MedCity News December 5, 2025
Open enrollment 2026 marks a turning point in U.S. healthcare. The cost pressures are no longer cyclical; they are structural. For payers and providers alike, the challenge is clear: we must modernize operations, not just manage costs.
Open enrollment for 2026 coverage is underway and is running through January 15, 2026, against a backdrop of unprecedented premium increases and policy uncertainty. Last year’s enrollment reached a record 24.3 million Americans in ACA marketplace coverage (CMS), more than double the 2020 enrollment. This year’s enrollment season brings stark financial challenges: ACA marketplace premiums are rising 26% on average for 2026, the largest increase since 2018, with Healthcare.gov-specific rates reportedly up 30% and some markets exceeding 50%. Meanwhile, Medicaid policy changes threaten...
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