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How Much and Why ACA Marketplace Premiums Are Going Up in 2026

A new analysis of initial rate filings for Affordable Care Act (ACA) Marketplace plans submitted by 312 insurers in all 50 states and the District of Columbia finds the median proposed increase for 2026 is 18%, more than double last year’s 7% median proposed increase. The proposed rates are preliminary and could change before being finalized in late summer. In addition to rising cost and utilization of services, insurers cited the expiration of enhanced premium tax credits as a significant factor in their rate hikes for next year.

Quick Take

Tariffs Are Driving 2026 Health Insurance Premiums Up

2025 Reconciliation Bill

Health Savings Account Provisions in the 2025 Tax and Spending Law

analysis

Health Insurer Financial Performance in 2023

Survey

Consumer Experiences with Health Insurance

Employer Coverage

Employer Family Premiums Climb to $25,572 in 2024, Survey Finds

Family premiums for employer-sponsored health insurance rose 7% in 2024, matching the 2023 increase, KFF's benchmark Employer Health Benefits Survey finds. Over the previous five years, the cumulative increase in premiums has been similar to the rise in general inflation and workers' wages. The survey also examines deductibles and other cost-sharing, coverage of GLP-1 weight-loss drugs, and more.

Read the News Release

How Affordability of Employer Coverage Varies by Family Income

Expansions to HSAs in House Budget Reconciliation

Higher Premiums Persist, Employer Strategies For GLP-1

Americans’ Challenges with Health Care Costs

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  • Claims Denials and Appeals in ACA Marketplace Plans in 2021

    Issue Brief

    This analysis of HealthCare.gov Marketplace insurers' transparency data finds that 17% of in-network claims were denied in 2021, with denial rates varying widely across insurers. Consumers appealed less than two-tenths of 1% of denied in-network claims.

  • 2024 Medical Loss Ratio Rebates

    Issue Brief

    Insurers estimate they will pay $1.1 billion in Medical Loss Ratio (MLR) rebates in 2024 to select individuals and employers that purchase their health coverage, according to a KFF analysis of preliminary data reported to state regulators. The estimated rebate for 2024 is larger than rebates issued in most prior years. Nearly $12 billion in rebates have been issued since 2012.

  • Access to Adult Dental Care Gets Renewed Focus in ACA Marketplace Proposal

    Policy Watch

    Adult dental care can lead to high out of pocket costs for consumers, especially for those with private insurance coverage. This post analyzes a proposed provision in the HHS Notice of Benefit and Payment Parameters for 2025, and possible implications for consumers who have Marketplace coverage.

  • Congressional District Interactive Map: How Much Will ACA Premium Payments Rise if Enhanced Subsidies Expire?

    Issue Brief

    This analysis and interactive map illustrate how much more enrollees in Affordable Care Act (ACA) Marketplace plans would pay in premiums at the congressional district level if the enhanced subsidies were to expire in 2026 as under current law. The tool presents scenarios for an older couple who would lose subsidy eligibility due to their income level and for a single person with a $31,000 income. It also presents net average premium payment increases in each district in states that use Healthcare.gov.

  • Coverage of Sexual and Reproductive Health Services in Medicare

    Issue Brief

    This brief describes Medicare coverage of sexual and reproductive health services, including contraception, and compares that coverage with private insurance plans and Medicaid. These benefits are particularly relevant to nearly 1 million women of reproductive age (20-49) who are eligible for Medicare due to having a long-term disability.

  • What resources are available for privately insured patients who get surprise balance bills?

    Issue Brief

    Most patients do not know about the new surprise billing protections and likely also do not know of resources available to seek recourse for incorrect medical bills. This brief provides resources to privately insured patients who receive surprise balance bills and also summarizes relevant policies and how they apply to balance billing.

  • Poll: Democrats Say They Are Hearing Enough From Presidential Candidates About Medicare-for-All and Expanding Coverage, But Want Them to Talk More about Health Costs and Women’s Health Care

    News Release

    Heading into tonight’s Democratic primary debate, most Democrats and Democratic-leaning independents say the candidates are spending the right amount or too much time talking about ways to provide coverage to more Americans and Medicare-for-all, two topics that have dominated health care discussions in the past three rounds of Democratic debates, the latest KFF Health Tracking…