Health Insurance Premiums Set to Soar in 2026: What You Need to Know
By Julie Appleby, KFF Health News
As we approach the upcoming year, it’s becoming increasingly clear that most of the 24 million people enrolled in Affordable Care Act health plans are facing a tough road ahead. Double-digit premium increases combined with a potential sharp drop in federal subsidies, which most consumers rely on to afford coverage, are on the horizon.
Insurers are seeking higher premiums to cover the usual suspects – rising medical and labor costs, increased usage, and the uncertainty surrounding policy changes implemented by the Trump administration and the Republican-controlled Congress. One critical factor influencing their rate proposals for 2026 is the looming question of whether Congress will allow the more generous ACA tax subsidies, introduced during the Covid-19 era, to expire at the end of December.
Experts warn that the impact of these changes on individuals’ out-of-pocket expenses could be significant, potentially leading many to forgo coverage altogether due to financial constraints. JoAnn Volk, co-director of the Center on Health Insurance Reforms at Georgetown University, predicts that the financial burden could be too much for some individuals to bear, resulting in increased rates of uninsurance.
The potential premium hikes come at a time when the nation is gearing up for crucial midterm elections, making them ripe for political scrutiny. Lawmakers on both sides of the aisle are reportedly exploring options to mitigate the subsidy reductions and lessen the financial strain on consumers.
Initial filings from insurers across the country reveal a median rate increase of 15%, significantly higher than previous years. Factors such as rising medical costs and the expiration of enhanced tax credits are contributing to these substantial increases. If the enhanced tax credits are extended, some states could see a reduction in the average statewide increase, as indicated by rate filings from Maryland.
The expiration of the enhanced tax credits could have a profound impact on consumers, with experts estimating that the average amount individuals pay for coverage could rise by over 75%. This could result in a significant drop in enrollment, with some projections suggesting a decrease of up to 57%.
While the future remains uncertain, insurers are bracing for the potential fallout from these changes. Premium increases to offset subsidy expiration, coupled with other factors such as Trump administration tariffs, are expected to drive up costs for consumers. Discussions are ongoing in Congress, with lawmakers considering various scenarios to address the subsidy issue and prevent a potential enrollment crisis.
As consumers await their new premium prices later this fall, the looming uncertainty underscores the importance of finding solutions to maintain affordable coverage for all Americans. The decision to extend or let the enhanced subsidies expire will have far-reaching implications for the health insurance market and the millions of individuals who rely on these subsidies to access essential care.
