There are three factors that will be increasing your 2026 Marketplace premiums.
Expanded Subsidies are expiring on December 31, 2025
The expanded premium tax credits —established during the pandemic and extended by the  Biden administration are set to expire at the end of 2025, unless Congress acts to extend them. There are no signs this will occur.
These subsidies increased the subsidies to people who were already eligible under the Affordable Care Act and expanded the eligibility to middle and higher-income households capping premiums at 8.5% of income.
The expiration of the expanded subsidies would reset the cap to 400% of the federal poverty level.
It is anticipated that net premiums are projected to rise by over 75% on average. Anyone with an estimated income for 2026 of more than 400% of the poverty level will become ineligible for any federal assistance.
Anticipated Premium Increases
We were notified in August that the ACA insurance carriers had submitted their proposed premium increases to the Department of Insurance for approval. The four major carriers in Arizona – Arizona Complete Health (Ambetter), United Healthcare, Cigna Healthcare of Arizona and Blue Cross Blue Shield of Arizona have requested price increases ranging from 30 – 50%. There is no reason for us to believe these rates will be denied by the Department of Insurance.
Exit of Banner Aetna from the Individual and Family Market
In 2025, many people enrolled in Banner Aetna plans. Their exit from the Marketplace will create less competition between the key players and reduce the options for many. We’re not sure how members on these plans will be treated. Will they be left to choose a new plan? Will they be automatically transferred to a different carrier plan? We’re uncertain at this time. Policyholders were notified of the exit during the summer, so this shouldn’t be a surprise to them.
What Are Your Options?
- Log into your Healthcare.gov account to look at plan options. If you take this route, please remember to include Cindy’s name as the person who assisted you. This will enable her to help you with any issues throughout the year.
- Click here to use our plan search tool to see what plans are available.
- Schedule a time in early November to talk with Cindy Gordon about your plan options. Please make sure you complete all the forms you’ll receive when you schedule an appointment. It is essential that this information is provided prior to your meeting to make the plan selection process most efficient. Open enrollment period is a very busy time of year. Appointment options will fill up quickly!
There are a variety of health coverage options outside the Marketplace. We’re happy to educate you on the different plans that may suit your needs and your budget. Schedule a 60-minute call today.