How Much ACA Marketplace Premiums Are Going Up in 2026 (State-by-State)

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What’s really happening to ACA premiums in 2026?

ACA Marketplace premiums are projected to rise by an average of about 20% in 2026, with some states seeing increases of 30% or more. These proposed rate changes, filed by insurers with state regulators, mark the biggest jump since 2018.

Below is a state-by-state interactive map showing how much premiums may change where you live. This view uses a simple average of insurer requests (we’ll add enrollment-weighted updates once states release covered-lives counts). Final approved rates may differ by state.

State-by-State: Estimated 2026 Premium Changes

0% (no change)

0.01%–5% increase

6%–15% increase

16%+ increase

How to read it: Hover or tap a state to see the estimated 2026 premium change. Colors indicate magnitude (yellow = modest increase; orange = mid-teens; red = 16%+). Washington, D.C., Alaska, and Hawaii are included.

Note for readers: Figures reflect a simple (unweighted) average of insurer requests per state using public filings summarized by KFF and state sources. We’ll update with enrollment-weighted averages when 2026 “covered lives” become available.

Quick takeaways

Some states—like Arkansas, Delaware, Mississippi, and New Mexico—show very large proposed increases.
Others—like California, Massachusetts, Oregon, Alaska, South Dakota—skew lower to mid-single digits or low teens.
Differences come from each state’s risk pool, local provider prices, pharmacy trends, and policy assumptions.

Why premiums are going up

Medical price inflation & utilization: Hospital, physician, and outpatient prices continue to rise. People are also using more care than a few years ago.
Pharmacy costs (GLP-1s & specialty drugs): Anti-diabetics/weight-loss GLP-1s and high-cost specialty meds push pharmacy trend well above general inflation.
Labor & contracting pressure: Health systems facing staffing and cost pressures are negotiating higher reimbursement rates, which flow into premiums.
Risk pool assumptions: Some filings assume changes to premium tax credits or eligibility rules, which can shift who stays enrolled and at what cost.

What this means for your wallet (and what to do)

Shop carefully during Open Enrollment. Prices and networks vary—don’t auto-renew without comparing options.
Check subsidies. Most enrollees qualify for premium tax credits that can reduce monthly costs.
Consider plan metal tiers and networks. Sometimes a narrower network or different tier keeps premiums in check.
Use zero-cost or low-cost care pathways. Annual checkups, preventive screenings, and in-network providers help avoid surprises.
Compare alternatives wisely. Options like Direct Primary Care or health sharing exist—but remember that they are not insurance and different rules apply.

Methods (how we built the map)

Dataset: insurer-level proposed 2026 rate change percentages by state (individual market).
Displayed metric: “Estimated 2026 premium change” = simple state average of insurer requests (not weighted by enrollment).
Sources noted in filings: ratereview.healthcare.gov, California DMHC, and insurer rate filings as summarized by KFF.
We’re requesting “covered lives / members affected” from state DOIs and carriers to calculate enrollment-weighted state averages in a future update.

FAQ: 2026 ACA Marketplace Premium Increases

Will ACA Marketplace premiums go up in 2026?

Yes. Insurers across the U.S. have filed proposed rate increases for 2026, and many states are seeing double-digit percentage requests. While final rates will be approved by state regulators later in the year, early filings point to higher monthly premiums in most states.

Which states have the highest ACA premium increases in 2026?

Arkansas tops the list with proposed increases averaging over 50%. Delaware, Mississippi, New Mexico, and Indiana are also among the states facing very large premium hikes, often above 30%.

Why are ACA premiums increasing so much?

Several factors are driving higher rates:

Rising hospital, physician, and prescription drug costs
Increased use of healthcare services compared to past years
Growth in expensive specialty medications (e.g., GLP-1s)
Insurers adjusting to risk pool dynamics and potential policy changes

Will subsidies offset the increases?

Premium subsidies (Advance Premium Tax Credits) are tied to your income and the cost of the benchmark Silver plan in your area. Subsidies will still help many families lower their monthly payments, but they may not fully offset larger premium hikes in some states.

How accurate is the state-by-state map?

The map reflects insurer proposals (simple state averages) from public filings. Final approved rates may differ, and we’ll update with enrollment-weighted averages once member counts are released.

Health shares are not insurance and do not offer insurance coverage. Membership in a health share does not guarantee the payment or reimbursement of medical expenses. Each organization operates under its own membership guidelines, which determine what expenses may be eligible for sharing. This publication is for informational purposes only and is not provided by an insurance company. For state-specific notices and full program details, please visit the respective health share’s official website.