Insurers Exit ACA Marketplaces, Employers Get Crushed By GLP-1s And Cancer Care, And Seniors Learn The IRA’s Cap Comes With New Deductibles

Hey all,

Happy Thursday! For all the big talk about making health care more “affordable,” the latest headlines show classic under performance by elected officials. UnitedHealth and Elevance are bailing on ACA plans in Colorado, leaving tens of thousands scrambling; employers are staring down yet another year of double-digit cost hikes thanks to pharmacy spend; and Medicare insurers are already twisting the Inflation Reduction Act into a way to hike seniors’ bills. Once again, the marketing copy promises relief, but the fine print makes clear: in U.S. health care, affordability is always just one clever plan design away from disappearing.

Enjoy the rundown! 

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Bloomberg) UnitedHealth, Elevance Set to Exit Colorado ACA Health Plans

UnitedHealth Group and Elevance Health have notified Colorado regulators they plan to exit some individual Affordable Care Act plans, potentially forcing 96,000 residents to seek new coverage next year. The move underscores broader instability in ACA marketplaces driven by rising medical costs, stricter enrollment rules, and the looming expiration of federal tax credits that currently make premiums more affordable. State officials warn that without congressional action to extend subsidies, one-third of Colorado’s 300,000 individual plan enrollees could face steep rate hikes or lose coverage. Full Article

(Business Group on Health) 2026 Employer Health Care Strategy Survey

According to a new Business Group on Health survey, employer health care costs have surged 62% since 2017, with 2024 and 2025 marking the steepest back-to-back increases in a decade and 2026 costs projected to rise another 9% (7.6% with plan design changes). Pharmacy spending alone accounted for 24% of health care dollars in 2024 and is expected to increase 11–12% into 2026, while 79% of employers report rising use of costly obesity medications and 73% have seen higher mental health service utilization. With cancer still the top cost driver and 67% of multinationals saying U.S. costs affect global benefits, CFOs abroad are now telling their U.S. benefits heads it’s time to actually read the vendor contracts and figure out exactly how they’re getting hosed. Full Article.

(JAMA Internal Medicine) Changes in Medicare Part D Plan Designs After the Inflation Reduction Act

A new cross-sectional study found that after the Inflation Reduction Act (IRA) capped annual out-of-pocket drug costs at $2,000 in 2025, Medicare Part D insurers—especially Medicare Advantage plans—raised deductibles and shifted more beneficiaries to coinsurance for brand-name drugs, leading to higher costs for patients who do not hit the cap. While the IRA aimed to improve affordability, these plan design changes suggest that many seniors may still face higher monthly medication expenses. In classic Washington fashion, we now have empirical proof that the “Inflation Reduction Act” is actually inflating seniors’ drug bills. Full Article