ACA Rates Jump 18%, Aetna Decides PPO Means Please Phase Out, And Lilly’s Pill Gets Beat In The GLP-1 Games

Hey all,

Happy Monday! Summer is usually when the healthcare and benefits world takes a nap—but apparently, this year it decided to throw a party for skyrocketing costs instead. Every week seems to bring a fresh round of bad news about rising premiums for employers and higher out-of-pocket costs for plan members, as if we were all begging for that. I’ll be taking a short break from the Rundown at the end of August, but until then, we’ve got plenty of cheery headlines to keep us company.

Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(BenefitsPRO ACA Premium Hikes

ACA Marketplace health insurance premiums could rise by as much as 18% in 2026, marking the steepest proposed increase since 2018, driven largely by rising health care costs, inflation, and high-priced drug utilization. Analysts warn that the potential expiration of enhanced premium tax credits at the end of 2025 could further boost out-of-pocket costs by over 75% for enrollees, potentially leading healthier individuals to drop coverage, while political leaders in some states are urging regulators to reject sharp hikes—because at this rate, the “Affordable” Care Act might need a rebrand to the “Very Slightly More Affordable but Definitely Not Actually Affordable” Care Act. Full Article

(Modern Healthcare) Aetna Joins the PPO Purge

Aetna is axing nearly 90 Medicare Advantage PPO plans across 34 states next year and will cut broker commissions for them starting Sept. 1—because nothing says “optimizing the member experience” quite like yanking someone’s plan and stiffing the person who sold it to them. It’s part of a broader industry trend, with UnitedHealthcare, Blue Shield of California, and others deciding PPOs are just too expensive to love. Soon, “choice” in Medicare Advantage will mean picking which narrow network you dislike the least. Full Article

(Endpoints News) Lilly’s Obesity Pill Shows Lower Efficacy Than Novo’s in Pivotal Data 

Eli Lilly’s oral GLP-1 drug orforglipron helped obese patients lose up to 11.2% of body weight in the Phase 3 ATTAIN-1 trial, falling short of analysts’ 15% expectations and below the 13.6% seen with Novo Nordisk’s oral Wegovy in a separate trial. While cross-trial comparisons are imperfect, results suggest Novo’s pill may deliver stronger weight loss, though Lilly’s small-molecule design offers manufacturing advantages and the company is stockpiling supply ahead of a potential 2026 launch. Full Article.