Health Insurance Market Instability: ACA, Medicare Advantage, No Surprises Act, and State-Level Fixes

ACA marketplace premiums rising sharply (double-digit increases in MO, KS, MN for 2027) with uninsured rates climbing. Medicare Advantage plan exits are forcing nearly 3M seniors to find new coverage (disenrollment rates jumping to 10%). The No Surprises Act arbitration process is being gamed, driving up insurer costs (3.4M disputes vs. 22K predicted). New York DFS has overhauled its independent dispute resolution process for surprise medical bills, a state-level fix. Policy debates over subsidy extensions, market stability, and potential federal reform are intensifying.