Donna Gerhardt retired and moved to East Stroudsburg from New Jersey in 2024.
But retirement isn't going as smoothly as she had hoped because of rising health insurance costs.
“I'm not having to give up on essentials, but certainly this hurts a whole lot more than I ever expected," Gerhardt said.
She’s not Medicare-eligible until next year, and purchases insurance from Ambetter Pennsylvania Health and Wellness on Pennsylvania’s Affordable Care Act marketplace, Pennie.
Gerhardt's monthly premium payment more than doubled, from $576 last year to a monthly payment of $1,495 this year, with the expiration of federal subsidies.
"For having spent my lifetime working towards being able to enjoy retirement ... I'm not enjoying retirement given this incredible expense,” she said.
Gerhardt is just one among thousands of Pennsylvanians who are already managing rising health care costs and now have to be concerned about insurers’ proposed rate hikes for 2027.
Gerhardt’s plan, Ambetter, proposed an average rate increase of 40.90%, the highest of any insurer.
Ambetter did not immediately respond to WVIA’s request for comment.
“Having to accept the sad inevitability of the loss of the tax credits was huge," Gerhardt said. "This now 41% increase will just be greed — that's what it feels like."
Rising health costs
According to the Pennsylvania Insurance Department, Health insurers for people who purchase their own insurance requested an average rate increase of 17.1%. For small businesses, insurers requested an average 11.5% rate hike.
“That is higher than we had hoped and reflects continued rising costs really across the healthcare environment,” said state Insurance Commissioner Michael Humphreys.
Federal Affordable Care Act, or ACA subsidies expired on Jan. 1, 2026 and were the driving force behind last year’s record-breaking government shutdown. A bill to extend the subsidies remains stalled in Congress.
BY THE NUMBERS:
● Proposed average 17.1% rate increase for individuals
● Proposed average 11.5% rate increase for small businesses
● 191,000 Pennsylvanians canceled Pennie health coverage since expiration of tax credits
● 102% average monthly premium increase for Pennie enrollees since expiration of tax credits
As of Aug. 10, Pennie reported that 191,000 Pennsylvanians canceled their health coverage since open enrollment for 2026. Pennie found that monthly premium payments increased by an average of 102% due to the expired subsidies.
The Pennsylvania Insurance Department welcomed public comment on the 2027 rate increase requests through Aug. 22, which it will now use to negotiate rates with the insurers.
“People are justifiably frustrated that it is taking on a larger piece of their paychecks as the cost of insurance really reflects the increased costs of healthcare and that really bears out across the markets,” Humphreys said.
Actuaries at the department analyze projections and data to ensure that the insurers’ rate requests are justified, pushing back on what Humphreys called requests that are “excessive, inadequate or unfairly discriminatory.”
“We need the insurers to be paying [customers'] claims, but we don't want their premiums any higher than what's necessary to be able to pay those claims,” he said.
Humphreys said he hopes rates are finalized, and lower than what insurers initially proposed, by the end of September, but by Nov. 1 at the latest in time for open enrollment.
And he suggests Pennsylvanians concerned about cost increases compare prices and plans for 2027 — even though prices will be rising across the board.
“We want people to go back to the Pennie website to make sure they're getting the policy at a price point that may be uncomfortable, but is more comfortable than the alternative of going uninsured,” he said.
Pennsylvanians respond to increasing costs
Advocacy group Affordable Healthcare for PA hosted a ‘Care-A-Van’ event to encourage insurance companies to freeze costs. The van drove from Scranton to Wilkes-Barre to Hazleton, before ending the advocacy trip at Geisinger’s headquarters in Danville.
“Some of my patients’ premiums have tripled from $300 to $900 already, and now the insurance corporations are demanding even higher prices, despite making huge profits,” Bette Grey, a patient advocate, and certified Pennie assister, said in a statement ahead of the event. “The devastating increases in premiums, copays and deductibles have forced people with serious, chronic medical issues like diabetes and back pain to drop their coverage.”
Humphreys called on Congress to bring prices down for Pennsylvanians.
“When you're talking about almost 200,000 [Pennsylvanians] losing their coverage because … Congress failed to act, that's a real hardship for a lot of individuals and families, and one would hope that they would prioritize looking at … what bringing back tax credits that help people afford health insurance could do for American families,” he said.
Annual open enrollment, the period when people can shop for and change their plans on the ACA marketplace, starts on Nov. 1.
Gerhardt said she’ll drop Ambetter in 2027 for a more affordable option in her remaining year left before Medicare eligibility — if she can find it.
“No one's getting a 40% salary increase or increase in their social security. It's just unconscionable to me. Because healthcare and taking care of your family and staying healthy or getting care if you're sick shouldn't be a luxury, and that's what it is feeling like in this country,” Gerhardt said.
