Health insurance for many Arkansans will be affordable in 2026 after all — if you shop around

If you buy health insurance on the individual marketplace in Arkansas and you're staring down a huge cost increase in 2026, here's the thing to remember: shop before you drop. Don't drop coverage without talking to an insurance agent or broker first. Even if the premium on your current plan is increasing, there may be much better deals out there. You've just got to look for them.

The cost of insurance is generally going up. For an unlucky group of about 12,000 middle- to upper-income Arkansas families, the hike will be brutal, with premiums increasing by hundreds of dollars per month or more. Tens of thousands of lower-income people could face smaller but still significant increases. The main reason is congressional Republicans' refusal to renew "enhanced" Affordable Care Act (ACA) subsidies that were put in place during the Biden administration and are set to expire at the end of the year. (Importantly, the ACA subsidies are not going away entirely in 2026 — they're just getting smaller, reverting back to the level they were before Democrats boosted them under Biden.)

But in Arkansas specifically, the overall situation is less dire than it appeared a few months ago. Surprisingly, most of the roughly 166,000 Arkansans who buy an individual plan on the marketplace should still have an affordable insurance option in 2026 after all.

The key is to shop around and compare prices. If you're currently on a marketplace plan that's going to become insanely expensive in 2026, there's a good chance you can find a different plan that's more reasonable.

Prices aren't rising by the same amount across the board: Premiums on some plans are skyrocketing, while others are not. Depending on your age, income, household size and other factors, you may even find higher-quality coverage in 2026 for a lower price than your current 2025 plan. As counterintuitive as it sounds, that's what we found upon reviewing costs on HealthCare.gov, the federal marketplace website.

For example: A hypothetical 50-year-old single woman in Pulaski County who makes $40,000 annually could buy a mid-grade "silver" plan in 2025 for about $145 a month. In 2026, the monthly premium on that same plan will more than double to $337, even as the deductible also rises. But if she switches to a "gold" plan next year, she'll pay as little as $109 a month, even though gold plans are generally higher-quality than silver plans and come with lower deductibles.

You can window shop on HealthCare.gov and see for yourself — compare 2025 prices with 2026 prices for a single person with an income between $23,000 and $60,000. The costs of silver plans are rising dramatically. The costs of gold plans are generally going down. "Bronze" plans, which have the lowest premiums and highest deductibles, are also getting cheaper.

Or consider a real-world example. Nathan Huffmaster, 27, is a resident of Benton and an organizer with Arkansas Community Organizations, where he makes about $17 an hour. Huffmaster currently buys a "Standard Silver" plan from Ambetter, one of the two companies that sells insurance on the marketplace in Arkansas, and pays a monthly premium of about $15. (Ambetter is also known as Centene, its parent company.) The coverage is "pretty decent," he said, with a deductible that's "a little bit high but manageable" for his health care needs.

If he kept the same plan in 2026, Huffmaster would have to pay $140 a month, a giant increase. "It seems like all the plans similar to mine are going to be $150 or more," he said. He saw bronze plans for very cheap on HealthCare.gov, but the deductibles were so high that they seemed "just about useless." He considered dropping coverage altogether — an option that's appealing to many people, especially if they're young and fairly healthy.

But then he checked out the gold options for 2026. A "Gold Value" plan from Arkansas Blue Cross and Blue Shield, the other insurer on the Arkansas marketplace, will cost Huffmaster just $17 monthly next year, with a $0 deductible. Some of his costs will be higher — co-pays on doctor visits are higher on the gold plan than with his current silver — but on the whole it's a very good deal. (Ambetter offers similarly priced gold plans in 2026.)

How is this possible? Why would mid-grade silver plans suddenly cost more than high-grade gold plans? Why are some Arkansans seeing costs go down when others are facing a backbreaking increase? How does it square with the congressional showdown over the looming ACA cuts? Or with the news in September that BlueCross and Ambetter would raise rates in 2026 by an average of 22%?

The short answer is that state regulators made some very clever policy moves earlier this year to offset the anticipated loss of the enhanced subsidies. Insurance companies are in fact raising rates by double digits in Arkansas, but most of that premium increase is concentrated just on silver plans. This is intentional — in fact, they've been directed to do it by the Arkansas Insurance Department. That's because the size of a given person's ACA subsidy is based partly on the cost of a benchmark silver plan in their local market. So, if Arkansas insurers raise premiums just on silver plans but not bronze or gold, that can actually increase the size of subsidies available to Arkansans.

This practice, known as "silver loading," is a state-level workaround to mitigate the broader reduction in federal subsidies happening nationally. Arkansas isn't the only state to do this; the national health policy expert Charles Gaba has written extensively about the use (and limits) of the policy here and elsewhere. Masochistic readers can find a more detailed explanation below. But the upshot is that many people on the marketplace in Arkansas will be hit less hard by the end of enhanced ACA subsidies than expected.

Provided they look around, that is. Most marketplace enrollees tend to simply let their current insurance plan renew at the end of the year rather than shopping. And many Arkansans have already received notices in the mail saying their premiums are shooting up next year. Some may assume the situation is hopeless and simply drop coverage without looking for other options.

If you're on a marketplace plan right now, don't let that be you. Shop before you drop. Plug in your information on HealthCare.gov and compare prices. If you're on a silver plan, check out prices on gold or bronze plans.

And most importantly, talk to a local insurance agent/broker for help — it's free, and it could make all the difference between having very solid insurance next year and going uninsured. For help finding your best options, you can find an agent by entering your city or ZIP code at HealthCare.gov. You can also call the Arkansas chapter of the National Insurance Benefit Coordinators at 501-372-4800. You need to enroll by Dec. 15 if you want coverage to start by the first of the year, so don't put it off. (The open enrollment window stays open for another month after that, but coverage won't kick in until the beginning of February if you sign up between Dec. 15 and Jan. 15.)

The longer explanation about why health insurance prices are changing in seemingly nonsensical ways is … well, long. It's impossible to understand what's happening in Arkansas right now without getting into the weeds of how the ACA works and how the subsidies are calculated. If you're simply looking for affordable coverage, feel free to stop reading now and go find an agent or broker to help you shop. If you want to know more, read on.

An ACA primer

The Affordable Care Act — the 2010 health reform law also called Obamacare — was intended to ensure that fewer Americans go without insurance. It accomplished this in two main ways.

For the lowest-income Americans, the ACA expanded Medicaid to cover millions more working-age adults. Medicaid is a partnership between the federal government and the states, and some red states refused to participate in Medicaid expansion, though most now do. In Arkansas, Medicaid expansion is known as ARHOME; it covers about 220,000 people with incomes below 138% of the federal poverty line.

(The poverty line is generally adjusted upward each year, and it varies according to household size: As shown in this table from the feds, the poverty line in 2025 was about $16,000 per year for a single person, and 138% of the poverty line was about $22,000. For a two-person family, the 138% threshold would be about $29,000. For a family of four, it's about $44,000.)

For low- to middle-income households, the ACA had a different way of getting people covered: the private market. It set up a system of federal income tax credits, or subsidies, to help people pay for premiums on private insurance plans they otherwise couldn't afford. The subsidies could be used to purchase any eligible plan sold on a new marketplace (also called an "exchange") set up under the ACA. The influx of newly subsidized customers was a boon for insurance companies, but the ACA also rewrote the rules for how those companies did business. It required them to cover a list of core benefits and did away with the practice of charging people more money based on preexisting medical conditions for any plan they sold on the marketplace.

Under the original ACA, the subsidies were available to anyone between 100% and 400% of the federal poverty line who couldn't get insurance in some other way, such as through a job or Medicaid. In states that expanded Medicaid, including Arkansas, that means the target population for marketplace coverage was anyone between 138% of the poverty line and 400% — those below the 138% mark will qualify for Medicaid instead.

Because affordability is the point, the size of the premium subsidy scales with a person's income. Someone making 150% of the poverty line, for example, gets a larger subsidy than someone making 300% of the poverty line.

All of this makes it crucial to distinguish between the gross premiums charged by insurers (before subsidies are applied) and the net premiums paid by consumers (after subsidies are applied). The steep rate hikes announced over the summer in Arkansas were increases in gross premiums. These are the sticker prices that the insurance companies charge for their plans, based on various risk calculations about the cost of medical procedures, prescription drugs, hospital stays, and so on. The net premium is the actual amount that a person pays each month for their insurance, which depends on how large of a subsidy they get.

The Biden upgrade and the subsidy cliff

In the years after passage of the ACA, Medicaid expansion proved to be very effective at getting people covered. The ACA marketplace was less so. As of 2019, only about 11.4 million Americans were insured through a marketplace plan, including about 64,000 in Arkansas. Millions continued to go uninsured.

For context, 63 million people in the U.S. were on Medicaid that year, including about 20 million covered by Medicaid expansion. About half of Americans — around 158 million in 2019 — got insurance through an employer or a family member's employer.

Marketplace signups overall were lower than the architects of the ACA had hoped, in large part because many people found insurance too expensive even with the subsidies. A person living on a modest income might still have to pay a net monthly premium of several hundred dollars, and face a large deductible to boot. And for people who made more than four times the federal poverty line, there was no help available whatsoever.

That 400% mark became known as the "subsidy cliff" among health policy wonks. If you made slightly less than that amount, you'd get a subsidy. If you made more than that amount, you'd have to pay the full cost of your premium out of pocket.

For context, 400% of the poverty line for a single person in 2025 is $62,600; for a household of two, it's $84,600. Most people making that much money probably aren't struggling with day-to-day expenses, but they're not living lavishly either, especially if they're in an area with high rents and other cost-of-living expenses. It's no surprise many people continued to choose to go without insurance, especially the young and healthy.

In 2021, Democrats passed the American Rescue Plan, a COVID-relief package that made the subsidies more generous for everyone on the marketplace. The bill also did away with the subsidy cliff, guaranteeing that many people making above 400% of the poverty line could now get a subsidy as well. It effectively capped the amount that anyone had to pay for premiums on a certain benchmark plan at 8.5% of household income. These changes (later extended by a few years under President Biden's Infrastructure Reduction Act) are the "enhanced" premium tax credits that are set to expire in 2026.

The effect of "enhancing" the subsidies has been dramatic: Marketplace enrollment doubled in the last five years nationwide, to more than 24 million. Arkansas enrollment is now at 166,000, a 250% increase. But now the original, stingier ACA subsidy rates are coming back. Unless Republicans agree to preserve the enhanced levels within the next few weeks, the subsidy cliff will be returning in 2026.

Assuming the enhanced subsidies do go away on Jan. 1, the worst of the pain will be felt by the middle- to upper-income group — those with incomes above 400% of the poverty line. According to the prices on HealthCare.gov, a 60-year-old single man in Pulaski County making $70,000 annually (that's a little over four times the poverty line) could buy a silver plan for about $480 a month in 2025, after applying the subsidy. That's no small amount to pay out of pocket in itself. But in 2026, the monthly premium on that same plan will quadruple to $1,900.

The cheapest silver plan available next year would cost him $1,767 a month. The cheapest bronze plan — the bare-bones, high-deductible type of insurance — would be $950. He could also buy what's called a "catastrophic" plan with a super-high deductible of $10,600. (These plans, which generally are useful only in a severe personal health crisis, aren't eligible for ACA subsidies.) Depending on his health needs and personal budget, his best option might be gold. The premium on the cheapest gold plan available to him next year would be $1,373 a month, almost $400 less than the cheapest silver. Still, he will be spending $893 more per month on health insurance premiums than he did in 2025.

About 12,000 Arkansans now enrolled in the marketplace fall into this middle- to upper-income tier — about one in 12 enrollees overall — and they all face astronomical increases in 2026. The sticker shock is twofold. First, the loss of the enhanced subsidies means they will now have to pay the full, unsubsidized price of the gross premium on any plan they buy. Second, those gross premiums are themselves going up by an average of 22% in Arkansas.

Findley Johnson, an independent insurance broker in Fayetteville, often advises self-employed people about their options on the marketplace. For those above the 400% mark, "what cost $600 is now doubling or tripling or more, depending on age," he said.

Johnson said he's encouraging his clients in that position to get creative. Some people whose income puts them just past the 400% subsidy cliff may be better off buying a bronze plan and starting a health savings account, or HSA. "That's money that is tax sheltered and goes into basically a rainy day fund for health care," he said. "So that's one way to lower [a person's] income to try to get back under the 400% mark and start receiving that subsidy again."

He gave the example of a 52-year-old couple with an income of $90,000. The 400% mark for a two-person household is $84,600, so they wouldn't get any subsidy in 2026 — unless they can reduce their income with HSA contributions. (Subsidies are based on your expected income in the coming year, not the current year.)

"What they need to do is they need to get their income under $84,500 so that they can start getting a huge subsidy," Johnson said. "Also, by doing that, they're going to be setting money aside just in case they do have a catastrophic event." If you have a bronze plan with a high deductible, it's important to have money on hand to cover medical costs out of pocket.

People with incomes substantially above the 400% mark will have to go a different route — either paying full-price for insurance or going without it. For this group, too, it pays to shop around on HealthCare.gov and see what's available. If you're on a silver plan in 2025, check out bronze and gold for 2026. Even without any subsidy, there's a good chance you can find a gold option that will be cheaper than what your current plan will be next year, and with a lower deductible.

Still: The financial impact for those above the 400% mark will be very bad any way you slice it. This group of marketplace shoppers, though, is relatively small. Of the 166,000 Arkansas on the marketplace, about 150,000 of them, or nine out of 10, have annual incomes under 400% of the federal poverty line. These folks will still have a subsidy coming to them in 2026, and most will have a decent coverage option at a reasonable net premium.

Maximize your subsidy

A person's subsidy is based on two things. The first is household income. The second is the cost of the gross premium on a specific "benchmark" plan, defined as the second-cheapest silver option for sale in a person's area. The ACA says a person should be expected to pay no more than a certain percentage of their income toward the premium on that benchmark silver plan, with the percentage varying on a sliding scale. In other words, a person's subsidy is the difference between (1) a certain required individual contribution amount, based on income and (2) the cost of that benchmark silver plan locally.

For example, under the enhanced Biden-era subsidy levels, a person making 200% of the poverty line should be required to contribute no more than 2% of their household income toward the premium of the benchmark. (That percentage was higher under the original ACA, and it will revert back to the higher level in 2026 unless Congress acts.) This calculator from KFF lets you see how much your subsidy amount would be for 2026 based on income, age and other factors.

Importantly, a person doesn't have to use their tax credit to buy the benchmark plan, or any silver plan. The gross cost of the benchmark plan determines the size of a person's subsidy — but that subsidy can be applied toward any ACA-compliant plan available in their marketplace, be it bronze or silver or gold.

That's how a rise in gross marketplace premiums in Arkansas overall can result in a decrease in net prices for certain plans for certain people. Increasing the gross premium on silver plans increases the size of the subsidies available for all marketplace plans. As mentioned earlier, the Arkansas Insurance Department has told insurance companies to specifically price silver plans higher than the other tiers so as to maximize the subsidy dollars available to consumers. This is called "silver loading" because silver prices are disproportionately "loaded" compared to bronze and gold.

What the policy means in practice is that the gross (and net) prices on silver plans are going through the roof, but the net prices on gold and bronze plans generally are not. In some cases, they're coming down. This is why Huffmaster, that 27-year-old from Benton who's currently on a silver plan, would see his net monthly premium increase from $15 to $140 in 2026 — but why he'll be able to get coverage for $17 if he levels up to the gold tier.

Arkansas is not the only state that's doing this. Charles Gaba, the national policy expert, has a recent analysis on how several states are using the strategy to cushion the impact of the loss of the enhanced subsidies (and a follow up here). Arkansas is one, along with Illinois and Washington. On average, Gaba says, the net cost of the average gold plan in Arkansas is now 31% less than the average silver plan. (Here's more from him on the history of silver loading and how the policy has evolved, and here's an analysis he did in September about how Arkansas specifically is deploying the strategy.)

As if that wasn't complicated enough, there's another feature of the ACA that's important here. The health reform law actually created two distinct forms of financial help for customers on the marketplace. One is the premium subsidies that are the focus of this article. The other is called "cost sharing reductions," or CSRs, which help people on the lower rungs of the income ladder pay for deductibles and co-pays.

The ACA requires insurance companies to give people reduced deductibles and co-pays ("cost sharing") if they make under 250% of the poverty line — after all, insurance doesn't do low-income people much good if they still can't afford to go to the doctor. The CSRs are based on a sliding scale, with very generous help available for those below 200% of the poverty line. If you make, say, $25,000 annually, you qualify for hefty CSRs that make your insurance much better.

But there's a problem: CSRs are available only on silver plans. For people in the 138% to 200% income range, silver loading means the net premium on their current (silver) plan is about to increase dramatically. They'll face a decision: switch to a cheaper bronze or gold plan in 2026 or pay much more each month to keep their CSRs. That's a hard choice for Arkansans who regularly use their insurance, such as people with chronic health conditions or expensive prescriptions. For many, the best route will be to stick with the silver, if they can afford it, because the CSRs provide such a good deal. (Again, people should talk to an agent/broker in their area for free professional help with making this decision.)

Even so, it appears most people on the marketplace who are under 400% of the poverty line will have an affordable insurance option next year. Enormous credit is due here to the staff at the Insurance Department. As I reported in September, internal records show that the agency instructed BlueCross and Ambetter earlier this year to price their plans using a silver loading strategy. After the huge gross rate hikes became public in August, sparking anger from Gov. Sarah Sanders, an insurance department employee sent a memo to the governor's office claiming that silver loading would have the effect of "[driving] down effective premiums for most Arkansans on the exchange." I was extremely skeptical at the time, but it appears I was wrong.

Then there's the governor herself, who in August publicly criticized BlueCross and Ambetter over their gigantic proposed rate increases. The companies lowered their proposals significantly the next month, from an average hike of 36% to 22%. The upside-down logic of silver loading makes it hard to gauge the impact of those gross rates on the net costs to most marketplace consumers — but for the folks above the 400% mark, it's a good thing the 2026 gross rate hike isn't even higher. If public pressure from Sanders helped, she deserves credit. But not too much. It's her Republican Party, after all, that's choosing to kill the enhanced subsidies and yank away support for the middle class.

It's also still unclear what marketplace consumers will actually do as open enrollment comes to a close. People are understandably very confused about what's happening. Most enrollees tend to simply renew their current insurance plan for the upcoming year, rather than shopping around — and most people on the marketplace are on a silver plan. That means some people may simply absorb a huge price increase without realizing a better, cheaper gold plan is at their fingertips. Others may drop coverage as soon as they see the projected premium increase for their silver plan for 2026. And if large numbers of people leave the marketplace because they think they can't afford it, that itself could drive up the price of insurance in the future.

Stepping back a bit, it's also worth noting just how crazy this all is. Silver loading is a great strategy for states to use, but no one would design a system this way from the ground up. Raising the gross cost of one product so as to arbitrarily lower the net cost of other products only makes sense within the byzantine rules of the ACA. We expect millions of ordinary people to somehow make informed decisions about the health of themselves and their families based on this unfathomable system. Whether it's through Medicare for all or some other arrangement, there has to be a better way.