Initial Affordable Care Act rates for 2026 have now been posted

The North Carolina Department of Insurance has posted the rate changes requested by insurers for the 2026 plan year individual and small-group market plans offered under the Affordable Care Act.

Posting of the requested rates is part of the rate review process required by the Centers for Medicare and Medicaid Services. Unlike some types of insurance, the NCDOI does not set rates for health insurance.

All insurers participating in the individual market are requesting increases for the 2026 plan year and some of the requested increases are significant. According to the insurers, in addition to the cost of health care which continues to increase, there are other factors this year that are creating uncertainty and contributing to the requested increases. These other factors include the expiration of the enhanced subsidies that were introduced in the American Rescue Plan Act and then extended in the Inflation Reduction Act. The enhanced subsidies have reduced what many people pay for premiums and have led to increased enrollment in the individual market. Now, the expiration of these subsidies will make it more difficult for people to afford their premiums and it is anticipated that many people will become uninsured.

As a result more healthy and younger people are expected to drop their coverages, leaving the pool more costly.

The effects of CMS’ 2025 Marketplace Integrity and Affordability Final Rule and the One Big Beautiful Bill Act, which make changes to the enrollment process are also impacting requested rates.

“These factors are affecting rates not just in North Carolina but all across the country,” said North Carolina Insurance Commissioner Mike Causey. “As part of the rate review process, NCDOI reviews the requested rates to make sure they are not excessive, inadequate or unfairly discriminatory, and exhibit a reasonable relationship to the benefits provided in the policy. NCDOI is carefully reviewing the requested rates to ensure that they are supported and meet all statutory requirements.”

Consumers with questions regarding their health insurance plans can contact NCDOI at 855-408-1212.