ACA premiums in Alabama could increase in 2026

WASHINGTON — Alabamians insured through the Affordable Care Act marketplace could see their premiums rise by about 20% next year, as enhanced premium tax credits are set to expire and increasing health care prices plague the industry.

Blue Cross and Blue Shield of Alabama, the largest insurer in the state, has requested a rate change of 19.3% for marketplace plans, according to an analysis from Peterson-KFF Health System Tracker. Celtic Insurance Company has requested a 29% change and UnitedHealthcare Insurance Company's request comes in at 20% in Alabama.

The rates for 2026 could change throughout the review process.

The ACA enhanced premium tax credits, introduced in 2021 as part of the American Rescue Plan, are set to expire at the end of 2025 unless Congress acts. An extension was not included in the GOP-led tax breaks and spending cuts package signed into law on July 4.

Some Republican members of Alabama's congressional delegation didn't rule out the possibility of Congress extending the subsidies past the end of the year, but the lawmakers also wouldn't directly tell Alabama Daily News if they would support extending them.

"We're taking a look at that and certainly open to those conversations," U.S. Sen. Katie Britt, R-Ala., told ADN in an interview before August recess.

U.S. Rep. Gary Palmer, a member of the Energy and Commerce Committee, which oversees health insurance, said he wants to ensure "people have access to quality health care that they can afford."

"I'll see what we do later on in regard to the subsidies on Obamacare," he told ADN in July.

In Alabama, more than 374,000 individuals were enrolled in a plan through the ACA marketplace in 2024, according to nonprofit health policy research organization KFF. About 98% of enrollees in Alabama received an advanced premium tax credit to help pay for their premiums in 2024.

Nationwide, insurance premiums on the marketplace are expected to rise at a median rate of 18%, according to the Peterson-KFF analysis. On average, the expiring tax credits are driving about 4% of the rising premiums costs next year.

"...most Alabama consumers purchasing on the Marketplace in 2025 qualify for a subsidy, which significantly reduces their out-of-pocket costs — with many low-income enrollees paying $0 or very little for coverage," Blue Cross Blue Shield of Alabama spokesperson Sophie Martin said in a statement. "Even in the unlikely scenario that ACA premiums decreased in 2026, eliminating the enhanced premium subsidies would still increase out-of-pocket premiums and put added strain on household budgets.

"This is why Blue Cross and Blue Shield of Alabama continues to strongly advocate for extending the enhanced ACA premium tax credits to ensure millions of households, including almost 500,000 Alabamians who are covered on an individual ACA plan, don't lose the healthcare coverage they have come to rely on."

Democrat Rep. Shomari Figures of Mobile opposed the new tax and spending law, expressing concern about the cuts to Medicaid. He said health care coverage should be as affordable as possible for residents in Alabama.

"We need to be doing everything that we can to make it more affordable and by removing this form of premium reductions, it does not get us any closer to that," Figures told ADN last month.

U.S. Senator and gubernatorial candidate Tommy Tuberville told reporters in July that the enhanced tax credits will be "evaluated" by Congress in the fall.

Lawmakers return to Washington after Labor Day.