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15h ago

ACA Marketplace Rates Poised for Sharp Rise in 2026 After Enhanced Subsidies Expire

Congress must decide whether to extend expiring ARPA-era tax credits that could leave subsidized enrollees with two-thirds higher net premiums next year

File photo: the exterior of the AdventHealth Clermont ER hospital in Clermont, Florida.
Isabella Ku, a San Francisco insurance agent, poses for a portrait on Jan. 24, 2020, in San Francisco. Health insurance premiums for Californians buying coverage through Covered California will rise by an average of 10.3% in 2026, the state marketplace announced Thursday. 
President Barack Obama signs the Affordable Health Care for America Act during a ceremony with fellow Democrats in the East Room of the White House March 23, 2010 in Washington, DC.
Health insurance premiums for Californians buying coverage through Covered California will rise by an average of 10.3% in 2026, the state marketplace announced Thursday. 

Overview

  • Insurers have submitted preliminary 2026 filings requesting a median 18% rate increase nationally, with more than 125 carriers seeking hikes of 20% or higher driven by medical inflation and costly drugs like GLP-1s.
  • The Trump-era Marketplace Integrity and Affordability Rule now factors individual market premium increases into inflation calculations, raising applicable percentages and allowable out-of-pocket limits for enrollees.
  • Covered California announced a 10.3% average premium increase and unveiled $190 million in state subsidies, yet warns that lapse of federal enhancements could drive net premiums up about 66% for 1.7 million people.
  • Analyses from KFF and Peterson-KFF project that expiration of enhanced ARPA credits would boost out-of-pocket premiums for subsidized enrollees by roughly 66%–75%, risking substantial coverage losses and adverse selection.
  • With open enrollment set to begin November 1, state rate approvals are pending and Congress remains the pivotal actor to prevent an affordability shock by year-end.