Health Insurance Premiums Expected to Rise in 2026
Health insurance companies nationwide are proposing significant premium rate hikes for their 2026 Affordable Care Act (ACA) plans, as revealed by two health policy research organizations.
The proposed changes range from reductions as low as -10% to substantial increases of 59%. On average, a rise between 12% and 27% has been suggested, according to data from the “Health System Tracker” compiled by the Peterson Center for Healthcare and KFF.
Coleman Drake, a professor at the University of Pittsburgh’s Department of Health Policy Management, remarked, “The increase in premiums linked to stronger subsidies will leave millions uninsured, as many will find it unaffordable to enroll in health coverage. Low-income individuals are particularly affected, as they are more sensitive to these premium hikes.”
Significance of the Issue
The rise in health insurance rates can be attributed to several factors. This seems to be following a trend seen in recent years, driven by escalating healthcare costs and increasing utilization rates.
Inflation also plays a role, as healthcare providers adjust reimbursement rates due to climbing labor expenses and ongoing challenges stemming from the Covid-19 pandemic.
Moreover, the surge in demand for GLP-1 medications like Ozempic and Wegovy, used for diabetes and weight management, is contributing to higher prescription drug spending.
Key Insights
Arkansas tops the list with the highest proposed premium increases, seeing a dramatic rise of 59%, and a minimum increase suggestion of 42.5%.
Paul Schafer, a health law and policy professor at Boston University, noted, “Arkansas is undergoing significant changes in how the ‘private’ Medicaid expansion aligns with market planning, impacting lower-income enrollees who face unique cost-sharing challenges.”
Schafer further explained, “The variations in premium rates depend on local market dynamics, including hospital competition and registration numbers in each state.”
Other states facing hefty proposed rate hikes include New Mexico (53%), New Hampshire (50.1%), and Arizona (49%). In contrast, Alaska leads with the lowest increase at 5.3%, followed by South Dakota (8.9%) and Oregon (12.5%).
A total of 125 insurance companies have suggested premium hikes of at least 20%, while four have proposed reductions. Companies in Pennsylvania have suggested a 10% reduction, along with modest cuts in Kansas (6.1%), Missouri (4.4%), and Alaska (0.8%).
Drake commented on the fluctuations, stating, “Both state regulators and insurers are faced with significant uncertainty regarding next year’s market policies.” He also noted that the expiration of expanded premium subsidies could lead to a “notable drop in enrollment,” thereby affecting insurers’ revenues.
He mentioned that other policy shifts have led some insurers to exit the market, while others raise their premiums.
Jonathan Gruber, an economics professor at MIT, added, “The level of competition in exchanges is crucial, impacting premium management.” He highlighted that states with robust competition and active exchange management tend to have lower premium increases.
Approximately 92% of ACA enrollees received subsidies in 2025, but with the expiration of premium tax credits expected in 2026, many may face significant increases, potentially raising out-of-pocket costs by over 75% based on information from the Health System Tracker.
Reactions
Drake emphasized, “The rise in premiums tied to stronger subsidies will lead to millions becoming uninsured, particularly affecting low-income registrants who are vulnerable to these hikes. Those maintaining their coverage will have to allocate a larger portion of their income to health plans.”
Schafer pointed out, “Insurers must navigate potential uncertainties related to high-cost drug usage, inflation, and provider consolidation. They need to make informed predictions about these factors for planning.” He cautioned that those receiving the least subsidies would experience the most impact, shouldering the full costs of their plans.
Looking Ahead
The 2026 ACA Marketplace Plan premiums are set to rise significantly for many, but the extent will vary depending on individual plans and state regulations.
