Originally published in The Tennessean, July 2026
Affordability has become a major challenge for Tennesseans who need health insurance, including those who buy their own coverage on the ACA Marketplace. This year, at least 73,000 fewer people in the state have Marketplace coverage after enhanced federal tax credits ended as of Jan. 1.
We’re still learning about the effects of those changes in Tennessee and across the country. Some people dropped their health insurance because it became too expensive. Others kept their coverage because they depend on it to manage health conditions, get prescriptions, or see their doctors regularly – but many chose plans with lower benefit levels.
When fewer people have insurance, costs can increase for those who remain covered.
At the same time, families continue to face higher costs for housing, groceries, child care, and other everyday expenses. Recent research found that half of Marketplace consumers who re-enrolled for 2026 said their health care costs were “a lot higher” this year. Many also said they had cut back on household spending to pay for health care and insurance.
We understand those challenges because we hear about them directly from our members. That’s why making health care as affordable as possible remains a top priority at BlueCross BlueShield of Tennessee.
That’s also why we encouraged members to start planning before Open Enrollment. We reached out to consumers, answered questions, and helped them understand their options if premiums increased or their financial situation changed.
We expected some people to move to lower-cost plans while others would leave the Marketplace altogether. New research also suggests that many consumers are choosing plans with higher deductibles to keep their monthly premiums lower.
With that in mind, we’ll continue offering a wide range of options across Bronze, Silver, and Gold plans for 2027. We’ve also worked to manage costs through provider negotiations, pharmacy programs, administrative improvements, and other efforts. We’re working hard to minimize rate increases for next year, and we’ll share details later in the fall once our plans are approved by regulators.
We don’t want families to face these challenges, but we believe it’s important to help consumers understand their choices and keep access to coverage that meets both their health needs and their budgets.
Insurance is here to protect against major, unexpected costs, but many plans also provide no-cost access to recommended preventive care services or options to low-cost virtual care for routine needs.
As Open Enrollment approaches this fall, consumers should:
- Look beyond the monthly premium and consider the total cost of a plan, including deductibles, out-of-pocket costs, and benefits.
- Review their coverage options and see whether they qualify for financial assistance.
- Compare plans based on their health needs, budget, and comfort level with financial risk.
- Ask questions and use available resources before making a decision.
Business leaders face similar challenges when providing health benefits to employees.
They want to offer competitive benefits while managing costs responsibly. They also expect health insurers like BlueCross to negotiate for high-quality care at an affordable price. Every unnecessary dollar spent in the health care system eventually affects someone, whether it’s an employee paying premiums, a family managing monthly bills, or an employer paying for benefits. That’s a responsibility we take seriously.
Simply put, there is no single health plan that’s right for everyone. The best choice will be different for every Tennessean. But taking time to understand your options can help you choose coverage that fits your needs, fits your budget, and provides the financial protection health insurance is designed to offer.
Michael leads teams in product strategy for all commercial business, including health and wellness offerings, and has responsibility for individual and small group product lines.