ACA Market insurers are proposing the biggest premium hikes since 2018, with a median 15% enhance projected for 2026, in line with a brand new evaluation. And several other coverage modifications appear to be a key perpetrator.
The evaluation, printed final week, is from KFF and the Peterson Middle on Healthcare. It examines preliminary charge filings from 105 ACA Market insurers in 19 states and Washington, D.C. It discovered that throughout these insurers, most are requesting premium will increase between 10% and 20% for 2026. Greater than 1 / 4 (27%) are requesting will increase of 20% or extra.
In recent times, premiums within the particular person market have been “comparatively flat or grown solely modestly,” the researchers stated. Solely 3% of insurers elevated premiums by 20% or extra final yr. As well as, in previous years, some insurers decreased premiums, whereas no insurers have requested charge decreases for 2026 thus far.
Rising healthcare prices are a key contributor to those charge will increase, as lately. GLP-1s and healthcare labor market pressures are having a significant impact on healthcare prices this yr, in line with the evaluation.
However along with rising prices, a number of coverage modifications are having an influence. This contains the expiration of enhanced premium tax credit on the finish of the yr, which have boosted monetary help for folks with ACA Market protection for the final 5 years. Until Congress renews the improved premium tax credit, premium funds for backed enrollees will enhance by greater than 75% in 2026.
“The overwhelming majority of insurers are mentioning this of their charge filings, with most saying they’ll elevate premiums by a further 4% than they might if the improved tax credit had been renewed,” the researchers stated.
Tariffs on medication, medical tools and provides are additionally having an influence, the evaluation confirmed. Some insurers challenge a mean enhance of three% past typical charges because of the tariffs.
The Trump ACA Integrity Rule can also be “creating uncertainty within the charge submitting course of.” This rule tightens eligibility verifications for ACA plans, amongst different modifications. It goes into impact in August and is predicted to trigger as much as 1.8 million folks to lose protection.
“Nonetheless, based mostly on what insurers have filed thus far, this usually doesn’t appear to be driving charge modifications in both route,” the report acknowledged. “Insurers and state regulators are nonetheless finalizing charges for the upcoming plan yr, so these filed premium will increase could change.”
The researchers added that the finalized 2026 charge modifications are anticipated to be launched in late summer season.
Picture: Ta Nu, Getty Photos
