ACA Premiums 2026 By State Reveal Unexpected Winners
The ACA marketplace premium increases for 2026 are expected to be steep nationwide, with the average benchmark silver premium rising about 26% overall, about 17% in state-run marketplaces, and about 30% in states that use Healthcare.gov; Arkansas is one of the hardest-hit states, with benchmark premiums reported up about 69%, while Alaska is the notable exception with no increase in that analysis.
What is driving the 2026 hikes?
The biggest pressure points are higher medical costs, insurer expectations of increased utilization, and the scheduled expiration of enhanced premium tax credits at the end of 2025, which could make many subsidized enrollees pay far more out of pocket even if sticker prices are only part of the story.
In KFF's state-level analysis, the median proposed increase across all 50 states and Washington, D.C. was 18%, which was more than double the prior year's median proposed increase of 7%.
How the increases vary by state
Premium changes are not uniform because each state has its own insurer mix, local health costs, competition level, and whether it runs its own exchange or relies on Healthcare.gov.
| State or market type | 2026 benchmark premium trend | What it means |
|---|---|---|
| Healthcare.gov states | About 30% average increase | Consumers in federal-marketplace states are seeing the sharpest average benchmark jumps in KFF's analysis. |
| State-run marketplaces | About 17% average increase | State-based exchanges are rising too, but generally less than federal-marketplace states. |
| Arkansas | About 69% increase | One of the most dramatic increases reported for 2026. |
| Alaska | No increase in the cited benchmark analysis | The exception in KFF's state-by-state summary. |
Why the sticker shock feels bigger
Even when an enrollee's premium tax credit softens the blow, the underlying premium is still rising fast enough that many households will notice a higher monthly bill, a narrower choice of affordable plans, or both.
CMS says the average HealthCare.gov premium after tax credits is projected to be $50 per month for the lowest-cost plan in 2026 for eligible enrollees, which is up $13 from 2025 but still below 2020 levels after subsidies.
KFF also estimates that if enhanced premium tax credits expire, currently subsidized enrollees could see their monthly premium payments increase by about 114% on average, which is the policy issue that could turn a premium hike into a much larger affordability problem.
Who is most exposed?
- People in states that use Healthcare.gov, where the average benchmark increase is about 30%.
- Households that rely on premium tax credits, because subsidy expiration would raise their net monthly costs sharply.
- Consumers in states with fewer insurers or weaker competition, where premium growth can be more volatile.
- Enrollees in high-cost markets such as Arkansas, where the benchmark jump is especially large.
What insurers are signaling
Across 105 marketplace insurers in 19 states and Washington, D.C., KFF found a median requested increase of 15% in early filings, with most insurers asking for hikes in the 10% to 20% range and more than a quarter requesting 20% or more.
KFF's later 50-state review found a median proposed increase of 18% across 312 insurers, reinforcing that 2026 is shaping up to be one of the sharpest premium years in recent memory.
The 2026 premium cycle is being shaped as much by policy uncertainty as by ordinary medical inflation, which is why the same national headline can mask very different state outcomes.
How this compares with recent years
Urban Institute said the 2026 benchmark increase of 21.7% was far above the average 2.0% growth seen between 2020 and 2025, which shows how unusual this year is compared with the recent trend.
That gap matters because even a few percentage points of premium growth can be manageable for some households, while a double-digit jump can force shoppers to downgrade plans, switch insurers, or delay enrollment decisions until the deadline.
What shoppers should do now
- Check your 2026 plan options during open enrollment, which began November 1, 2025 and runs through January 15, 2026 for HealthCare.gov states.
- Compare the benchmark plan and your current plan side by side, because the cheapest plan is not always the best value after subsidies.
- Recalculate your subsidy eligibility, especially if your income, household size, or state exchange has changed.
- Watch for state-specific filing updates, because initial rate requests can still change before final approval.
- Review whether a different metal tier or insurer offers a lower net premium without sacrificing the coverage you need.
State-by-state takeaway
The simple answer is that 2026 ACA premiums are rising almost everywhere, but the pain is not evenly spread: federal-marketplace states are seeing the biggest average benchmark jumps, a handful of states are facing extreme increases, and subsidy policy will determine whether many consumers feel a moderate rise or a major affordability shock.
For readers searching for the biggest headline, the most important number is not just the 26% national average benchmark increase; it is the combination of state variation, expiring subsidies, and local plan competition that will decide how much each household actually pays.
Key concerns and solutions for Aca Premiums 2026 By State Reveal Unexpected Winners
Will ACA premiums go up in every state?
Almost every state is seeing higher 2026 premiums in the cited analyses, with Alaska the exception noted in KFF's summary.
Why are subsidized enrollees worried more than unsubsidized enrollees?
Because the expiration of enhanced premium tax credits could more than double monthly premium payments on average for people who currently get subsidies, even if the gross premium increase is lower.
When do shoppers see the new prices?
Consumers typically see final plan options during open enrollment, and CMS says the 2026 HealthCare.gov enrollment period began on November 1, 2025 and runs through January 15, 2026.
Which states are hit hardest?
Arkansas stands out in the cited reporting with a benchmark increase of about 69%, while state-run marketplaces as a group are averaging smaller increases than Healthcare.gov states.