Open enrollment for health insurance in Pennsylvania is just a few months away. Self-employed people, retirees under 65, and those without job-based coverage should start planning now, experts say, as insurance rates are expected to rise sharply.
Premiums for 2026 are likely to increase in the double digits. There is also uncertainty about how changes to the federal Medicaid program could affect insurance costs in the state. Many people may lose subsidized coverage through Pennsylvania’s health insurance marketplace, Pennie.
Joshua Brooker, principal and certified healthcare advocate at PA Health Advocates in Lancaster, said these concerns need attention at both the state and federal levels. “It’s not too late to fight for changes,” he added.
Statewide Rate Increases Expected
According to the Pennsylvania Insurance Department (PID), insurance costs will rise in 2026 due to both state and federal factors. On Aug. 1, PID released proposed rate increases requested by insurance companies for the individual and small-group markets.
The average proposed increase statewide is 19%. The PID website lists company-specific requests. This includes insurers participating in Pennie and those selling directly to employees, meaning workers may see significant increases regardless of their coverage source.
Thomas Purcell, vice president of health plan options at URL Insurance Group in Harrisburg, noted that final rates are likely to be lower than requested but will still be high.
PID said the rate hikes are driven by rising healthcare costs, increased use of benefits, and the pending end of the federal Enhanced Premium Tax Credits, which expire Dec. 31 unless Congress extends them.
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