Health insurance costs are on the rise, and 2026 may bring the biggest jump yet. According to recent insurer filings analyzed by the Commonwealth Fund, marketplace premiums are projected to increase by a median of 18 % nationwide, marking one of the steepest hikes in recent years.
This increase comes as several federal policies and economic factors converge, creating a perfect storm for higher costs. Here’s what’s driving these changes, who will be most affected, and how you can prepare with the help of Scout Insurance.
What’s Causing the 2026 Premium Hikes
The 2026 premium surge isn’t random; it’s largely the result of expiring federal subsidies, rising medical costs, and new policy restrictions that may alter who stays covered.
1. Expiring premium tax credits
The “enhanced” subsidies that made Affordable Care Act (ACA) plans more affordable are set to expire at the end of 2025. These subsidies helped millions of Americans lower their monthly premiums. Without them, many will lose financial assistance and face full-price premiums beginning in 2026.
2. Increasing medical and administrative costs
Insurers expect medical costs to climb by 7–8 % in 2026, fueled by inflation, higher hospital and provider fees, and rising prescription drug prices. Administrative costs, such as claims processing and compliance, are also growing.
3. Policy and enrollment changes
New federal policy proposals could make it harder for consumers to renew or maintain their coverage by adding more paperwork requirements. That could push healthier individuals out of the market, leaving a smaller, higher-risk pool and driving premiums up even more.
How Much Will Premiums Increase?
Nationwide, insurers are proposing an average 18 % increase for 2026, more than double last year’s average rate hike.
- Several states, including Arkansas, Illinois, Indiana, and Washington, have already approved increases exceeding 20 %.
- Premiums for middle-income Americans could jump by 80 % or more once subsidies expire.
- For some older consumers, especially those just above the subsidy eligibility threshold, premiums could more than double.
Even lower-income individuals who continue receiving reduced credits will still see higher out-of-pocket costs, as subsidy amounts shrink in proportion to total premiums.
Who Will Be Impacted the Most
Currently, about 93 % of marketplace enrollees receive premium tax credits. When the enhanced credits expire in December 2025, the hardest hit will include:
- Middle-income earners who no longer qualify for any subsidy.
- Older Americans nearing retirement who pay higher age-based rates.
- Families who depend on ACA plans for comprehensive coverage but fall just above subsidy limits.
Without legislative action to renew or replace these credits, millions of households could face premium increases of 50 to 100 % or more in 2026.
Key Dates to Remember
- End of 2025 — Expiration of enhanced ACA premium tax credits.
- 2026 Plan Year — New rates take effect; average 18% increase projected.
- September 2025 – Insurer filings released — Confirmed major increases in multiple states.
These dates are critical for anyone relying on marketplace coverage or considering switching to a new plan.
What You Can Do Now
- Review your current plan. Check your coverage level, deductible, and subsidy status.
- Anticipate rate changes. Ask your insurer for next year’s projected premium before renewal.
- Explore new options. There may be private or employer-based plans offering better value in 2026.
- Get professional help. The rules around subsidies, income thresholds, and plan comparisons can be complex. An insurance advisor can help you understand your best options.
Scout Insurance Can Help You Prepare for 2026
With premiums set to climb and policies shifting, now is the time to act, not later. Scout Insurance helps individuals and families:
- Analyze coverage and anticipate cost changes.
- Identify plans that balance affordability and protection.
- Navigate marketplace updates and subsidy eligibility.
- Compare private, group, and ACA options before renewal season.
Don’t wait until your premiums double to make a move. Scout Insurance can help you stay ahead, save money, and protect your health coverage before these changes take effect.
Act now, and contact Scout Insurance today to schedule a free consultation and get a personalized plan review. Let us help you secure affordable coverage before the 2026 rate hikes hit.