ACA Marketplace Premiums Surge 20 Percent, Worsen Coverage Crisis
Analysis of rate filings found Affordable Care Act Marketplace premiums rose an average of 20 percent nationwide for 2026, with some states facing increases up to 67 percent. The jump threatens affordability for millions, reshapes federal subsidy spending, and concentrates harm in states that rely on the federal exchange.
Affordable Care Act Marketplace premiums climbed sharply for 2026, raising fresh concerns about affordability and access for Americans who buy individual coverage. MoneyGeek.com analyzed official rate filings from all 50 states and Washington, D.C. and found population weighted gross premiums for Silver tier benchmark plans for a 40 year old adult increased roughly 20 percent from 2025 to 2026. Some states experienced premium spikes as large as 67 percent, with the largest increases concentrated in states that use only the federal exchange.
MoneyGeek’s population weighted approach adjusted each state average by its 2024 Census population to reflect the national impact, offering a clearer picture of what rising rates mean for consumers across regions. The analysis focused on Silver tier benchmark plans, which serve as the federal standard for measuring premiums and play a central role in determining premium tax credits that lower costs for eligible enrollees.
The steep rise in benchmark premiums carries immediate implications for both households and the federal budget. Because premium tax credits are calculated relative to the benchmark Silver plan, dramatic increases will boost federal subsidy spending for those who qualify, while leaving people who do not qualify more exposed to higher out of pocket premium costs. For low income adults and families who live in states with limited consumer protections or who fall just above eligibility thresholds, the increase can create untenable choices between health care and basic needs.
Geographic variation in the filings underscored long standing equity concerns. States that rely solely on the federal exchange tended to show the largest increases, intensifying disparities between states that operate their own exchanges and those that do not. Communities of color, lower income families, and rural residents, who already experience higher uninsured rates and greater barriers to care, are likely to be disproportionately affected by reduced affordability and potential coverage churn.
The premium surge arrives as policymakers debate options for stabilizing individual markets. State level tools such as reinsurance programs and insurer rate review can blunt volatility, while federal policy levers include targeted increases in premium tax credits and measures to encourage insurer competition. Any policy response will need to weigh federal fiscal costs against public health and equity outcomes, because rising premiums threaten preventive care access, chronic disease management, and financial stability for households.
Health care providers and local safety net organizations are likely to face increased demand if higher premiums push people out of comprehensive coverage and toward emergency care or delayed treatment. In states that expanded Medicaid the program will continue to function as a buffer for low income adults, but in non expansion states the safety net is more limited.
The MoneyGeek analysis of 2026 rate filings made clear that this year’s premium changes were substantial and uneven, with consequences that reach beyond insurance markets into public health, community wellbeing, and social equity. As regulators and lawmakers consider responses, consumers contend with steeper costs and a system that continues to produce widening gaps in who can afford to be covered.
