ACA Plans Seek 18% Median Premium Hike Across 50 States in 2026

Health insurers are requesting a median 18% increase in Affordable Care Act (ACA) premiums for 2026, more than doubling last year's 7% request and marking the largest proposed hike since 2018. This increase is driven primarily by the scheduled expiration of enhanced federal premium tax credits that have significantly subsidized coverage, which would lead to a projected 75% rise in out-of-pocket premium costs for many enrollees. The subsidy expiration is expected to cause healthier individuals to drop coverage, leaving a riskier and more expensive pool for insurers. Rising healthcare costs, including labor, inflation, and expensive prescription drugs such as GLP-1 medications for diabetes and obesity, are also contributing to the premium surge. While some insurers cited tariffs on imported goods as a factor, there is uncertainty about their impact, and only a few referenced tariffs as a reason for rate increases. Some states, like Arkansas, are pushing back against the large proposed premium hikes, calling on insurance commissioners to reject certain insurer requests.