Harrisburg, PA – Today, the Pennsylvania Insurance Department (PID) launched its educational tour to prepare Pennsylvanians for significant health insurance premium increases for the upcoming year. Pennsylvania health insurers are requesting an average increase of 19% in the individual market (for people who buy their own insurance) and 13% in the small group market (for small business) for the 2026 coverage plan year. PID has been carefully reviewing these proposed rate increases and questioning the insurers on many details, as rates vary by plan and region, to ensure rates are appropriate and fair. PID does not approve rates that are excessive, inadequate or unfairly discriminatory to Pennsylvanians.
The spikes in premium costs are not only being seen t in Pennsylvania – states across the country are seeing health insurance premiums rising 18% on average, which is 11% higher than last year.
“We realize that this is not an ordinary filing year for insurers, and Pennsylvanians should be prepared to see higher costs to their health insurance,” said Pennsylvania Insurance Commissioner Michael Humphreys. “While we continue to work with the insurance companies to try to keep premiums low, we will begin meeting with Pennsylvanians throughout the Commonwealth to help prepare them for the potential premium increases and provide information they need to choose the best plan for them ahead of Open Enrollment in November.”
Throughout September and October, PID will host free, in-person educational sessions in communities across the Commonwealth. The goals of these sessions are to:
- Explain the rate review process and PID’s role in regulating the health insurance market;
- Provide an overview of the factors influencing premiums next year;
- Offer guidance on how to compare plans, costs, and provider networks during Open Enrollment; and
- Share tools and resources to help Pennsylvanians find coverage that fits their health care and budget needs.
Pennsylvanians can find a full list of these sessions, with date as location information, on PID’s website.
Insurers have requested higher premiums for plan year 2026 as a result of:
- The rising cost of healthcare;
- The higher use of more expensive service, benefits, and prescription drugs; and,
- The end of the Enhanced Premium Tax Credits (EPTC) available through Pennie, which are set to expire on December 31, 2025, unless Congress acts to extend them.
Pennie is Pennsylvania’s official health insurance marketplace. Half a million Pennsylvanians are currently enrolled through Pennie, which is the Commonwealth’s largest enrollment since Pennie’s inception. Three of every four enrollees on Pennie have only experienced enrollment with the enhanced tax credits in effect. Without the enhanced tax credits, premiums would rise by an average of 82%. This could force many to downgrade plans or go without insurance.
“The increase in rates, the expiration of the enhanced premium tax credits, and other recent federal policies make coverage more expensive and harder to get.” said Devon Trolley, Executive Director of Pennie. “Pennie will be communicating directly with enrollees about these updates. Every single Pennie enrollee should read mail from Pennie, and plan to log in to their accounts to update information and compare plan options starting November 1. Pennie is here to help.”
If these credits are not extended, consumers will see the direct impact once Open Enrollment begins November 1. Additional information about how the expiration of the enhanced premium tax credits could affect Pennsylvanians can be found on Pennie's website.
Pennie also has free resources available to help consumers. Help is available through online resources, FAQs, and video tutorials. Pennie Customer Service can assist consumers over the phone or through chat. There is a statewide network of local Pennie-certified Assisters and Brokers that can help consumers apply, shop, and enroll in a health plan that is the right fit for their needs and budget. All help is no cost to the consumer. Pennie Customer Service can be reached at 844-844-8040, and to be connected with free, expert help, go to pennie.com/connect.
Current Pennie enrollees can learn more about the potential cost increases due to the expiration of the Enhanced Premium Tax Credits on Pennie's website.
Consumers who have a question about their insurance or need to file a complaint may visit pa.gov/consumer or call 1-866-PA-COMPLAINT.
Visit PID's website for more details about the ACA rate filings.