By Trish Pearson
Insure Your Future
Trish Pearson
Many people who are enrolled in health insurance through the Connecticut health exchange (Access Health CT) have by now experienced sticker shock from their new premium.
Many who qualified for help with their premiums in 2025 now find themselves ineligible for a tax credit, and the premium has doubled or tripled. There has been much publicity surrounding the Affordable Care Act and extension of these tax credits. Many people are justifiably confused and concerned about the costs and coverages for 2026.
The situation is still fluid, but this is what is in place as of this writing: The deadline to enroll in coverage has been extended to Jan. 31. There is some talk that it may be extended, but that’s not confirmed.
Congress has not extended the tax credits. However, Gov. Ned Lamont and the state legislature have appropriated funds to assist those who are losing tax credits or no longer qualify for HUSKY. The funding does not equal the 2025 tax credits, but it does raise the income limit to qualify for some help.
If you have already enrolled in a plan, and now qualify for a tax credit, the premium will be adjusted retroactive to Jan. 1. Any other changes that come about because of action by the federal government will also likely result in retroactive adjustments to tax credits and net premiums.
As a result of the dramatic increases in premiums, many companies that offer “short-term” or alternate insurance plans have stepped up their advertising. While they may be much less expensive than a traditional ACA plan, they are not comprehensive plans. This means that they can exclude coverage for current or preexisting health conditions as well as certain chronic illnesses such as diabetes, cancer or heart conditions. They can also deny basic needs such as maternity and mental health. Rates are determined based on age, gender, medical history and geographic area.
Traditionally, short-term plans carry a coverage maximum of up to four months. However, the Trump administration expanded the time period to up to three years. They claimed it would give people more options – but left out the important detail that it is not the same coverage as people expect or need. Many states have banned the plans, but there are some that were operating before and have resurrected former plans.
Thanks to the diligence of Connecticut regulators, these “self-insured” plans are generally not offered in Connecticut. However, “faith-based plans” have managed to find a way in. As with other non-ACA plans, these exclude more than then they cover.
This has been a difficult time for individuals and small business owners who get their health coverage through the health exchange. While there is much debate over the Affordable Care Act, it is the best we have and has enabled many people who were uninsured or underinsured to purchase affordable health care. It has also helped those with potentially serious conditions to receive treatment, thereby avoiding multiple trips to the emergency room and ultimately saving us all money in the long run.
Those of us in the insurance profession are working diligently to assist people to receive what they can afford and avoid an all-consuming debt.
Trish Pearson is a licensed independent insurance agent and certified long term care specialist. Contact her at 203-640-5969 or trishpearson281@gmail.com.