Summary
Big changes are on the horizon for health insurance costs in 2026. If you purchase your own health insurance through the ACA marketplace, it's crucial to understand how potential rate hikes could impact your finances.
If you buy your own health insurance, get ready for some potentially significant changes in your monthly premiums. Recent reporting from the Wall Street Journal indicates that insurers are seeking sizable rate increases for 2026 Affordable Care Act (ACA) marketplace plans, also known as Obamacare. This could result in a substantial jump in your monthly payment.
Higher Costs on the Horizon
Major insurers across the country are requesting double-digit increases. For example:
- Blue Cross & Blue Shield of Illinois is looking for a 27% hike.
- Its sister plan, Blue Cross & Blue Shield of Texas, is requesting 21%.
- Leading ACA plans in Washington state, Georgia, and Rhode Island are also proposing increases of over 20%.
These requests come after years of relatively stable, single-digit rate increases in the ACA market, where about 24 million people currently get their health insurance.
Why the Jump?
Insurers point to two main reasons for these proposed increases:
- Rising Healthcare Costs
The expense of medical care continues to climb. Insurers like Centene and Elevance Health have already seen their financial results impacted by higher claims this year, citing factors such as increased emergency-room visits, costly prescription drugs, and greater use of behavioral healthcare among ACA enrollees.
- Changing Federal Policy, Specifically Subsidy Cuts
This is a big one. Enhanced federal subsidies, passed by Congress in 2021 to help consumers afford their plans, are set to expire at the end of December. This reduction in subsidies is not only contributing to higher premiums but also making it more difficult for many people to afford the cost of their coverage.
As Cynthia Cox, a vice president at health-research nonprofit KFF, explains in a recent Wall Street Journal article, some people are going to be hit with a “double whammy:” facing both higher monthly insurance bills and the loss of financial assistance that previously helped offset those costs.
KFF’s analysis of public rate filings across 17 states and the District of Columbia found that the median requested premium increase is around 15%. If approved, this would be the steepest increase since 2018.
What This Means for You
While a spokesman for Health Care Service (the parent company of Blue Cross & Blue Shield of Texas and Illinois) noted that “plans are priced to reflect anticipated healthcare needs” and that rate changes would vary, the overall trend is clear: many individual health insurance plans are set to become more expensive.
At GTM Insurance Agency, we understand that these potential changes can be concerning. As these rate requests are reviewed and finalized, it’s more important than ever to understand your options and ensure you have the coverage you need. We’re here to help you navigate these complexities and explore solutions tailored to your situation. Call us today at 518-373-4111 or request a complimentary consultation.
