ACA insurers plan biggest rate hikes in eight years

Axios – Friday, July 18, 2025
By Maya Goldman

Health plans on the Affordable Care Act marketplaces are requesting their biggest premium hikes since 2018, in some cases over 30%, according to a new analysis from KFF.

The big picture: The growing cost of care combined with the anticipated expiration of enhanced ACA premium subsidies and tariffs are driving the increase, according to insurers’ preliminary filings with state regulators for 2026.

By the numbers: ACA premiums are on track to rise by a median 15% next year, based on 105 filings submitted across 19 states and D.C. that KFF examined.

• Thirty-two insurers anticipate a 10% to 15% increase in premiums. Another 24 insurers expect increases of 15% to 20%.
• No insurer proposed decreasing premiums. Five said they would hike premiums no more than 5%, while eight insurers seek an increase of 30% or more.
• State regulators and insurers will finalize rates by late summer. Republicans’ new tax-and-spending law, as well as new regulations from the Trump administration, could alter the plans’ premium calculations, KFF says.

Between the lines: Marketplace enrollees who qualify for ACA premium subsidies typically won’t feel the effects of annual premium increases, KFF notes.

• But if Congress doesn’t extend enhanced subsidies for people making more than 400% of the federal poverty level, middle-income ACA enrollees could feel an average surge of 75% in monthly coverage costs from this year to next.

Zoom out: Many Americans with employer-sponsored insurance will also see higher health care costs next year.

• Just over half of employers surveyed by Mercer said they’re likely to raise deductibles, out-of-pocket maximums or make other changes to their plans, the survey found.

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