Health Care Matters | July 10
ACA Marketplace Premiums Poised for Another Double-Digit Increase
ACA Marketplace insurers are proposing a median premium increase of 14% for 2027, based on preliminary filings from 77 insurers across 16 states and the District of Columbia. If approved, this would mark the second consecutive year of double-digit increases and push typical premiums up by more than one-third over two years. Insurers point to rising hospital, physician, and prescription drug costs, elevated labor expenses, increasing claims severity, and growing use of high-cost medications as major drivers. The expiration of enhanced premium tax credits is also contributing to higher rates by prompting some healthier, more price-sensitive consumers to leave the market, leaving behind a smaller and more costly risk pool. Final rates are expected later this summer. Read more here and here.
Why It Matters
These proposed increases matter because Marketplace affordability is being squeezed by both rising health care costs and the scheduled expiration of enhanced premium tax credits. As coverage becomes more expensive, healthier and more price-sensitive consumers may be more likely to drop coverage, leaving a sicker risk pool and putting further upward pressure on premiums. The result could be a compounding affordability problem, with the steepest impact on unsubsidized consumers and those who lose eligibility for enhanced assistance. The filings provide an early view into how federal policy changes, provider and pharmacy cost growth, and claims severity are being reflected in 2027 pricing, with implications for consumers, federal subsidy spending, and broader commercial market affordability.
CMS Keeps Close Watch Over Rural Health Transformation Funding
The Rural Health Transformation (RHT) Program was framed as a state-led opportunity to invest in new approaches to rural care, but the early implementation process is showing a more tightly managed federal role. CMS has rejected or redirected some state proposals, including efforts to use funding to offset the effects of broader federal health program cuts, and states are being reminded that approved plans come with conditions. The agency has authority to withhold or recover funding if states do not follow their approved applications or meet program expectations, turning the $50 billion rural health fund into something more structured than a flexible block grant. Read more here and here.
Why It Matters
The clawback language gives RHT a different feel than a typical state funding opportunity. The program still leaves room for state-specific approaches, but that flexibility now sits inside a more closely managed federal process, where approved plans may be harder to change once implementation begins. That matters because rural health transformation rarely moves in a straight line. Workforce realities, local partnerships, provider capacity, and community needs can all evolve between application and execution. As states move into implementation, much will depend on how CMS handles requests to pivot when local market needs change, especially if those pivots require states to move away from the priorities or activities outlined in their approved applications.
Look for the Helpers: Food Pharmacy Helps New and Expectant Mothers Access Fresh, Local Food
Third Street Family Health Services in Mansfield, Ohio, is helping families experiencing food insecurity through a food pharmacy that provides biweekly boxes of fresh, locally sourced food. By partnering with Yellowbird Foodshed, the program has expanded its reach and can tailor deliveries to household size while accounting for barriers such as transportation and limited cooking equipment. The effort shows how health care organizations and community partners can work together to support maternal and infant health beyond the exam room. Read here.
New Resource
Coral Health Advisors’ Rural Health Transformation Program Tracker
Coral Health Advisors has launched a new tracker to help organizations monitor RHTP activity across states. The tracker brings together state updates, procurement opportunities, webinars, deadlines, and other key developments in one easy-to-navigate dashboard, with filters and preferences that allow users to focus on the states and topics most relevant to their work.
With the purchase of the RHTP Tracker, subscribers will also receive complimentary access to Coral’s grant toolkit. The toolkit provides practical guidance to help organizations prepare for RHTP-related opportunities, including eligibility considerations, proposal development, budgeting, and post-award readiness.
Learn more about the RHTP tracker in this product demo.
If you have any questions or would like to learn more about subscription options, please don't hesitate to reach out at info@coralhealthadvisors.com
What We Are Reading
Medical Ethics Responds to Private Equity
Health Affairs Forefront examines revised AMA ethical guidance for physicians entering contracts with private equity-owned organizations, with a focus on protecting professional judgment and patient welfare. Read here.
Medicaid/CHIP Monthly Enrollment Tracker
KFF’s updated tracker shows that Medicaid and CHIP enrollment fell to 74.3 million in March 2026, down 6% from the prior year, and provides national and state-level enrollment trends. Read here.
One Platform, 25 Hospitals: How Billings Clinic–Logan Health Is Rethinking Rural Care
A Becker’s article profiles how Billings Clinic–Logan Health is using a shared technology platform to improve care coordination and extend new tools across its rural and critical access facilities. Read here.
HRSA Opens Applications for $140M in Rural Health Grant Funding
Fierce Healthcare summarizes new HRSA funding opportunities supporting rural substance use treatment, workforce development, provider collaboration, and telehealth. Read here.
Pop Health Podcast
What the LEAD Model Means for Specialty Care and ACOs
Specialty care has long been one of the harder pieces of accountable care to operationalize. In this episode, Coral’s Joy Chen speaks with Theresa Dreyer, CEO of the Health Care Transformation Task Force, about what CMS’s Long-term Enhanced ACO Design, or LEAD, Model could mean for ACOs and specialty groups. They discuss why specialty engagement has been challenging across payer lines, how LEAD creates more formal pathways for ACO-specialist arrangements, what different types of specialty groups may need to consider, and what it will take for these models to move from payment design to practical changes in care delivery.