ACA Marketplace insurers seek 18% median premium hikes for 2026

Phone Call Script: Health Insurance Marketplace - Check 2026 Plan Selection

Opening: Hello, I'm calling to confirm my 2026 plan selection and verify whether I received an advanced premium tax credit in 2025.

Key information to have ready:

• Your Marketplace account information
• Social Security Number
• 2025 tax information (if available)
• Current plan details

Key points to discuss:

• Peterson-KFF analysis shows insurers seeking 18% median premium hikes for 2026, up from 7% for 2025
• CMS reports 24,166,491 consumers selected 2025 Marketplace coverage as of Jan. 15, 2025
• About 92% of marketplace enrollees received a subsidy in 2025
• Many insurers built an average 4 percentage points into rates assuming enhanced premium tax credits expire on Dec. 31, 2025

Questions to ask:

1. What is my current 2025 plan and premium?
2. Did I receive an advanced premium tax credit in 2025, and if so, how much?
3. What will my 2026 premium be if I keep my current plan?
4. Will I still qualify for premium tax credits in 2026?
5. What happens if enhanced premium tax credits expire on Dec. 31, 2025?
6. When do I need to select my 2026 plan?
7. Are there other plans available that might be more affordable?

Why this matters: With insurers seeking 18% premium increases and enhanced tax credits potentially expiring, your 2026 costs could increase significantly. Understanding your current situation and options now will help you prepare for open enrollment.

Specific request: I'm requesting detailed information about my 2025 coverage, tax credits, and projected 2026 costs so I can make an informed decision during open enrollment.

Contact: Health Insurance Marketplace: 1-800-318-2596 TTY: 1-855-889-4325 Website: https://www.healthcare.gov/

Thank you for your assistance.

Phone Call Script: State Insurance Department - Estimate Subsidy Impact

Opening: Hello, I'm calling to understand how losing enhanced premium tax credits could affect my health insurance costs in 2026.

Key information to have ready:

• Your current income information
• Current premium amount
• Current tax credit amount (if receiving one)

Key points to discuss:

• Peterson-KFF analysis shows insurers seeking 18% median premium hikes for 2026
• Many insurers built an average 4 percentage points into rates assuming enhanced premium tax credits expire on Dec. 31, 2025
• If enhanced credits expire, subsidized enrollees could see out-of-pocket premium increases of more than 75% on average
• This is on top of the 18% premium increase insurers are seeking

Questions to ask:

1. How can I estimate my 2026 premium if enhanced tax credits expire?
2. What will my out-of-pocket premium be if I lose enhanced credits?
3. Are there state-level programs that could help offset increased costs?
4. What resources are available to help me understand my options?
5. When will final 2026 rates be available?

Why this matters: The combination of 18% premium increases and potential loss of enhanced tax credits could make health insurance unaffordable for many people. Understanding the impact now helps you plan and advocate for continued subsidies if needed.

Specific request: I'm requesting help modeling how losing enhanced premium tax credits would affect my 2026 health insurance costs, so I can prepare for potential significant increases.

Contact: Find your state insurance department: https://www.naic.org/state_web_map.htm Or call your state insurance commissioner's office

Thank you for your assistance.