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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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  • 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.

  • SCOTUS Case Could Weaken the Impact of Regulation on Key Patient and Consumer Protections

    Issue Brief

    This brief discusses the longstanding legal doctrine, Chevron deference, being challenged in two cases before the U.S. Supreme Court and includes examples of what could be at stake for health care consumers should federal courts no longer use this doctrine to address litigation related to federal health regulations. The focus here is on patient and consumer protection regulation, but overturning the Chevron deference would have implications in all areas of health care.

  • 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.

  • 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.

  • Charges for Emails with Doctors and other Healthcare Providers

    Issue Brief

    Patient-provider email messaging accelerated early in the COVID-19 pandemic as more patients sought medical care remotely, and the addition of billing codes for digital health services and subsequent changes in insurers’ payment policies have enabled providers to bill insurers and patients for messaging.

  • Employer Responsibility Under the Affordable Care Act

    Other

    The Affordable Care Act does not require businesses to provide health benefits to their workers, but applicable large employers may face penalties if they don’t make affordable coverage available. The employer shared responsibility provision of the Affordable Care Act penalizes employers who either do not offer coverage or do not offer coverage that meets minimum value and affordability standards. These penalties apply to firms with 50 or more full-time equivalent employees. This flowchart illustrates how those employer responsibilities work.

  • Since Dobbs, Few Large Firms Have Changed Their Plan’s Abortion Coverage Policy

    News Release

    According to an analysis of responses to KFF’s Employer Health Benefits Survey in 2023, relatively few (8%) large firms (with 200 or more workers) offering health benefits report reducing or expanding coverage for abortion since the U.S. Supreme Court overturned Roe v. Wade with the Dobbs v. Jackson ruling.

  • Coverage of Abortion in Large Employer-Sponsored Plans in 2023

    Issue Brief

    This brief presents findings from the 2023 KFF Employer Health Benefits Survey on coverage of abortion services in large employer-sponsored health plans, changes employers made to abortion coverage since the 2022 Supreme Court ruling, and employers’ provision of financial assistance for travel out of state to obtain an abortion.

  • Preventive Services Covered by Private Health Plans under the Affordable Care Act

    Fact Sheet

    Note:  This content was updated on February 28, 2024  to incorporate new FAQs from CMS. Tables 1 and 2 were also updated to include updated recommendations. It has been more than ten years since the Affordable Care Act (ACA) required private insurance plans to cover recommended preventive services without any patient cost-sharing.