Ahead of the upcoming Affordable Care Act (ACA) enrollment period in November, the nation’s health care marketplace insurers are seeking the largest premium increases in more than five years, according to a new analysis by the Peterson Center on Healthcare and health policy nonprofit KFF.
The KFF analysis examines insurers in the District of Columbia and 19 states: Connecticut, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, Rhode Island, Texas, Vermont, and Washington.
Finalized 2026 rate changes are expected to be published in late summer, and individuals will be able to see how their plans’ premiums are changing just before open enrollment begins in November.
“This is expected to cause healthier enrollees to drop their coverage and create a sicker risk pool,” the report states.
The Congressional Budget Office (CBO) projects that, on average, gross benchmark silver premiums will ultimately be 7.9 percent higher than they would otherwise be as the risk pool becomes sicker, on average, and that many enrollees will become uninsured.
“Unless the premium tax credits are extended, consumers can expect increases in both the net premium payments and gross premiums,” the June 3 report states.
Tariffs could also drive up the cost of certain drugs, medical equipment, and supplies, the July 18 report stated. It further notes that some insurers report that tariffs—and the uncertainty surrounding them—are causing rate increases.
Many insurers submitted proposed rates before Congress passed the budget reconciliation legislation and the Centers for Medicare and Medicaid Services (CMS) finalized the Marketplace Integrity and Affordability rule. The legislation and new Medicaid rules, which explain how the ACA marketplace operates and how individuals enroll, were only finalized recently, and it is still unclear how insurers might respond, the report states.
“Early indications are that individual market insurers will be increasing premiums in 2026 by more than they have since 2018, the last time policy uncertainty contributed to sharp premium increases,” the new Peterson-KFF report stated, noting that across 105 ACA Marketplace insurers in 20 markets, premiums are increasing by a median of 15 percent.
Another factor creating uncertainty in the rate filing process is the implementation of the Trump administration’s ACA integrity rule. Based on what insurers have filed so far, this does not generally appear to be driving rate changes in either direction, the report states.
“Insurers and state regulators are still finalizing rates for the upcoming plan year, so these filed premium increases may change,” the report stated.