Why health insurance costs so much more in 2026. The plain-English version.

The headline numbers

On the marketplace side, KFF's analysis of 2026 rate filings found a median proposed premium increase of 18%. And it was not a few outliers dragging the number up. Of the 312 marketplace insurers whose filings KFF reviewed, only 4 lowered rates, 183 proposed increases of up to 20%, and 125 proposed increases of 20% or more.

Employer coverage is climbing too. The Business Group on Health 2026 Employer Health Care Strategy Survey (121 employers covering 11.6 million lives) projects a 9% employer health care cost increase for 2026, the largest jump in over a decade. Employer costs are now running 62% higher than in 2017.

Why insurers filed such big increases

Rate filings are insurers' written homework: they have to explain to state regulators why they need more money. Per KFF's analysis, three drivers show up again and again in the 2026 filings.

1. The enhanced premium tax credits expired

The temporarily enhanced credits that lowered marketplace premiums from 2021 through 2025 expired at the end of 2025 because Congress did not pass an extension. Insurers expected fewer healthy people to keep their coverage once the subsidy help shrank. When healthier enrollees leave, the people who remain need more care on average, and the whole pool gets more expensive to insure. Insurers priced that expectation directly into their 2026 filings.

2. Medical costs keep rising

Hospital prices, physician costs, and prescription drug prices all continue to climb, and premiums are ultimately a pass-through of what care costs.

3. People are using more care

Higher utilization means more claims per enrollee, which pushes premiums up even before prices rise.

The double hit for subsidized enrollees

If you get marketplace subsidy help, 2026 hit you twice.

Hit one: the sticker price of the plan itself went up, per the rate increases above.

Hit two: on January 1, 2026 the subsidy rules reverted to the pre-2021 framework. Households above 400% of the federal poverty level no longer qualify for any premium tax credits, and the required income percentages, the share of income you are expected to pay toward your benchmark plan, rose across all brackets. So even if your income did not change, your subsidy shrank.

A bigger sticker price and a smaller subsidy compound each other. That is why many subsidized enrollees saw average premiums more than double, and why the increase on your renewal letter can be far larger than 18%.

What you can actually do

1. Check your state's premium assistance program. Start at healthcare.gov. If your state runs its own marketplace, it will route you there, and any state-level help for 2026 will show up in your quoted price.
2. Re-shop during open enrollment instead of auto-renewing. With rate changes this uneven across insurers, the plan that was the best deal last year may not be this year. Ten minutes of comparison can be worth real money.
3. Check your subsidy status anonymously. The healthcare.gov savings tool screens you without an account, so you know what help you qualify for under the current rules before you shop.
4. If you are healthy and above the subsidy cutoff, compare both lanes. With no subsidy help, you are paying the full marketplace rate, so it is worth getting a private plan ballpark next to that baseline. Be clear-eyed about the trade-offs: private plans require medical underwriting, so not everyone qualifies, and per healthcare.gov most plans sold outside the marketplace are not marketplace-style qualifying coverage. Our subsidy cliff guide and marketplace vs private comparison walk through this honestly. If you have significant pre-existing conditions, the marketplace is usually still your best lane even at full price.
5. If you are covered at work, review your options at open enrollment. With employer costs projected up 9%, many employers are adjusting premiums, deductibles, or plan lineups. Do not assume this year's plan mix looks like last year's.

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