Rep. Smucker Calls out Pennsylvania Insurance Department for Misleading Claims on ACA Rates, Calls for State Action to Lower Costs

WASHINGTON - Rep. Lloyd Smucker (PA-11) sent a letter to Pennsylvania Insurance Department (PID) Commissioner Michael Humphreys requesting full transparency regarding the assumptions and estimates used in the Department's recent analysis of 2026 health insurance rates.

The letter specifically references claims made in PID's October 14th press release that overstated the effects of the expiration of the Affordable Care Act's (ACA) enhanced premium tax credits (EPTCs) on Pennsylvania consumers, including those in the 11th Congressional District.

"Pennsylvanians deserve fair and accurate information about their health care premiums," said Rep. Lloyd Smucker (PA-11). "The Department's claims about 'skyrocketing' premiums are misleading and paint a false picture for consumers. The reality is, most Pennsylvanians will continue to qualify for affordable coverage and the average after-tax premium on HealthCare.gov for 2026 will be just $50 per month. Unfortunately, fearmongering is all Pennsylvanians have come to expect from the Shapiro administration."

"The department should focus less on instilling fear and more on cost-saving solutions for Pennsylvania families," Smucker continued. "Congressional Republicans and President Trump have made great progress expanding access to care and lowering costs through the Working Families Tax Cuts Act, and it is past time that the Commonwealth considers policies to support families, as well."

The letter reads, "Let's be clear: should the EPTC structure expire, the vast majority of enrollees will continue to receive substantial subsidies. Contrary to rhetoric from Democrats and some insurance companies, 90 percent of enrollees will retain a generous federal tax credit."

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"Your press release which states that "Congress can act now to extend the EPTCs and immediately reduce insurance rates by three to five percent" inadvertently underscores the point: EPTCs account for a miniscule share of the expected premium increase in 2026."

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"It is disingenuous to attribute premium increases entirely to the expiration of COVID-era subsidies. Moreover, the Pennsylvania's Insurance Department itself holds substantial authority to lower costs but has declined to exercise it. For example, the Department could:

• Expand short-term limited duration insurance (STLDI) beyond minimum federal limits to provide working families more affordable bridge coverage.
• Encourage Association Health Plans (AHPs) and level-funded arrangements to help small businesses and self-employed workers pool risk and reduce costs.
• Approve Health Savings Account (HSA)-eligible catastrophic plan designs, now made possible under federal law, which President Trump's Working Families Tax Cuts legislation expanded to every county and every consumer on HealthCare.gov.
• Use reinsurance waivers or rate review flexibility to reward innovation.

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"Pennsylvania has the authority to lower costs immediately by expanding short-term insurance options, approving HSA-eligible plans, and encouraging innovative coverage models for small businesses. Washington can't be blamed for the Department's refusal to act."

Click here to read the full letter.