Pennie health plan costs are going up an average of 102% in 2026

Oct. 16—Philadelphia residents who buy Obamacare health insurance will pay, on average, more than twice as much in 2026 after the Pennsylvania Insurance Department announced this week rates that anticipate the end of a critical financial incentive program.

Philadelphia's collar counties will see more moderate cost increases, ranging from an average 46% price hike in Chester County to a 70% average increase in Delaware County.

Across Pennsylvania, the monthly cost of plans sold through Pennie, the state's Affordable Care Act marketplace, is rising an average of 102%.

The impact will be greatest in rural parts of Pennsylvania, where residents are expected to lose more tax credit dollars than in urban counties, according to Pennie.

Juniata County, between Harrisburg and State College, will see the greatest premium price increase, with residents paying an average of 485% more in 2026.

Individual factors, such as age, income, household size, and plan type also affect cost, which is why the data released this week are represented as estimates and averages.

The cost increase is largely due to Congress failing to renew a critical financial incentive program that is set to expire at the end of the year. Without the enhanced tax credits, people who buy Obamacare health plans will need to pay for a greater share of the premium themselves.

The overall cost increase also includes rising premium prices, which are going up an average of 21% across Pennsylvania. This is because insurers and regulators anticipate that people who remain in their health plans will be sicker and require more expensive care, according to the Pennsylvania Insurance Department.

While the program doesn't expire until the end of the year, insurance administrators had said that they would need to approve insurers' proposed rate increases for 2026 and notify consumers of their expected prices by mid-October, in order to give people time to review their coverage options before the fall enrollment period, which begins Nov. 1.

The tax credits, in peril in all states, were a major sticking point in the federal budget debate that ultimately led to the ongoing government shutdown. Democrats wanted the enhanced subsidies extended permanently as part of the budget deal, and Republicans refused, arguing that they could address the issue separately, before they expire at the end of the year.

Here's a look at cost increases across Pennsylvania:

'Staggering' increases

The "staggering" increases put an "unacceptable burden" on families who rely on Pennie for health coverage, said Antoinette Kraus, executive director of Pennsylvania Health Access Network, which helps people enroll in coverage. Pennie provides health plans to people who do not have access to insurance through an employer, but earn too much to qualify for Medicaid, the publicly funded health program for low-income families and people with disabilities.

If Congress renews the tax credits before the end of the year, Pennie will work to update rates as quickly as possible. But insurance administrators and patient advocates said they worry that, by then, people who have abandoned their plan because it was too expensive will not return.

Pennie administrators estimate about 150,000 of the 500,000 people who bought plans this year will drop out because they find the plans unaffordable. Others may opt for a cheaper plan with less coverage, or look for other ways to spend less on healthcare, such as rationing medications or skipping appointments, Kraus said.

"For people living with diseases like cancer or diabetes, this could be the difference between getting lifesaving treatment or going without it," she said.

Premium tax credits in peril

Under the ACA, people who earn less than 400% of the federal poverty level — about $60,000 — are eligible for tax credits on a sliding scale, based on their income, to help offset the monthly cost of an insurance premium.

That tax credit is part of the law, and therefore not expiring. The change affects an expansion in 2021, when Congress increased financial assistance so that those buying coverage through an Obamacare marketplace do not pay more than 8.5% of their income.

As a result, people who already received a credit got larger subsidies, and people who previously missed the income cutoff were able to get financial assistance.

About 90% of people who bought insurance through Pennie for the current year qualified for some amount of tax credit.

If the enhanced credits end, people who earn less than $60,000 will still qualify for income-based financial help. But the size of their tax credit will decrease.

Editor's note: This story has been updated to clarify that the monthly cost of Pennie plans is rising 102%, which includes premium increases and the loss of tax credits.

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