Significant Premium Increases for Oregonians’ Health Insurance in 2026
Many Oregonians purchasing their own health insurance, or obtaining it via small businesses, are in for a rough ride next year as state regulators have set new premium rates that average notable increases.
This week, the Oregon Department of Financial Regulation unveiled these new rates after a delay in the review process caused by recent financial turmoil. A federal court challenge concerning new rules from the Centers for Medicare and Medicaid Services has also been a factor in this delay.
In the individual market, approximately 126,000 Oregonians buy plans through the Affordable Care Act marketplace—often referred to as Obamacare. Insurers have announced an average premium rise of nearly 9.7%, which is a slight jump from last year’s average of 9.3%.
For small group health plans aimed at businesses with 50 or fewer employees, premiums are expected to go up by an average of 11.5%, a modest decrease compared to last year’s 12.3% increase. Although many employers help cover their employees’ monthly premiums, this hike will still affect around 140,000 Oregonians with small business insurance.
Five major insurers—BridgeSpan, Moda, PacificSource, Providence, and Regence—will be offering individual plans statewide. The Kaiser Foundation Health Plan of the Northwest will provide coverage in 11 counties.
Each of these companies typically presents at least three plan options, classified as Bronze, Silver, and Gold. These categories differ by how costs are shared between the consumer and the insurer; on average, consumers cover about 40% of costs for Bronze plans, 30% for Silver, and 20% for Gold.
For a typical 40-year-old in Portland looking at a mid-tier Silver plan, premiums can range from around $518 per month with Kaiser to $620 per month with Bridgespan. Plans from other insurers are in between; Providence’s averages $584, Moda’s $539, PacificSource’s is $593, and Regence’s is $591. These prices do not account for income-based subsidies available via the Affordable Care Act.
For small businesses providing insurance, premiums for a 40-year-old in Portland may vary from approximately $450 per month with Kaiser to $613 per month for a United Healthcare plan, depending on the insurer.
State regulators have pointed to medical inflation and climbing prescription drug costs as major factors behind these premium hikes. Additionally, the upcoming expiration of enhanced federal insurance premium tax credits is significantly impacting rates, according to the Oregon Department of Consumer and Business Services.
These subsidies were initially introduced to help lower health insurance costs during the COVID-19 pandemic and are currently extended through 2025. They helped many Oregonians reduce their monthly premiums. However, without congressional action to extend these enhanced subsidies, families may face a steep reduction or complete removal of this federal aid by the end of 2025.
This situation has become entangled in the federal government shutdown debate. Democrats contend that allowing these subsidies to lapse would escalate health care costs for hardworking families and unsettle the insurance marketplace. Yet, many Republicans push back, suggesting that this issue should be settled separately from other emergency funding discussions.
If these subsidies fall away, particularly some middle-income families in Oregon could see their monthly costs skyrocket—by as much as 300% to 400% in some cases, according to state officials.
People earning above 400% of the federal poverty level, which is about $62,000 annually for an individual, $84,000 for couples, and $128,000 for a family of four, will no longer qualify for the expanded subsidies.
Last year, over 145,000 Oregonians enrolled in health insurance through the marketplace, with around 80% receiving some federal subsidies to help ease their premium costs.
The open enrollment period for health insurance through the Obamacare Marketplace is set to begin on November 1st and will continue until January 15th. Residents can find more information and tools through the state’s Health Insurance Marketplace Online Calculator.
