. 14 release stretched the facts and misled consumers about what’s actually happening with 2026 rates.
The department had used a York County couple as its poster case – a 60-year-old married pair earning $82,000 – and claimed their annual premium would soar from $7,032 to $35,712 if enhanced ACA tax credits expire.
Smucker called the example an outlier, not remotely typical for the families he represents. He asked for full disclosure of the math behind it – income assumptions, age factors, and regional rating details.
Pennsylvania regulators weren’t alone in warning about rate hikes.
Officials in Nevada, Missouri, Idaho, Oklahoma, Colorado, and Washington all cited double-digit increases in individual and small-group markets, blaming expiring subsidies, pricier care, and higher utilisation.
But Smucker said most Pennsylvanians will still qualify for affordable coverage, estimating the average after-tax premium rise on Healthcare.gov at about $50 a month next year.
“The department should focus less on fear and more on cost-saving solutions,” he said, adding that Republicans and President Trump had “made great progress” through the Working Families Tax Cuts Act.
The bill, introduced in March as H.R. 1833, hasn’t moved out of committee and mostly deals with income deductions, not health policy. Smucker didn’t respond to questions clarifying his statement.
He also urged the department to flex its authority on affordability – expanding short-term limited duration plans, promoting association and level-funded plans, and approving HSA-eligible catastrophic options. He mentioned reinsurance waivers and rate-review flexibility as other ways to ease cost pressures.
Meanwhile, an AM Best report underscored why regulators are nervous. The enhanced ACA tax credits, which expire at year’s end, have suppressed premiums and kept enrollment high.
Without renewal, healthier members may drop coverage, leaving costlier risks behind. Medicaid’s recent eligibility rollback has already pushed more people into ACA plans, shifting the risk pool toward higher morbidity.
If the enhanced tax credits lapse, that utilisation gap gets worse – and the market loses its healthier enrollees.
Jason Hopper, associate director at AM Best
Congress is still tangled over the fix. The Senate’s latest deal to reopen the government, passed Nov. 9, skipped the tax credit extension but promised a December vote.
Until then, insurers, regulators, and lawmakers are stuck in limbo, arguing over what happens next – and who takes the blame if rates really do explode.
