Proposed Health Insurance Premium Increases in Pennsylvania for 2026

Insurers participating in Pennsylvania's health insurance marketplace, known as Pennie, have submitted requests for significant premium increases for 2026. The Pennsylvania Insurance Department announced that the average proposed increase is approximately 19% for individual plans and 13% for small group plans. This marks a substantial rise compared to previous years, where average increases were 7.9% in 2024 and 4.2% in 2023. The proposed hikes are attributed to escalating healthcare costs, including outpatient services and medications, as well as the impending expiration of federal tax credits that have aided low-income individuals in affording coverage.

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The proposed rate changes vary significantly among insurers. For instance, Ambetter Health of Pennsylvania Inc. has requested a 30.1% increase, while Capital Advantage Assurance Company seeks a 26% rise. Other notable requests include Geisinger Health Plan at 14.1%, Highmark Inc. at 17.2%, and Independence Blue Cross at 16.7%. Conversely, Partners Insurance Company Inc. has proposed a decrease of 10.1%. The Pennsylvania Insurance Department will evaluate these requests to ensure they are not excessive or discriminatory, with public comments accepted until September 2, 2025.

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The proposed increases are compounded by the expiration of enhanced federal subsidies, which are set to end on December 31, 2025. These subsidies have been crucial in helping many families afford their health insurance premiums. Experts warn that without these subsidies, families could face drastic increases in their monthly costs. For example, a family of four in Dauphin County with an annual income of $120,000 could see their costs for a bronze plan rise from $5 to over $1,000 per month.

Pa. health insurance rates to jump as subsidies end

Critics have raised alarms about the potential impact of these increases on low-income families and individuals who rely on Pennie for their health coverage. Joshua Brooker, a healthcare advocate, emphasized the need for public comments and legislative action to address these concerns. He noted that many individuals could lose subsidized insurance, leading to increased financial strain and reduced access to necessary healthcare services.

Pa. health insurance rates to jump as subsidies end

The Pennsylvania Insurance Department has stated that it will thoroughly review the proposed increases and consider public feedback before finalizing the rates. The department aims to ensure that any adjustments are justified and do not disproportionately affect vulnerable populations.

Pa. health insurance rates to jump as subsidies end

As the open enrollment period begins on November 1, 2025, individuals and families are encouraged to assess their healthcare needs and financial situations. Experts recommend proactive measures, such as contacting legislators and exploring income planning strategies, to mitigate the financial impact of the proposed premium increases. The final approved rates are expected to be released in October 2025, following the public comment period.

Pa. health insurance rates to jump as subsidies end