Florida health insurers seek massive rate increases, with one proposing a 41% hike for 2026 - Insurance News | InsuranceNewsNet

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August 13, 2025 Newswires
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Florida health insurers seek massive rate increases, with one proposing a 41% hike for 2026

Christine Sexton / Florida Phoenix / Special to Islander NewsThe Islander News

Property insurance may be what's on residents' minds as Florida continues to grapple with high housing costs, but people need to look out for soaring health insurance costs in the coming year, too.

Fourteen insurers writing individual policies in Florida have proposed double-digit rate increases for Affordable Care Act-compliant plans in calendar year 2026, a review of federal data shows.

The Centers for Medicare & Medicaid Services (CMS) data show that Molina Healthcare wants an overall rate boost of nearly 41% for calendar year 2026, more than any other plan. According to its supporting documents, the increase could affect more than 90,000 policyholders.

AmeriHealth Caritas requested the second highest overall rate hike at slightly more than 37% overall. Its justification data indicate the hit would average 35% for 55,000 policyholders.

Centene Venture Co. Florida requested the smallest rate increase, 18.73%. According to its supporting data, the increase would affect an estimated 1.3 million individuals.

Blue Cross and Blue Shield of Florida proposed an overall rate change of nearly 27%, according to the CMS website, although its rate justification notes that some members will experience increases above 15%.

Not alone

The proposed rate changes are preliminary and could change during the rate review process, which is expected to be completed by the federal government at the end of the summer. Open enrollment for 2026 individual coverage under the ACA, also known as "Obamacare," through the federal health insurance marketplace begins in the fall, as it does for most employer-sponsored insurance plans.

The federal government presents the rate changes in terms of an overall increase because the amount charged individuals varies depending on their geographic location, age, and which tier plan they choose to enroll in: bronze, silver, gold, or platinum.

Florida is not alone in these rate hikes — insurers nationwide are filing double-digit increases. A KFF review of marketplace plans submitted by 312 insurers in 50 states and the District of Columbia shows that the median proposed increase for 2026 is 18%, more than double last year's 7% median proposed increase.

Insurers cited rising costs, utilization of services, and the loss of enhanced advanced premium tax benefits as the reasons behind the rate increases, according to KFF.

Mums the word?

While the proposed increases haven't been finalized, they are looming and it's not clear what, if anything, Florida insurance officials are doing to get the word out to people.

Attempts to contact Florida Insurance Consumer Advocate (ICA) Tasha Carter for this story were unsuccessful. There's no reference to rising health insurance rates on the ICA's website dedicated to consumer alerts and there's no reference to health insurance rates in its Current Insurance Topics section.

Florida Conservatives for Affordable Health Care is holding a press conference in Tallahassee on Wednesday morning to address the rising rates and how they will soar particularly for those who have been relying on the enhanced premium tax credits to help with affordability.

Montana State Auditor James Brown issued a statement on Aug. 1 advising residents of the impending increases.

"The increase will affect small group health insurance plans offered both on and off the federally facilitated marketplace (HealthCare.gov as well as indiviudal marketplace plans — the plans used by many Montana small employers, independent workers, and families," Brown said in the statement. "We want Montanans to be informed and prepared."

Small-group filings

Carriers also filed proposed rate increases for plans sold to Florida's small employers for 2026, those with of 50 or fewer workers. While less steep than the individual policies, many of the carriers requested double-digit or near double-digit increases.

Neighborhood Health Partnership requested the highest overall increase for small group plans with a proposed overall 12.78% rate hike, whereas National Health Insurance Co. came in with the smallest proposed rate increase, at 8.38%.

According to the most recent Florida Office of Insurance Regulation data, most people in Florida who purchased health insurance policies in 2023 have individual coverage, and most of them have policies sold on the federal health insurance exchange.

The 2023 data show that more than 5.8 million people maintained commercial health insurance policies, and most of those people, 3.6 million-plus, had individual health insurance plans. Nearly 1.8 million people had large group plans, those sold to businesses with more than 51 employees. Small group policies insured another 400,164 lives in 2023.

While more recent data on small group and large group enrollment isn't available Obamacare enrollment in Florida in 2025 topped more than 4.6 million people.

This article appeared on the website of the Florida Phoenix, a nonprofit news organization dedicated to coverage of state government and politics from Tallahassee.

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