The ACA has failed to accomplish its original goals. In Washington State, the average premium hike for 2026 is over +20%, with the highest insurer rate hike requesting +37%.
WA individual buyers of health insurance could face a ‘double whammy’
Ultimately, it’s the actual $s paid per month in premiums that mark the failure.
In 2024, our last year on ACA policies, our Oregon Bronze ACA policy premium was about $20,000 per year for two adults, with a $19,200 family deductible. That’s catastrophic insurance only coverage that almost no one can afford.
As of 2026, individuals can no longer afford insurance, and the ACA prohibits other policy options that might have been affordable. The ACA itself defined “Affordable” as premiums being less than about 8.5% of annual household income. For $20,000 per year to meet that threshold, you’d have to make over $235,000 per year!
The ACA destroyed the individual insurance market by merging the “high risk” state run insurance pools, and many of the uninsured with pre-existing conditions, into the very tiny individual market (per state) insurance pools. The effect was for individual market premiums to skyrocket as these tiny pools had to share the costs of some very expensive patients. The ACA literally gutted the individual market.
Unfortunately, Jonathan Gruber, Ph.D., the MIT health economist. is famous for speaking at a conference and saying that he and his pals had intentionally obfuscated the language used to describe the ACA in order to “get it past the stupid American voter”.
But … you are saying … the ACA prohibited pre-existing condition exclusions! True, but so did the HIPAA Act of 1995 – but it only did so for group policy members and left out the tiny individual market. The ACA prohibited those exclusions in the tiny individual market – but a majority of U.S. states had passed similar pre-existing condition exclusion protection after 1995! The number of people who did not have any pre-existing condition protection was actually quite small by the time the ACA took effect in 2014.
But the ACA did not actually get rid of them entirely – instead, it converted them to a pre-X waiting period. If you are diagnosed with a disease on February 1 and did not have insurance – too bad – you’ll have to wait until January 1st of the following year to sign up. That’s a pre-existing condition waiting period – which is one of the ways those conditions have been handled in the past.
Almost everything about the ACA was an enormous lie. And after breaking the individual health insurance markets in the U.S., neither the Democrats nor Republicans have shown any interest in fixing what they made worse.
