US Health Insurance Premiums Projected to Surge in 2026

Health insurance premiums in the United States are projected to rise significantly in 2026, with insurers proposing the largest increases since 2018. A study by KFF, analyzing rate filings from 105 insurers across 19 states, indicates a median premium increase of 15%. This surge is primarily attributed to the anticipated expiration of enhanced federal premium tax credits at the end of 2025, which have been instrumental in reducing costs for Affordable Care Act (ACA) enrollees. Without these subsidies, out-of-pocket premiums are expected to rise by over 75% on average, potentially leading to a significant number of individuals losing coverage. Additionally, rising healthcare costs, including increased medical claims and the expense of prescription drugs, are contributing factors. State-specific data reflects this trend; for instance, Pennsylvania insurers are requesting an average 19% increase in the individual market, while Colorado anticipates a 28% hike. The potential expiration of these subsidies has also sparked political debate, with concerns about affordability and access to healthcare coverage.

The enhanced federal premium tax credits, introduced to make ACA plans more affordable, are set to expire at the end of 2025. Without these subsidies, out-of-pocket premiums are expected to rise by over 75% on average, potentially leading to approximately 4 million more Americans becoming uninsured.

Increased medical claims, particularly from emergency room visits and mental health treatments, along with the rising expense of prescription drugs—including popular and expensive medications like GLP-1 drugs for diabetes and obesity—are driving up costs. Additionally, rare but high-cost gene therapies and cancer treatments are contributing to higher premium prices.

State-specific data reflects this trend; for instance, Pennsylvania insurers are requesting an average 19% increase in the individual market, while Colorado anticipates a 28% hike.

The expiration of EPTCs could lead to approximately 4 million more Americans becoming uninsured. This would disproportionately affect individuals in rural areas and those with lower incomes, exacerbating existing health disparities.

The loss of coverage could have a ripple effect across the healthcare industry, leading to reduced payments to healthcare providers, potential job losses, and decreased state and local tax revenues.

The potential expiration of these subsidies has sparked political debate, with concerns about affordability and access to healthcare coverage. Republicans may still consider extending the enhanced ACA subsidies set to expire at the end of 2025, which have lowered premiums and increased enrollment but represent a significant government cost. Key Republican Senators indicated reluctance, but they have not ruled out a potential inclusion in next year's budget reconciliation process. However, House GOP leaders are more firmly opposed. Without an extension, millions could lose coverage or face higher premiums, with increased lobbying expected from hospitals, insurers, and patient advocates.

As the expiration of enhanced premium tax credits approaches and healthcare costs continue to rise, Americans are bracing for substantial increases in health insurance premiums in 2026. The potential surge in uninsured individuals and the broader economic implications underscore the urgency for policymakers to address these challenges to ensure continued access to affordable healthcare coverage.