Duncan Smith, director of The Corinthian Plan, looks at changing governmental priorities and their impact on health and health/medical insurance — and how we can respond.
Duncan Smith has been director of The Corinthian Plan, MC USA’s healthcare plan for pastors and church workers, since 2014. Previously, he served as a conference minister and several pastorates, including transitional interim positions. Smith’s pastoral experience spans both urban and rural settings.
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I was living in New York City when the “perfect storm” hit the northeastern United States in 1991. Conditions were the worst in New England, but it was also bad in the Bronx. We deiced as much as we could when the storm first hit. Those who did not deice found their cars and anything left outdoors encased in ice for a while.
Since that time, the term “perfect storm” has been used when circumstances and events have come together to create something that is much more significant than it otherwise might have been.
Currently, there are events and circumstances coming together that are having a major impact on health, as well as medical and health insurance costs. It might not be a “perfect storm,” but let’s look at some of these effects.
Changes in government priorities are likely to have a major impact on the health of U.S. residents. For example, cuts in food support, such as the Supplemental Nutrition Assistance Program (SNAP) and Head Start, will likely lead to less healthy children and families. Compounding this are cuts in Medicaid support for hospitals and clinics, which will lead to less available healthcare. History shows that this will result in more frequent emergency room visits, poorer outcomes and overall higher medical costs.
While some of the dynamics above may take longer to roll out, increases in the cost of everyone’s health coverage are almost guaranteed to rise at a higher rate than usual for 2026. Here are three major reasons why:
- First, the enhanced premium tax credits for Affordable Care Act (ACA) Marketplace plans — originally expanded under the American Rescue Plan and extended through the Inflation Reduction Act —expire at the end of 2025. The recently passed One Big Beautiful Bill Act did not include provisions to renew these subsidies. Without further legislative action, millions of enrollees will face higher premiums starting in 2026.
- Second, proposed U.S. tariffs on imported pharmaceuticals and medical equipment — some as high as 25% (perhaps higher) — are expected to raise costs and disrupt supply chains. While implementation may be gradual, experts warn of increased prices for branded drugs, potential shortages of generics and higher insurance premiums. These effects could extend to Medicare and private insurance plans.
- Third, the 2025 Budget Reconciliation Act (also known as the One Big Beautiful Bill Act) includes substantial cuts to Medicaid, projected to reduce federal spending by $698 billion and result in 10.3 million fewer enrollees by 2034. These changes are expected to lead to increased rates of preventable hospitalization, medication nonadherence, delayed care and excess deaths. Rural hospitals and safety-net providers are particularly vulnerable to financial strain and closures.
The dynamics above are already being built into the new premiums from the Affordable Care Act to employer-based coverage. Increases are typically going to be in double digits, perhaps over 20% in some cases.
I am writing this to encourage you to be proactive. Wherever you get your health coverage be aware of the following two things:
- Has your health insurance coverage changed?
- What are your premium increases for the coming year? Take charge of your choices as you are able.
Every year, The Corinthian Plan sets premium increases by projecting variables of medical cost and claims experiences. Our goal is to gain zero and lose zero. The Corinthian Plan usually seeks to mitigate premium increases by using reserves. Now in its 16th year of comprehensive coverage, the plan offers mutual aid through subsidies for congregations in need and shares equally in premium increases, regardless of participants’ claim experiences. The Corinthian Plan has not changed deductible levels over this time, which makes coverage more equal to Gold plans in the Affordable Care Act Marketplace.
However, The Corinthian Plan is not immune to increases in medical expenses. In recent years, we also have seen high claim levels, which, of course, we are committed to covering. For these reasons, The Corinthian Plan premium increases, while not yet set, will be likely be higher than usual. Since The Corinthian Plan was created in 2010, increases have been below the industry average. We hope that to be true again this year.
I am mostly a positive person; I approach storms by trying to figure out what I need to do. Sadly, though, I mourn that our government priorities will now offer less care for all of the people who live in its land. In the midst of what can feel like a stormy season, my encouragement is for all of us to find ways to engage, even in small ways. I encourage you to be aware of the health and well-being in your own communities (church, city, town) and find a way to engage. Contribute where you can. Buy that extra bag of groceries for the food pantry. Help someone with their medical bill. Take to heart loving your neighbor. I also encourage you to pray and speak to those who represent you.
The views and opinions expressed in this blog belong to the author and are not intended to represent the views of the MC USA Executive Board or staff.
Other Resources
Operational impacts of the One Big Beautiful Bill
- MHSA by Clare Krabill
ACA Tax Credit Changes
Potential Tariff Impact Medical Expenses
Medicaid Changes