Health marketplace enrollees in for ‘big brutal increases,’ sticker shock for 2026

Health insurance marketplace customers will face sticker shock when they begin to shop for 2026 coverage.

Beginning Aug. 1, the health care marketplace site healthcare.gov will begin publishing rates that carriers have submitted for Affordable Care Act coverage for the 2026 plan year. Open enrollment for 2026 begins Nov. 1.

“The forecast is clear; Americans will face big brutal health care increases this summer on individual marketplace,” said Anthony Wright, executive director of Families USA, during a news conference. “These Americans will face a double whammy – double digit increases in the base rate and the expiration of enhanced tax credits enabling them to buy coverage.”

So far, 19 states and the District of Columbia have announced individual marketplace rates submitted by carriers, Wright said. Average premium. So far, average premium rates have increased more than 15%, compared with single-digit percentage increases over the last few years.

In some states, average premium increases have gone up even higher, Wright said, citing 20.5% average increases in Indiana, 24% in Maine and 35% in Delaware.

“But as bad as these base rate increases are, families will experience an even worse rate shock with the expiration of enhanced tax credits,” Wright said.

Expiration of tax credits will hurt consumers

The American Rescue Plan Act of 2021 included enhanced marketplace tax credits to enable more Americans, including those in “middle” income brackets to obtain ACA coverage. The Inflation Reduction Act of 2022 extended those enhanced tax credits. But they will expire at the end of this year unless Congress acts to keep them.

With those enhanced tax credits set to expire at the end of the year, the average premium is expected to jump by as much as 75%, according to KFF. Wright said that on average, those affected by this will pay an average of $700 more per month for coverage, not including the increase in the base rate.

Enrollees who are older and live in rural areas will be hit hardest, he said.

“These increases will impact more than 20 million Americans,” Wright said. “The budget bill combined with the marketplace integrity and affordability rule will make it harder to get covered and to stay on coverage. This will leave a smaller and sicker risk pool.”

Wright said that the expiring enhanced tax credits along with an increase in people losing coverage would turn the ACA marketplace “into the dreaded death spiral.”

“Marketplaces could see their enrollment cut in half,” he said.

Wright called on consumers to contact their representatives in Congress and urge them to keep the enhanced tax credits in place while addressing affordability in the marketplace.

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].