Tennessee ACA Premiums to Rise 15% in 2026 Amid Tax Credit Expiry

Health insurance premiums for Tennesseans using the Affordable Care Act (ACA) are projected to rise significantly in 2026, with an expected median increase of 15%. This represents the largest premium hike for ACA plans in Tennessee since 2018, driven primarily by rising medical costs and the expiration of enhanced tax credits introduced during the Biden administration. These tax credits, which helped reduce premiums and boost enrollment, are set to expire at the end of 2025, potentially increasing consumer out-of-pocket premium payments by over 75% on average. In 2025, approximately 627,797 Tennesseans are enrolled in ACA plans, underlining the impact of these changes on a substantial population segment.

This premium surge coincides with legislative changes including the passage of the "One Big Beautiful Bill Act," which reduced funding for programs like Medicaid and SNAP, although its full impact on ACA insurance rates remains uncertain. Additionally, new federal regulations will terminate the special enrollment period that allowed low-income Americans earning below 150% of the federal poverty level to enroll year-round. These changes also include the discontinuation of automatic ACA enrollment renewals, requiring consumers to submit updated income and eligibility information annually.

Beyond the ACA marketplace, employees with employer-sponsored health insurance may also face increased costs. Benefits research by Mercer indicates that approximately 51% of large employers plan to offset rising insurance expenses by increasing deductibles, copayments, or out-of-pocket maximums for their workers. This trend reflects broader cost pressures in the U.S. healthcare system, affecting both public and private coverage sectors.

Overall, these developments suggest a challenging landscape for health insurance affordability in Tennessee for 2026. The expiration of subsidies combined with shifts in enrollment rules and employer cost-sharing measures underscore the complexity of managing health coverage amid evolving regulatory and market conditions. Insurance professionals should monitor these dynamics closely to advise stakeholders effectively on compliance, cost management, and consumer impact.