Arkansas is facing a proposed health insurance premium rate hike as high as 59 percent for 2026 Affordable Care Act (ACA) marketplace plans, the highest proposed rate increase overall in the nation.
Data compiled by the Peterson Center on Healthcare and KFF’s ‘Health System Tracker’ reveals that insurers across the country have been proposing particularly high increases, with Arkansas registering the steepest maximum proposed change.
Other states grappling with some of the highest proposed premium rate increases include New Mexico (53 percent), New Hampshire (50.1 percent), and Arizona (49 percent).
These proposed rate changes, which vary widely from modest reductions (as low as -10 percent) to the extreme high of 59 percent, with the average increase falling between 12 and 27 percent, highlight significant uncertainty facing the marketplace ahead of the critical expiration of enhanced premium tax credits in 2026.
Arkansas’s 59 percent proposal places it at the top of the range; the state also reported the highest range of proposed increases, with its lowest requested increase starting at 42.5 percent.
Experts suggest Arkansas’s high proposed rates may stem from “a large adjustment” in how it prices cost-sharing reductions for lower-income enrollees and special circumstances related to its ‘private’ Medicaid expansion tied into Marketplace plans.
The significant variation in proposed rate changes is attributed to large uncertainty facing both state regulators and insurers regarding the policy environment for the upcoming year, along with local dynamics such as the competitiveness of the hospital market.
Conversely, Alaska reported the lowest highest proposed premium rate increase at 5.3 percent, followed by South Dakota (8.9 percent) and Oregon (12.5 percent). While 125 health insurers proposed increases of at least 20 percent, a few proposed reductions were also noted, including in Pennsylvania (-10 percent), Kansas (-6.1 percent), Missouri (-4.4 percent), and Alaska (-0.8 percent).
These escalating premiums reflect an ongoing trend driven by several factors, including the increasing price of care and an uptick in general health care usage.
Inflation and elevated labor costs—spurring providers to seek higher reimbursement rates—are also contributors. Furthermore, the growing demand for expensive medications, such as GLP-1 drugs like Ozempic and Wegovy, has significantly increased prescription drug spending.
A major concern is the impending expiration of enhanced premium tax credits in 2026. Health industry experts have warned that increases caused by the expiration of these subsidies could cause millions of marketplace enrollees to become uninsured because they will no longer be able to afford coverage.
These coverage losses are expected to be largest among lower-income enrollees. For some, this policy shift could lead to out-of-pocket premium payments increasing by more than 75 percent. Premiums for ACA marketplace plans are thus expected to significantly increase for some in 2026, though the degree of impact will vary by state and plan.