I just finished writing up a deep dive into the Arkansas Insurance Dept's move from laissez faire-style Silver Loading to fully-regulated & maximized Premium Alignment in an attempt to mitigate the massive net premium damage about to be caused if the enhanced ACA premium tax credits expire at the end of 2025.
However, it's not just Arkansas which has finally seen the light and joined about a dozen other states in putting full-bore Premium Alignment (PA) pricing into place to help reduce the financial burden on ACA individual market enrollees in 2026.
Other states which have already done so in the past include Colorado (sort of), Texas, New Mexico, Maryland, Pennsylvania (somewhat), Illinois, Vermont and Wyoming.
State Highlights Rising 2026 Health Insurance Rate Proposals
SAINT PAUL, MN: Minnesotans are facing unnecessarily higher health insurance rate hikes, and the blame lies with new Republican-led federal policy changes passed in Washington, says Minnesota Commerce Commissioner Grace Arnold.
“While HR1 has been dubbed the “One Big Beautiful Bill” by Republicans, many in our state will find nothing beautiful in health insurance premium increases they’ll experience for 2026,” Arnold said. “These will be the highest rate hikes since 2017 for individual and group markets.”
Last week I noted that Colorado legislators passed (and Gov. Polis signed) legislation to scrape together up to $100 million in emergency funding to backfill perhaps 40% or so of the federal tax credits the state expects their ~225,000 subsidized enrollees to lose in 2026 when the enhanced IRA credits expire this December:
...The Senate then approved House Bill 25B-1006, which would sell tax credits to bring in money for the Health Insurance Affordability Enterprise fund. That pays for programs to reduce individual insurance market premiums.
The bill aims to raise $100 million for that enterprise to soften the impact of the expiration of federal enhanced premium tax credits. Health insurance premiums for people who buy insurance on the individual market are expected to face an average of a 28% increase next year, with higher increases along the Western Slope.
OLYMPIA, Wash. — Fourteen health insurers have requested an average rate change of 21.2% for Washington state's 2026 Individual Health Insurance Market. Insurers base their requested rate changes on assumptions they make about the services their policyholders will use and the cost to deliver that care. The health plans and proposed rate changes are currently under review by the Office of the Insurance Commissioner.
Wellpoint Washington, Inc. is new to the market and plans to sell in Grays Harbor, King and Spokane counties.
Back in June I ran an analysis to try and break out just how many Americans are likely to lose healthcare coverage in every Congressional District nationally under the recently-passed MAGA Murder Bill, officially known as H.R.1, the One Big Beautiful Bill.
As I showed at the time, while there's around 65% more people enrolled in Medicaid via ACA expansion in House districts held by Democrats (roughly 12.7 million in blue districts vs. 7.7 million in red districts), there's around 34% more ACA exchange enrollees in red districts (around ~13.9 million vs. ~10.4 million in blue districts).
I then went a step further and broke out the House districts into 10 tiers based on what percent of the vote Donald Trump received last year to take a more granular look and found that, shocker, there's no "winners" here; every district is a loser across the ideological spectrum.
Marketplace enrollees from across the country joined State-based Health Insurance Marketplace leaders and insurance experts at a virtual press conference today to discuss the immediate, real-world impacts of potentially losing their health insurance tax credits.
More than 24 million Americans enrolled in Health Insurance Marketplaces have come to rely on increased insurance affordability, thanks to enhanced premium tax credits (EPTCs) set to expire at the end of 2025. Without Congressional action by September 30, the loss of EPTCs is estimated to cause 4.2 million Americans to lose their health insurance. Marketplace consumers are expected to see an average 75 percent cost increase across states.
From small towns to the nation’s most populous state, enhanced premium tax credits are helping millions of Americans get the financial help they need to get connected to affordable health insurance.
Maine has around 64,000 residents enrolled in ACA exchange plans, 85% of whom are currently subsidized. I estimate they also have another ~4,500 unsubsidized off-exchange enrollees.
Combined, that's around 70,000 people, although it could be somewhat lower due to net enrollment attrition since January.
For months now I've been shouting from the rooftops about the imminent expiration of the improved federal tax credits for ACA enrollees, repeatedly pointing out that those already paying full price are gonna get hit with average premium hikes of over 23% while most of the 92% of exchange enrollees who currently receive at least some federal assistance will see their net premiums skyrocket by up to 100%, 200% or even 300% or more.
Having helped cause this crisis in the first place both by refusing to push Congressional Republicans to extend the enhanced subsidies as well as by changing the Premium Adjustment Percentage Index formula (PAPI) to make the remaining subsidies even less generous, the Trump Regime has come up with what I'm sure they think of as a brilliant "solution" to the problem.
As I noted last month, Colorado's ~321,000 individual health insurance market enrollees are currently staring down the barrel of massive premium hikes less than four months from today:
Every state government is handling this situation differently. In Arkansas and New Hampshire, the strategy seems to be to either shout at or beg carriers to re-file with lower gross premium increases for 2026. New Mexico, California and New Jersey, in contrast, are all retooling their existing state-based supplemental subsidy programs to help cushion at least some of the impact.
Nevada has around ~110,000 residents enrolled in ACA exchange plans, 87% of whom are currently subsidized. I estimate they also have another ~23,000 unsubsidized off-exchange enrollees.
