ACA Marketplace insurers are proposing the largest premium hikes since 2018, with a median 15% increase projected for 2026, according to a new analysis. And several policy changes seem to be a key culprit.
The analysis, published last week, is from KFF and the Peterson Center on Healthcare. It examines preliminary rate filings from 105 ACA Marketplace insurers in 19 states and Washington, D.C. It found that across these insurers, most are requesting premium increases between 10% and 20% for 2026. More than a quarter (27%) are requesting increases of 20% or more.
In recent years, premiums in the individual market have been “relatively flat or grown only modestly,” the researchers said. Only 3% of insurers increased premiums by 20% or more last year. In addition, in past years, some insurers decreased premiums, while no insurers have requested rate decreases for 2026 so far.
Rising healthcare costs are a key contributor to these rate increases, as in recent years. GLP-1s and healthcare labor market pressures are having a major effect on healthcare costs this year, according to the analysis.
But in addition to rising costs, several policy changes are having an impact. This includes the expiration of enhanced premium tax credits at the end of the year, which have boosted financial assistance for people with ACA Marketplace coverage for the last five years. Unless Congress renews the enhanced premium tax credits, premium payments for subsidized enrollees will increase by more than 75% in 2026.
“The vast majority of insurers are mentioning this in their rate filings, with most saying they will raise premiums by an additional 4% than they would if the enhanced tax credits were renewed,” the researchers said.
Tariffs on drugs, medical equipment and supplies are also having an impact, the analysis showed. Some insurers project an average increase of 3% beyond typical rates due to the tariffs.
The Trump ACA Integrity Rule is also “creating uncertainty in the rate filing process.” This rule tightens eligibility verifications for ACA plans, among other changes. It goes into effect in August and is expected to cause up to 1.8 million people to lose coverage.
“However, based on what insurers have filed so far, this generally does not seem to be driving rate changes in either direction,” the report stated. “Insurers and state regulators are still finalizing rates for the upcoming plan year, so these filed premium increases may change.”
The researchers added that the finalized 2026 rate changes are anticipated to be released in late summer.
Photo: Ta Nu, Getty Images
