Ohio ACA Premiums Surge as Enhanced Subsidies Expire, Uninsured Rate Set to Rise

Ohio is facing a significant increase in uninsured rates in 2026, with more than 1 in 6 individuals currently insured through the Affordable Care Act (ACA) expected to drop coverage. This projected 29% rise in the uninsured population is driven largely by the expiration of COVID-era enhanced premium tax credits on January 1, 2026, which had temporarily reduced out-of-pocket costs for enrollees across income levels. With these subsidies ending, premiums in Ohio, which uses the federal healthcare.gov marketplace, are anticipated to increase by approximately 30%, surpassing the national average increase of 26%. States operating their own marketplaces are expected to see smaller increases, averaging 17%. Premium hikes are attributed to rising hospital costs, increased use of high-cost pharmaceuticals and biologics, inflationary pressures, labor shortages, and economic uncertainties such as potential tariffs on medical supplies. The uncertainty around premium increases has complicated enrollment decisions, with a number of individuals, especially younger and healthier enrollees, opting to forgo coverage due to unaffordability, while others with chronic conditions or anticipated medical needs continue coverage despite rising costs. In addition to premium changes, the health insurance landscape in Ohio is further affected by exits of some Medicare Advantage plans in certain counties and steep premium increases in employer-sponsored plans. Moreover, plan networks are becoming more limited, prompting consumers and insurance brokers to carefully evaluate network adequacy when selecting plans. The Ohio Department of Insurance reports five ACA plan providers available in Hancock County for 2026, underscoring the evolving market dynamics. This shift raises important considerations for insurers, providers, and policymakers regarding coverage stability, access to care, and the financial risks faced by consumers amid an increasingly costly and complex insurance environment. The expiration of enhanced subsidies and related coverage decisions will be critical factors shaping health insurance coverage rates and affordability in Ohio and states utilizing the federal marketplace in the upcoming plan year.