Maryland Health Insurance Premiums Jump 13.4% in 2026 - ACA Marketplace Rate Hike Explained (2025)

• Health

Officials, insurers say the increase is needed to counter a loss in enrollment due to the anticipated end of popular federal tax credits

Nearly 300,000 Marylanders who bought health insurance on the state’s Affordable Care Act Marketplace will see monthly health care costs jump next year, as state officials finalize premium rate increases for 2026.

The Maryland Insurance Administration announced the approval Friday of a 13.4% average premium rate increase for 2026, meaning individuals and households will have to pay hundreds more in health costs over next year.

While the approved rates are slightly better than what insurance companies initially asked for earlier this year, it’s still going to be a significant hike in health care costs for families already struggling to pay their bills.

“It’s going to hit patients hard,” said Gene Ransom, CEO for MedChi, the Maryland State Medical Society, noting that families are already struggling with other expenses. “That’s a significant increase for those who are not getting raises to keep up.”

The Maryland Insurance Administration said that the premium increases will be needed to offset the likely end of federal tax credits that help keep costs down for low- to middle-income Marylanders.

Health advocates, state officials brace for ‘sticker shock’ if ACA tax credits expire

Those tax credits are set to expire at the end of the year and health care advocates fear that people will drop their health care coverage because they can no longer afford their plans.

Matthew Celentano, executive director of the League of Life & Health Insurers of Maryland, agrees that the increase in premiums will reduce enrollment, which impacts costs for all policyholders, not just those covered through the Affordable Care Act.

“Frankly, it’s the healthier people that leave the market. The sick are more expensive, and to cover that cost we have to see higher premiums,” Celentano said.

The insurance administration added that rising medical and pharmaceutical costs also contributed to the higher premium rates.

For this year, insurance companies initially asked for a17.1% premium increase, but after negotiations with the insurance administration, they landed on an average 13.4% increase for the 294,189 people who have individual ACA health care plans.

Still, that’s more than twice the rate of increase from last year, when individual ACA plan premiums rose an average of 6.2%. The lowest premium rate increase in recent history was in 2022, with just a 2.1% average increase across marketplace plans.

How much more plans will cost for Marylanders will vary based on a person’s insurance carrier, location and household income and size.

For a 40-year-old living in Baltimore with a silver plan, that person could see a monthly increase anywhere from $17 to $75, depending on their carrier, according to state estimates. A family of four in the same situation could see an increase of $57 to $258, on top of their current premiums.

The General Assembly approved funding this year that would partially replace the soon-to-expire federal tax credits for the upcoming year, but those state subsidies are temporary fixes and plenty of people will still pay more each month for health care than they did this year, analysts say.

“With the pending expiration of the enhanced federal tax credits and with the state subsidy only able to partially replace the reduction, consumers may see sizable rate increases, much higher than in recent years,” Insurance Commissioner Marie Grant said in a written statement.

State officials, insurance companies and health advocates are urging Congress to extend premium tax credits, instead of letting them expire in December, though that window is closing.

“This can still be fixed,” said Vincent DeMarco, president of the Maryland Health Care for All coalition. “We really hope that they will do something … if Congress fails, it will hurt Marylanders.”