Overview
Health insurance premiums in the Affordable Care Act (ACA) Marketplace could increase by as much as 18% in 2026, marking the steepest jump since 2018. This spike is driven by a combination of rising health care costs, economic pressures, and changes to premium tax credits.
Key Drivers Behind the Spike
- Rising Health Care Costs: Hospital services, physician visits, and prescription drugs—especially high-cost specialty medications—are all becoming more expensive.
- Macroeconomic Pressures: Inflation and higher labor costs in the health care sector continue to push premiums upward.
- Policy Uncertainty: The expiration of enhanced premium tax credits at the end of 2025 could cause out-of-pocket premiums to rise by an average of 75%, leading some healthier individuals to drop coverage.
Historical Context
This projected increase is 11 percentage points higher than last year’s rate changes, making it one of the largest year-over-year jumps in recent history.
Regulatory Pushback
Some state officials are pushing back on insurers’ proposed rate hikes. In Arkansas, for example, proposals include increases of more than 50% from one major carrier and over 25% from another—drawing sharp criticism from regulators.
Impact Beyond the ACA Marketplace
Employer-sponsored health plans are also expected to see continued cost increases, as economic and policy factors affect the entire health insurance market.
What You Can Do
- Compare Plans Carefully: Once final rates are released later this year, review all available options—especially if your current insurer is proposing a large increase.
- Prepare for Tax Credit Changes: If enhanced premium tax credits expire, be ready for higher monthly costs. Estimate your expenses now so you’re not caught off guard.
- Follow State Developments: States may reject or modify excessive rate hikes, so keep an eye on local decisions that could affect your premiums.