Weight loss drugs 1 factor behind ACA premium increases: 3 things to know

Premiums for plans on the ACA marketplace will rise 7% on average in 2025, according to an analysis from Peterson-KFF Health System Tracker published Aug. 5. 

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Most insurers participating in the marketplace requested premium increases between 5% and 10%. Around 15% of plans requested rate decreases, and less than 10% requested rate increases higher than 15%. 

The report analyzed public reports insurers made requesting premium increases. Several insurers said GLP-1 drugs, including Ozempic and Wegovy, are one of the things driving premium increases. 

“The pharmacy trend, especially cost, is heavily influenced by the impact of GLP-1 drugs and their use in diabetes treatment as well as the expectation for continued use with the approval for expanded indications,” Priority Health, a Michigan insurer, wrote. 

Here are three other factors contributing to rising costs: 

  1. Rising medical costs were one of the most commonly cited factors behind the increases. Some insurers also pointed to general economic inflation, increasing administrative and staffing costs for health plans. 
  2. Hospital market consolidation and workforce shortages are also driving up costs, insurers said. Providers are requesting higher rates from payers to cover these rising costs. 
  3. In addition to GLP-1s, other specialty drugs are driving up costs. Some insurers estimated gene therapy costs would rise in 2025, requiring higher premiums. 

Read the full report here. 

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