2026 health-insurance costs rise, ACA plans hit hardest

Health insurance markets are bracing for a broad round of price increases in 2026, with the largest spikes expected in Affordable Care Act marketplace plans. Insurers and brokers say costs are rising on several fronts—more health care use, higher-cost drugs, and the potential collapse of enhanced premium tax credits that have subsidized coverage for millions. The combination could push many patients toward higher premiums, higher out-of-pocket costs, or even loss of coverage if Congress does not act before the enrollment period begins.

Insurers report that the cost pressures come from a shift in patient mix and increasing care needs. More people are using expensive emergency and mental-health services, while a growing share of healthier customers are dropping out of the individual market. That concentration of sicker, higher-claim patients tends to drive up premiums. At the same time, many plans are tightening eligibility verifications that were loosened during the pandemic, making it harder for some individuals to stay enrolled. Industry observers describe the current moment as one of unusual uncertainty across all health insurance sectors.

A significant part of the cost...