Health Premium Increases Approved in Rhode Island for 2026
On September 15, 2025, Rhode Island’s Office of Health Insurance Commissioner (OHIC) approved new health insurance premiums for 2026, marking a significant shift in costs driven by rising healthcare and drug expenses. This change will not only impact residents in Rhode Island but could have broader implications nationwide, as increasing unit prices for medical services and products continue to escalate.
The approval includes substantial fee adjustments approved by the General Assembly, adding to consumer costs. According to the OHIC announcement, premium increases will see a “weighted average rate change” of 21.0% for individual plans, 17.6% for small groups, and 19.3% for large groups.
Health Insurance Commissioner Cory King noted that the forthcoming premium hikes are more pronounced than those seen in recent years. He emphasized the need for healthcare providers and insurers to take greater responsibility for managing costs effectively to prevent double-digit increases from becoming a recurring issue.
To ease the financial strain on Rhode Island residents, OHIC declined all proposed administrative cost increases from insurers. Over the past two years, administrative increases have been kept in line with inflation, which remains below the state-regulated caps for hospital price hikes.
Additionally, OHIC pointed out that, alongside rising usage, the expiration of the federal Enhanced Premium Tax Credits (EPTCs) will significantly affect individual market premiums. Initially established by the American Rescue Plan Act of 2021 and extended by the Inflation Reduction Act of 2022, these credits have lowered costs for eligible Rhode Islanders purchasing insurance through HealthSource RI. If they expire after 2025 as anticipated, many households could face an average increase of about 85%, roughly $1,250 annually, before considering the 2026 rate increases. Those with lower incomes or older individuals will feel the effects the most.
It has been suggested by OHIC that fewer people might opt for insurance once the tax credits disappear. This could lead to a risk pool predominantly featuring individuals with higher healthcare needs, which, in turn, would drive up premiums for everyone remaining in the pool.
Furthermore, a new health insurance fee was passed by the General Assembly under the FY 2026 state budget, introducing a fee of about $50 per person annually. This funding will support Medicaid rate increases for primary care and important healthcare initiatives. Estimated to be around $4 per member each month, this fee adds roughly 0.5% to 0.6% to premiums, which had to be incorporated after the initial rate filings were made in May.
