Harrisburg, PA – The Pennsylvania Insurance Department (PID) today announced that most of the nine largest Pennsylvania health insurers are requesting significant premiums increases in plan year 2026. On average, insurers are asking for a 19% increase to premiums in the individual market (for people who buy their own insurance), and a 13% increase to premiums in the small group market (for small businesses).
In their filings to PID, insurers highlight that these requested increases are due to:
- The rising cost of health care;
- The higher use of benefits, including for more expensive out-patient services and medication; and
- The end of the Enhanced Premium Tax Credits (Tax Credits), which are set to expire on December 31, 2025 unless Congress acts to extend them.
The higher monthly premium cost and the potential failure to renew the tax credits could mean that over 150,000 Pennsylvanians may lose their health insurance because the plans they have now would become too expensive.
“Insurance rates were already trending up because of rising health care costs. The pending Congressional legislation makes matters far worse for hundreds of thousands of Pennsylvanians who rely on Pennie coverage,” said Pennsylvania Insurance Commissioner Michael Humphreys. “If Congress fails to renew critical enhanced premium tax credits and instead enacts barriers for consumers to continue coverage, Pennsylvanians will be forced to choose between coverage and basic necessities. That’s not a choice any family should have to make.”
Insurance companies offering individual plans and small group health insurance plans are required to file proposed rates with PID for review and approval before plans can be sold. PID reviews rates to ensure that the proposed prices are not actuarially excessive, inadequate, or unfairly discriminatory.
More information on proposed rates, including an opportunity for public comment, will be posted on the Department’s website later this summer. Final approved rates will be made public in the fall.
Pennsylvanians who have any insurance related questions or have an issue with their insurer or agent may file a complaint with PID by visiting pa.gov/consumer, or by calling 1-866-PA-Complaint.