ACA Premium Increases in 2026: What to Expect
ACA premium increases in 2026 are turning out to be one of the steepest hikes in years. A recent report depicts most Marketplace insurers are proposing hikes between 10% and 20%, with a median proposed increase of 15%, which would be the highest since 2018.
As per an analysis by KFF and Peterson Center on Healthcare, about 25% of insurers are asking for increases of 20% or more in their 2026 filings. This time, it isn’t just inflation; policy changes and expiring subsidies are also major drivers.
What’s Driving the 2026 ACA Premium Increases?
In the past, Marketplace premiums have remained stable, with many insurers even lowering their rates. However, that trend is reversing for 2026, and here’s why:
- Rising Medical & Drug Costs
Drugs used for diabetes and weight loss, such as GLP-1 drugs, along with staff shortages, and a hiking rate of inflation, are pushing the healthcare costs to be higher than ever. With such cost pressures, consumers are inevitably facing higher premiums.
- Expiring Enhanced Subsidies
Enhanced premium tax credits were lowering costs for millions during the pandemic. These are however, set to expire at the end of 2025, unless they are extended by Congress. If not, many subsidized enrollees could face premium hikes of up to 75%. Insurers have already anticipated this change, and most have added an extra 4% to their rate proposals in case the subsidies lapse.
- Tariffs on Medical Supplies
Another relevant factor is the new tariffs imposed on drugs, equipment, and medical supplies. According to some insurers, it is estimated that 3% of premium hikes are directly tied to these increased import costs.
Policy Uncertainty Contributes to the Pressure
The ACA Integrity Rule is going into effect in August, and it is expected to tighten eligibility requirements for individuals seeking insurance. This may even result in up to 1.8 million people losing coverage. Even though it hasn’t caused any significant pricing shifts yet, insurers are observing it closely.
Given that rate filings are still under review, these proposed increases may change before plans are finalized later this summer.
What This Means For You
If you or your business relies on ACA Marketplace coverage, here’s what you need to know:
- Expect higher base premiums, whether or not you qualify for subsidies
- Subsidy expiration could drastically raise monthly costs
- Now is the time to review your plan options for 2026
And if you’re helping employees or clients plan for health coverage, rising rates could affect overall benefit budgets and contribution strategies.
Feel free to contact us for a strategy session.
Conclusion
ACA premium hikes in 2026 are rather the highest we have seen in years. With medical costs rising and key subsidies set to expire, both individuals and businesses need to stay informed and proactive.
Need help navigating the changes ahead? Talk to our team to make sure you’re protected against the upcoming hike.
Shayne Bevilacqua, MBA, TRA, is a licensed insurance advisor and Principal of Professional Liability Insurance Group (PLIG) and Bevilacqua Insurance Group (BIG). He partners with healthcare organizations and other professional sectors to navigate evolving regulatory and market environments, aligning risk management strategies to ensure clients remain protected, compliant, and poised for long‑term success.
