8. Increased focus on chronic-care and risk selection by insurers

Insurers are adjusting how they manage members with chronic conditions, including via network design, plan types, and benefit structures. For example:

In the Medicare Advantage space, plans for chronically ill are growing rapidly; insurers are shifting strategy.

Impact for regular plans:

Expect benefit designs to increasingly take into account high-cost conditions and risk profiles.

Network narrowings or benefit carve-outs (e.g., for high-cost drugs or specialty care) may increase.

What to do: If you have a chronic condition, verify that your providers remain in-network and that any plan changes for 2026 don’t reduce access or increase your out-of-pocket burden.