Maryland Insurers Seek Average 13.4% Premium Increase for ACA Plans

Health insurers in Maryland are seeking a 13.4% average increase in premiums for Affordable Care Act (ACA) plans next year. This proposal comes after a 13.7% approved increase for 2026, leading to a potential cumulative rise of over 27% in two years, pending Maryland Insurance Administration (MIA) approval. The requested increase highlights ongoing challenges in balancing premium rates and regulatory compliance requirements.

Factors Influencing Premium Hikes

Marie Grant, Maryland Health Insurance Commissioner, attributes the proposed increases to the expiration of federal premium tax credits. This could affect risk management by causing healthier individuals to leave the insurance pool, increasing costs for remaining policyholders. The MIA will assess this request in the fall, with a public hearing scheduled for July 23.

State Financial Assistance and Impact

Despite the expiration of federal credits, Maryland offers its own financial assistance to residents earning up to 400% of the federal poverty level and younger adults aged 18-37. Approximately 177,000 of 250,000 enrolled individuals benefit from state-based aid, potentially curbing premium hikes compared to other states. Nonetheless, an 8% disenrollment from ACA plans occurred, affecting around 18,000 residents earlier this year.

Projections by the Congressional Budget Office suggest a substantial increase in uninsured individuals after the loss of tax credits. Meanwhile, insurers like CareFirst and UnitedHealthcare report significant profits of $240 million and $14.4 billion, respectively. The MIA's decision on the proposed rate changes will heavily impact Maryland's healthcare market dynamics moving forward.