U.S. health insurers are seeking the steepest premium hikes for Obamacare plans since 2018, driven by concerns over the possible expiration of premium subsidies and looming tariffs on medical products, according to an analysis by health policy research group KFF.
Insurers are requesting a median premium increase of 15% for 2026, according to KFF, which analyzed rate filings from 105 insurers across 19 states. In contrast, premiums have remained relatively stable or seen only modest growth in recent years.
The industry is grappling with shifting enrollment trends and escalating medical costs. Major insurers like UnitedHealth and Centene have suspended their annual earnings guidance, while others have revised their profit forecasts downward.
Insurers have cited slowing market growth and an increase in higher-risk enrollees in Affordable Care Act (ACA) plans as key challenges. These plans primarily serve individuals who lack coverage through an employer, Medicaid, or Medicare.
Insurers also pointed to the scheduled expiration of COVID-era premium tax credits in 2026 as a contributing factor. According to KFF’s analysis, premiums are projected to rise an additional 4% compared to what they would be if the enhanced subsidies were extended.
For 2026, insurers generally reported that the underlying cost of healthcare is holding steady at around the 8% increase seen last year.
Several insurers noted that rising costs are being driven in part by increased use of GLP-1 drugs for weight loss and diabetes, as well as labor market pressures impacting negotiations with healthcare providers.
"Insurers also expressed concern over the uncertainty surrounding the 'ACA Integrity Rule' — a set of finalized regulations aimed at enhancing verification processes and curbing improper enrollments in Obamacare plans, the report said.
Health insurers Centene, Molina, UnitedHealth, Cigna, Elevance, CVS Health, Oscar Health, and Kaiser Permanente did not promptly respond to requests for comment.
