CANTON ‒ AultCare will no longer offer some individual and family health insurance plans and a plan for small employers beginning next year.
On- and off-Marketplace plans for individuals and families and Small Group Insured Affordable Care Act plans for employers with less than 50 employees will be discontinued, said the health system, which also operates Aultman Hospital, Aultman Alliance Community Hospital and Aultman Orrville Hospital.
The change will affect about 6,000 enrollees. Altogether, AultCare insures about 100,000, according to a spokesperson for the company.
On-Marketplace plans, available via HealthCare.gov, are supported by premium federal subsidies, typically in the form of a tax credit, based on annual income. Enrollees are often individuals who are not offered health care coverage through their employer. The small business plan is also supported by federal tax credits in the Affordable Care Act.
Uncertainty about the future availability of subsidies was the main reason AultCare decided to discontinue the plans, said Mark Wright, president of AultCare health plans and chief financial officer of Aultman Health Systems.
“It was a very difficult decision for us,” Wright said. “There’s a significant level of uncertainty right now with this product about the premium subsidies that will be available to enrollees in the future.”
Enhanced premium tax credits offered to many Affordable Care Act Marketplace enrollees are set to expire at the end of 2025 unless they are extended by Congress.
“That uncertainty, combined with financial losses we’ve incurred in this product, would make it difficult for us to continue to provide that value and affordability (we’re committed to),” Wright said.
Individuals enrolled in the discontinued plans remain covered through Dec. 31, but will need to elect new coverage for 2026.
AultCare sent notification by mail to customers who are affected. The letters should’ve been received this month.
Expiring tax credits, potential tariffs create uncertainty for insurers
Many U.S. insurers are also anticipating changes to Marketplace plans in 2026, a KFF analysis of preliminary rate filings shows.
According to preliminary rate filings, premiums for Marketplace plans will rise by a median of 15% for 2026, the biggest increase in premiums since 2018.
Expiring tax credits and potential tariffs are contributing to that trend, Matt McGough, policy analyst in KFF’s Affordable Care Act program, said in an email.
“As it is unclear whether Congress will act on extending enhanced premium tax credits and ongoing uncertainty around tariffs on pharmaceuticals and medical goods, many Affordable Care Act Marketplace insurers are making conservative assumptions in their rate filings,” he said.
Insurers are increasing premiums 4% above what they normally would have because of the expiration of tax credits, McGough said. Some insurers are adding an extra 3% to their rates to account for tariffs.
Higher premiums could also drive customers, especially healthy people, out of the market, McGough said.
“The large enrollment growth over the last five years has drawn a lot of insurers into the individual market,” he said. “But as enrollment could decline amid rising premiums, some insurers may opt to decrease their footprint in the market.”
How to get covered for 2026
Ohio’s open enrollment period to select health insurance begins Nov. 1.
“At that time, individuals can choose another plan, and there are multiple plans that are offered within our region,” Wright said. “We would encourage individuals to shop for a plan that best meets their specific needs.”
Wright said there are plans available that have access to Aultman providers as well.
An agent or broker can help people find a new plan or they can visit the HealthCare.gov website for more information on what’s available, Wright said.
If they were insured through an employer plan, people should contact their employer about coverage.
AultCare will still offer Medicare Advantage, other insurance plans
Other AultCare health insurance plans, including Medicare Advantage, commercial group insured plans, self-funded plans and Multiple Employer Welfare Arrangement (WEWA), will not be impacted.
“We still continue to offer a broad range of products,” Wright said.
Contact AultCare at 330-363-6360 or 800-344-8858 for questions about coverage.
This article originally appeared on The Repository: AultCare to discontinue some insurance plans, affecting about 6,000 enrollees
