One year after steepest premium increase in a decade, RI health insurers seek double-digit hikes

One year after commercial health insurers sought the steepest annual commercial premium hikes in over a decade, the companies that insure one third of Rhode Islanders have barely tempered their requested increases.

The 2026 rate requests published by the Rhode Island Office of the Health Insurance Commissioner Monday would, if approved, increase residents' annual premiums by 7.7% to 30.4%, depending on type of plan and insurer. The weighted averages are slightly less than the record premium hikes that insurers filed in 2025, but not by much. The 50,000 people who buy their own private insurance could see premiums spike 20.1%, on average, compared with the 23.8% requested last year.

"It's not a win," Health Insurance Commissioner Cory King said in an interview Monday. "Even though the average increases across the three markets are lower than what they requested last year, it's still unsustainable."

How to comment

The Rhode Island Office of the Health Insurance will hold a virtual town hall for community input on any and all insurer premium rate requests on Monday, July 20, from 4 to 5 p.m.

A separate set of hearings specific to Neighborhood Health Plan of Rhode Island's individual plan rate requests will be held in person on Tuesday, July 14, at 6 p.m. and Wednesday, July 15, at 9 a.m. at the Public Utilities Commission offices in Warwick.

Written comments can also be submitted via mail or email through 5 p.m. on Friday, July 24, to [email protected] or the OHIC office, 1511 Pontiac Ave., Cranston, 02920.

Especially United Healthcare's 34.9% rate hike request for the nearly 9,000 people covered under its large-employer insurance plans — the first time an insurer has endeavored to raise premiums by more than 30% in a single year, King said.

The eye-popping premiums being sought for 140,000 residents come as no surprise. Rising costs for medical treatments and prescription drugs, including the pervasive use of GLP-1s for weight loss, have put pressure on providers, and in turn, the insurers that reimburse them for their services. Another major pain point: the precipitous drop in participation in the state health exchange at the start of the year after enhanced federal discounts expired. The smaller pool of HealthSource RI participants, like their counterparts in state exchanges nationwide, are generally older and sicker, creating more risk and cost for the insurance companies that cover them.

Aligning the seemingly contradictory interests of insurance companies, health care providers and patients is a puzzle King's office seeks to solve every year in its commercial rate review and approval process. OHIC only reviews rates for fully-insured plans, or those in which the insurer assumes financial risk for medical costs. That means the office does not inspect rates for the approximately 65% of Rhode Islanders with self-funded insurance — employer-sponsored plans in which the business, not the insurer, pays workers' health care claims directly.

A balancing act

The state health insurance commissioner is required by law to guard the solvency of insurance companies, which in turn affects payments to hospitals and health care providers. But the commissioner also cannot legally approve a requested rate hike that is not in the public's interest.

"As much as I'd love to just not give rate increases this year, we have to look at the data," King said. "We can't make an arbitrary decision that would not stand up to judicial scrutiny."

Rhode Island Attorney General Peter Neronha has unsuccessfully attempted to convince King to reject any increases, relying on actuaries and health policy experts to back up its consumer-focused affordability arguments.

Tim Rondeau, a spokesperson for Neronha's office, confirmed in an email Monday that the attorney general has for the second year in a row retained Christopher Whaley, a Brown University health policy economist, to serve as its expert witness during hearings on the individual plan rates requested by Neighborhood Health Plan of Rhode Island (NHPRI).

Neighborhood proposed a 24.9% average rate increase for the 34,000 people it insures through the health insurance marketplace.

"Our advocacy will focus on the detrimental impact these rate increases will have on consumers, and suggested methods for lowering NHPRI's requested rate," Rondeau said.

Elizabeth McClaine, vice president of commercial and Medicaid products for Neighborhood, defended its commitment to affordability.

"Even with the requested 2027 rates, Neighborhood continues to offer the lowest-cost plans on HealthSource RI and is focused on delivering value to its members," McClaine said in a statement Monday. "Neighborhood is steadfast in its commitment to improving care quality, promoting preventive care and addressing the underlying drivers of health care costs."

Neronha's office also plans to submit expert testimony on rate hikes requested by Blue Cross Blue Shield of Rhode Island, the other insurance exchange plan provider, during a general public comment hearing, Rondeau said.

Blue Cross is seeking a 9.8% weighted average rate increase for its 16,000 health exchange participants.

Comparison trap

Across insurers and plans, proposed premium spikes vary widely. Blue Cross, which also provides insurance for small and large-group employers, came in the lowest of all insurers in all three plan types. Its 12.2% rate request for large employers is nearly one-third of the 34.9% sought by United Healthcare, for example.

"We are working hard to better manage medical costs and to improve efficiency across our operations, and are making good progress, which is driving lower requested rate increases this year," Rich Salit, a Blue Cross spokesperson said in a statement Monday.

"A Key priority is to better support complex members, delivering more proactive care in Rhode Island. This improves their experience and reduces their total cost of care. Together, we can improve access to high-quality preventive care, reduce costs, and build the healthcare system that Rhode Islanders deserve."

United Healthcare did not respond to requests for comment Monday.

Variation between premiums reflects more than insurers' goodwill. It is often driven by uncontrollable factors like the size and health risk of their covered population, King said. United Healthcare, for example, has historically had high loss ratios, spending close to 90% of its premiums on claims from covered patients in 2025, according to information filed with King's office, he said.

How much more is justifiable to cut from insurers' requested premium increases remains under review by King's office. Final decisions are expected in early fall, he said.

Two additions in Rhode Island's newly approved fiscal 2027 budget may justify some relief on rate hikes: a $22 million state earmark for HealthSource RI participants, and repeal of a state health assessment fee. Lawmakers agreed with state administrators to nix the $4 per-person monthly premium charge, which began in January, amid concerns that it violated federal rules under the One Big Beautiful Bill Act. Eliminating the fee will shave 0.4%, on average, off of requested premium hikes, King said.

How to comment

The Rhode Island Office of the Health Insurance will hold a virtual town hall for community input on any and all insurer premium rate requests on Monday, July 20, from 4 to 5 p.m.

A separate set of hearings specific to Neighborhood Health Plan of Rhode Island's individual plan rate requests will be held in person on Tuesday, July 14, at 6 p.m. and Wednesday, July 15, at 9 a.m. at the Public Utilities Commission offices in Warwick.

Written comments can also be submitted via mail or email through 5 p.m. on Friday, July 24, to [email protected] or the OHIC office, 1511 Pontiac Ave., Cranston, 02920.

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Courtesy of Rhode Island Current