Pennsylvania Health Insurance Rates for 2026 Show Average 19% Increase

The Pennsylvania Insurance Department has announced tentative health insurance rate proposals for 2026, indicating an average increase of 19% for individual plans and 13% for small business group plans. These rate hikes are subject to state approval and public comment through early September, with final rates to be disclosed in the fall.

The department's review ensures rates are neither excessive nor unfairly discriminatory. The significant rise in proposed rates compared to previous years is attributed primarily to escalating healthcare costs, increased utilization of benefits including high-cost outpatient care and pharmaceuticals, and the anticipated expiration of the Affordable Care Act's Enhanced Premium Tax Credits by the end of 2025.

Insurers such as Ambetter Health of Pennsylvania and Keystone Health Plan Central are proposing some of the largest increases, exceeding 25%, while a few carriers like Partners Insurance Company anticipate rate decreases. For the small group market, increases vary but remain substantial, with notable adjustments from Highmark and UnitedHealthcare plans. These changes reflect ongoing shifts in healthcare economics and regulatory factors impacting insurer pricing strategies within Pennsylvania's insurance marketplace.