Insurers on the ACA market offer the largest premium increases since 2018, with a median increase of 15% planned for 2026, according to a new analysis. And several political changes seem to be a key culprit.
The analysis, published last week, is from Kff and the Peterson Center on Healthcare. He examines the preliminary rate deposits of 105 insurers on the ACA market in 19 states and Washington, DC, he found that in these insurers, most require bonus increases between 10% and 20% for 2026. More than a quarter (27%) require increases of 20% or more.
In recent years, premiums on the individual market have been “relatively stable or cultivated only,” said researchers. Only 3% of insurers increased bonuses by 20% or more last year. In addition, in recent years, some insurers have decreased bonuses, while no insurer has requested a reduction in the rate for 2026 so far.
The increase in health care costs is a key contributor to these rate increases, as in recent years. GLP-1 and pressures on the health care labor market has a major effect on health care costs this year, according to the analysis.
But in addition to the cost increase, several policy changes have an impact. This includes the expiration of tax credits for improved premiums at the end of the year, which have strengthened financial assistance for people with ACA market in the past five years. Unless the Congress renews tax credits for improved premiums, bonus payments for subsidized registrants will increase by more than 75% in 2026.
“The vast majority of insurers mention it in their rate deposits, most saying that they will increase the bonuses by an additional 4% that if the increased tax credits were renewed,” the researchers said.
Medicines, medical equipment and supplies also have an impact, has shown the analysis. Some insurers project an average increase of 3% beyond typical rates due to prices.
The ACA Trump integrity rule is also “to create uncertainty in the rate deposit process”. This rule tightens the admissibility checks to the ACA plans, among other changes. It comes into force in August and should cause up to 1.8 million people are lost.
“However, on the basis of what insurers have filed so far, this does not generally seem to conduct rate changes in both directions,” said the report. “State insurers and regulators always finalize the rates for the next year of the plan, so these increases in deposited premiums may change.”
Researchers added that the finalized rate changes 2026 should be published at the end of the summer.
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