Each spring and summer, health insurers submit rate filings to state regulators to justify premium changes for the coming calendar year. Several factors drive premium changes, and usually the cost of medical care (the prices of health services and the amount of care people are receiving) is the primary driver of premiums. However, heading into 2026, there are also policy changes that insurers expect will drive up their costs and, thus, increase premiums beyond what they would otherwise charge.
Some of the factors that insurers cite as contributing to higher rates next year include:
- Enhanced premium tax credits that make coverage more affordable will expire at the end of 2025, driving up out-of-pocket premium payments by over 75% on average. This is expected to cause healthier enrollees to drop their coverage and create a sicker risk pool. An earlier Peterson-KFF Health System Tracker analysis showed the expiration of enhanced premium tax credits raised proposed rates by an additional 4 percent, on average.
- Tariffs could drive up the cost of some drugs, medical equipment, and supplies. Some insurers report that tariffs—and the uncertainty around them—are driving rate increases about 3% higher than they otherwise would be.
Additionally, many insurers submitted proposed rates before the budget reconciliation legislation passed and the Centers for Medicare and Medicaid Services (CMS) finalized the Marketplace Integrity and Affordability rule. The legislation and rule make changes to how the Marketplaces operate and how people are enrolled. These changes were only finalized in early July and late June, respectively, and it is not yet clear how insurers may respond.
Early indications are that individual market insurers will be increasing premiums in 2026 by more than they have since 2018, the last time policy uncertainty contributed to sharp premium increases. Across 105 ACA Marketplace insurers in 20 markets (19 states and the District of Columbia), premiums are increasing by a median of 15%. These filings are still preliminary and may change.
