Health insurance increases expected

The Pennsylvania Insurance Department has launched its educational tour to prepare Pennsylvanians for significant health insurance premium increases for the upcoming year.

Pennsylvania health insurers are requesting an average increase of 19% in the individual market (for people who buy their own insurance) and 13% in the small group market (for small business) for the 2026 coverage plan year, the department reported.

PID has been carefully reviewing these proposed rate increases and questioning the insurers on many details, as rates vary by plan and region, to ensure rates are appropriate and fair, a press release. states.

PID does not approve rates that are excessive, inadequate or unfairly discriminatory to Pennsylvanians, the press release from the state said.

The spikes in premium costs are not only being seen in Pennsylvania – states across the country are seeing health insurance premiums rising 18% on average, which is 11% higher than last year.

"We realize that this is not an ordinary filing year for insurers, and Pennsylvanians should be prepared to see higher costs to their health insurance," said Pennsylvania Insurance Commissioner Michael Humphreys.

"While we continue to work with the insurance companies to try to keep premiums low, we will begin meeting with Pennsylvanians throughout the Commonwealth to help prepare them for the potential premium increases and provide information they need to choose the best plan for them ahead of Open Enrollment in November."

Throughout September and October, the insurance department will host free, in-person educational sessions in communities across the Commonwealth.

The goals of these sessions are to:

Explain the rate review process and PID's role in regulating the health insurance market;

Provide an overview of the factors influencing premiums next year;

Offer guidance on how to compare plans, costs, and provider networks during Open Enrollment; and

Share tools and resources to help Pennsylvanians find coverage that fits their health care and budget needs.

Pennsylvanians can find a full list of these sessions, with dates and location information, on PID's website.

The insurance department said insurers have requested higher premiums for plan year 2026 as a result of:

The rising cost of healthcare;

The higher use of more expensive service, benefits and prescription drugs; and;

The end of the Enhanced Premium Tax Credits available through Pennie, which are set to expire on Dec. 31, 2025, unless Congress acts to extend them.

Pennie is Pennsylvania's official health insurance marketplace.

Half a million Pennsylvanians are currently enrolled through Pennie. Three of every four enrollees on Pennie have only experienced enrollment with the enhanced tax credits in effect, the department said. Without the enhanced tax credits, premiums would rise by an average of 82%. This could force many to downgrade plans or go without insurance, the state said.

"The increase in rates, the expiration of the enhanced premium tax credits, and other recent federal policies make coverage more expensive and harder to get," said Devon Trolley, executive director of Pennie.

"Pennie will be communicating directly with enrollees about these updates. Every single Pennie enrollee should read mail from Pennie, and plan to log in to their accounts to update information and compare plan options starting Nov. 1. Pennie is here to help."

If these credits are not extended, consumers will see the direct impact once Open Enrollment begins Nov. 1.

Additional information about how the expiration of the enhanced premium tax credits could affect Pennsylvanians can be found on Pennie's website.

Pennie has free resources available to help consumers. Pennie Customer Service can be reached at 844-844-8040 or go to http://pennie.com/connect.