Vidya Sethuraman
India Post News Service
Speakers at the ACom weekly briefing unpacked the massive changes in health care costs for 2026 and beyond, and offered perspective on creating a more equitable and affordable healthcare structure.
Tomas Bednar, Senior Vice President & Counsel, Healthsperien LLC pointed out that one of the most critical changes in 2026 is that if the advanced premium tax subsidy cannot be extended, individual market premiums will skyrocket, and most people may face a premium increase of more than 70%. About 22 million people across the country are insured through the individual market, 92% of whom rely on subsidies. Once the subsidies disappear, millions of people will be unable to renew their insurance. Bednar emphasized that rising medical costs, declining medical access, and the potential for political gridlock in 2026 will make it difficult to promote large-scale reforms. He also pointed out that the Trump administration’s resumption of public charge regulations may cause immigrant communities to give up applying for Medicaid for which they are already eligible due to fear, creating a clear chilling effect.
Amber Christ, Managing Director for Health Advocacy, Justice in Aging said the Big and Beautiful bill brings unprecedented reductions to Medicaid, Medicare, and food stamps (SNAP), which is equivalent to tax cuts that use the living resources of low-income families to subsidize high-income groups. She pointed out that most of the elderly in the United States have limited incomes, with the average income being only about US$30,000, and 70% less than US$50,000. It is the medical support of this group of people that will be most affected by the “Big and Beautiful” cuts.
The most impactful one is the disqualification of some legal immigrants, refugees, and asylum applicants for Medicaid and federal health insurance, which even affects those who have paid taxes for many years and are currently receiving federal health insurance. Christ pointed out that these people are also unable to afford market insurance, and losing eligibility for premium subsidies means they are directly excluded from medical coverage. She pointed out that many states have already reduced medical expenditures in advance due to budget constraints, such as cutting long-term care services (HCBS), dental, vision and other optional items.
Sophia Tripoli, Senior Director, Health Policy, Families USA looked at the medical cost structure and pointed out that price is the biggest driver of soaring medical expenses in the United States, not excessive use or poor health behaviors by the people. She pointed out that large hospital systems, pharmaceutical companies, insurance companies, etc. in the medical system have accelerated mergers and acquisitions in recent years, forming monopoly advantages.
Also Read: AAPI Announces 2026 Global Healthcare Summit in India
