Medicare Part B Premiums Rise 9.2% Amid ACA Subsidy Uncertainty

The Medicare open enrollment period is concluding on December 7, with the average Part B premium increasing by 9.2%, from $185 in 2025 to $206 in 2026. This premium hike reflects a broader trend of health care costs rising faster than overall inflation, posing challenges for payers and beneficiaries alike. Dr. Mehmet Oz, CMS administrator, highlighted efforts to curb costs by including GLP-1 weight loss drugs in Medicare coverage with a $50 copay, citing long-term savings due to reduced chronic conditions like diabetes and hypertension. The article situates this development within the broader federal debate over health care spending, especially concerning the expiration of enhanced Affordable Care Act (ACA) subsidies at the end of December. Approximately 22 million Americans who rely on ACA marketplace insurance and receive these subsidies face increased costs unless Congress acts. Despite initial signals from Dr. Oz and former President Trump supporting a two-year extension of enhanced subsidies, congressional opposition—particularly from Republicans—has stalled progress. Dr. Oz criticized flaws in the ACA program for driving insurance price increases and overall health care inflation, impacting Medicaid, Medicare, and ACA insurance markets. To mitigate these trends, he proposed restoring "cost-sharing reductions" (CSRs), which previously helped reduce out-of-pocket costs for low-income enrollees but were discontinued in 2017, leading insurers to raise premiums that ultimately increased federal spending. The likely expiration of enhanced subsidies may lead to 4.8 million Americans aged 50 to 64 facing higher premiums, with a risk of coverage drop-offs. This dynamic could further strain Medicare costs, as individuals deferring preventive care may require more costly treatments upon Medicare eligibility at age 65. The CMS expects roughly 69 million individuals to enroll in Medicare this year. To assist beneficiaries during enrollment, Dr. Oz announced improvements to the Medicare.gov platform, including an enhanced plan finder tool to better navigate plan options amid recent changes. He emphasized the federal effort to streamline access and diminish complexity for seniors during this critical enrollment window.