Full Breakdown
Rising Health Insurance Premiums for Federal Employees and ACA Enrollees in 2026
10/10/2025, 2:04:46 AM
Significant Increases in Federal Health Insurance Premiums
Federal employees and retirees are facing substantial increases in health insurance premiums for 2026. The Office of Personnel Management (OPM) announced that participants in the Federal Employees Health Benefits (FEHB) program will see an average premium increase of 12.3%, translating to approximately $26.40 more per pay period. This follows a 13.5% increase in 2025, marking the second consecutive year of double-digit hikes. Similarly, enrollees in the Postal Service Health Benefits (PSHB) program will experience an average increase of 11.3%, or about $21.51 more per pay period.
Context of the Increases
The increases in health insurance premiums are occurring amid ongoing staffing shortages at OPM, which is projected to lose about 1,000 employees by the end of the year. These staffing challenges have raised concerns about the operational capacity to manage health insurance programs effectively. Additionally, the federal government typically covers around 75% of a participant's premium, but the government's share is also increasing, contributing to the overall rise in costs.
Impact of the Government Shutdown
The announcement of these premium increases comes during a government shutdown, which has created uncertainty for federal employees regarding their paychecks and health benefits. Despite the shutdown, OPM confirmed that the Open Season for health insurance changes will proceed as scheduled from November 10 to December 8, 2025. During this period, federal employees can make changes to their health plans, although premium payments will be paused during the shutdown.
Broader Implications for ACA Enrollees
The expiration of enhanced premium tax credits under the Affordable Care Act (ACA) is expected to have a significant impact on millions of Americans. Enhanced subsidies, which were initially enacted during the COVID-19 pandemic, are set to expire at the end of 2025. If Congress does not act to extend these credits, average premiums for ACA enrollees could more than double, with some estimates suggesting increases of up to 300% in certain states. This could lead to approximately 4 million Americans losing their health insurance coverage.
Criticism and Opposition
Critics argue that the failure to extend the enhanced subsidies will disproportionately affect low- and middle-income families, forcing many to choose between essential needs and health coverage. Health policy experts warn that the loss of these subsidies will not only increase the number of uninsured individuals but also exacerbate existing health disparities. Democratic lawmakers are advocating for the extension of these subsidies as part of a broader government funding package, while Republicans have expressed concerns about potential fraud in the program.
Official Statements & Responses
Shane Stevens, OPM's Associate Director of Healthcare and Insurance, acknowledged the unsustainable trajectory of rising healthcare costs, stating, “We recognize that increasing health care expenses at this clip is not a sustainable path.” He emphasized OPM's commitment to improving healthcare quality and accessibility while addressing waste and fraud in the system.
What's Next
As the Open Enrollment period approaches, federal employees and ACA enrollees are urged to review their health insurance options carefully. The potential for significant premium increases underscores the urgency for Congress to act on extending the enhanced premium tax credits to mitigate the financial burden on millions of Americans. The outcome of these discussions will have lasting implications for healthcare affordability and access in the coming year.
