Health Insurance Marketplace Premiums Set to Surge 18%: Insights from KFF | TechTarget

New research shows that Health Insurance Marketplace premiums are set to rise significantly in 2026. According to a recent analysis by the Peterson Center on Healthcare and KFF, we’re looking at an average increase of about 18% across the board. This marks the biggest proposed hike since 2018, a time also marked by policy uncertainty.

The study examined filings from over 300 insurers in all 50 states and Washington, D.C. Interestingly, while some insurers plan to cut premiums by as much as 10%, most expect increases between 12% to 27%. Certain filings even suggest hikes could reach 59%.

So, what’s driving these increases? The main issues are rising costs, especially for expensive prescription drugs like GLP-1s and gene therapies. A related report from CMS highlighted that premiums for Medicare Part D plans are also rising, with an average bid forecasted to be 33% higher, reaching $239.27.

General market conditions aren’t helping. Higher labor costs and inflation mean healthcare providers are asking for more in negotiations. This is compounded by the financial struggles many face after the COVID-19 pandemic. Furthermore, the ongoing consolidation of healthcare providers boosts these reimbursement rates.

A significant factor influencing premium adjustments is the potential end of enhanced premium tax credits initially introduced by the American Rescue Plan Act of 2021. These credits have made Marketplace coverage more affordable, especially for middle-income families, and have nearly doubled enrollment from 11.4 million in 2020 to 24.3 million in 2025. Most enrollees depend on these credits to manage their monthly costs.

If Congress allows these credits to expire, many healthier enrollees might drop their plans. Payers foresee that this could lead to a sicker pool of insured individuals, which would further raise premiums. Some states, like Illinois and Maryland, have even submitted alternative rate filings to account for the possibility of these credits being renewed. These alternative filings suggest lower hikes, indicating flexibility based on policy outcomes.

Interestingly, the analysis also pointed to past policies from the Trump administration—like tariffs and specific rules aimed at cutting fraud in healthcare—as contributing factors to the expected increases, although they are not as prominent as rising costs.

Payers are expected to finalize their rate changes by late summer. As these developments unfold, they bring to light how deeply interconnected policy, economics, and individual health choices are in the healthcare landscape.

Jacqueline LaPointe is an expert in healthcare finance and has been covering this field since 2016.

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