Largest Increase Ever From Top Insurers. Will Ensign Group Employees Be Affected?

Healthcare Provider Update: Ensign Group Healthcare Provider The Ensign Group primarily operates skilled nursing facilities, assisted living facilities, and memory care services. They are known for providing a diverse range of healthcare services, including rehabilitation and care for patients with chronic conditions. Their operating model emphasizes patient-centered care, and they often partner with various healthcare providers to ensure comprehensive service delivery to their residents. Potential Healthcare Cost Increases in 2026 As the landscape of healthcare continues to evolve, significant premium hikes are anticipated in 2026, particularly for Affordable Care Act (ACA) marketplace plans. With some states forecasting increases exceeding 60%, the loss of enhanced federal premium subsidies could lead to average out-of-pocket costs spiking by over 75% for the majority of policyholders. This surge is attributed to rising medical costs and the record profits reported by major insurers, creating a perfect storm for healthcare consumers facing steep financial challenges ahead. As consumers prepare for 2026, proactive financial strategies will be essential to mitigate the impact of these escalating costs. Click here to learn more

'With ACA premiums expected to rise in 2026, Ensign Group employees should compare marketplace and employer-related options early, model net costs with and without current subsidies, and coordinate with HR and a qualified tax professional for decisions suited to their situation.' — Patrick Ray, a representative of The Retirement Group, a division of Wealth Enhancement.

'With ACA marketplace premiums expected to climb in 2026, Ensign Group employees should compare employer and marketplace options early, estimate net costs under both current and lapsed subsidy scenarios, and coordinate with HR and a qualified tax professional to align coverage with their budget.' — Michael Corgiat, a representative of The Retirement Group, a division of Wealth Enhancement.

• In this article we will discuss:

  1. The expected premium increases for ACA marketplace plans in 2026 and their potential impact on Ensign Group employees and retirees.

  2. The major national insurers and states with the largest requested rate hikes.

  3. The primary economic, legislative, and industry factors driving these increases.

  In 2026, health insurance rates for plans purchased through the Affordable Care Act (ACA) marketplace are  expected  to surge, with several insurers requesting increases exceeding 60%. ¹  For Ensign Group employees and retirees using ACA coverage, this could mean a substantial rise in health care costs. State insurance filings and industry publications point to higher medical expenses, the potential end of enhanced federal premium subsidies, and significant rate-hike proposals from major insurers as key drivers of the increase.

  According to KFF’s analyses, the vast majority of marketplace enrollees receive premium tax credits, and if the enhanced credits expire after 2025, average out-of-pocket premium payments for subsidized enrollees could rise by more than 75% in 2026. ¹  As of January 2025, 24.2 million people selected 2025 marketplace coverage, ²  and about 93% of marketplace enrollees rely on premium tax credits. ³  KFF also reports that requested premium increases for 2026 are the largest in years, with most proposals falling between roughly 12% and 27% and a median of 18% across reviewed filings. ⁴

  Top 10 States With the Largest Requested Premium Increases for 2026:

  • New York:  UnitedHealthcare requesting up to  +66.4%  (individual market).

  • Arkansas:  QualChoice  +54.4% , Ambetter (Celtic)  +42.5% , statewide average  +36.1% .

  • Colorado:  Western Slope  ~+38.8% ; statewide average  +28.4% . Rocky Mountain HMO  +36.4% , Cigna  +29.4% , Anthem  +33.6% , Kaiser  +15.3% .

  • Florida:  Molina  ~+41% , Florida Blue  +27% , Centene Venture  +18.73%

  • Maine:  Anthem (revised)  +24.8% ; statewide weighted average  +25.9% .

  • Washington:   14  insurers; requested average  +21.2% .

  • Vermont:  BCBS Vermont  +23.3% . 

  • Maryland:  Requested statewide average  +17.1%  (individual market).

  • Illinois:  BCBS Illinois  +27% . 

  • Texas:  BCBS Texas  +21% .

  Major National Insurers and Their 2026 Requests:

  • UnitedHealthcare (UnitedHealth Group):  Up to  +66.4%  in New York.

  • Elevance Health (Anthem BCBS):   +33.6%  in Colorado;  +24.8%  in Maine. 

  • Kaiser Permanente:   +15.3%  in Colorado (individual market). 

  • Centene Corporation (Ambetter/Celtic):   +42.5%  in Arkansas;  +18.73%  in Florida.

  • Cigna Healthcare:   +29.4%  in Colorado. 

  • Molina Healthcare:   ~41%  in Florida.

  • HCSC (BCBS IL, TX):   +27%  in Illinois;  +21%  in Texas. 

  • GuideWell (Florida Blue):   +27%  in Florida. 

  • CareFirst BlueCross BlueShield:  Maryland requested statewide average  +17.1% .

  • CVS Health/Aetna:  Withdrawing ACA marketplace plans in  17 states  in 2026, affecting  ~1 million  members.

  Key Factors Driving the Increases:

  • Loss of Enhanced Premium Subsidies:  The American Rescue Plan and Inflation Reduction Act extended ACA subsidies through 2025. Without renewal, subsidized enrollees could see sharp increases in monthly premiums beginning in 2026 (KFF estimates more than a 75% jump in average out-of-pocket premiums for subsidized enrollees if the enhancements lapse). ¹

  • Medical Cost Inflation:  Leading consultancies report elevated medical cost trends heading into 2026—about 7.5% in the individual market and 8.5% in the group market ⁵ —driven by hospital/physician services and prescription drugs.

  • Regulatory Shifts:  Market rules and state laws have influenced filings. For example, analysts note federal policy changes (e.g., the Marketplace Integrity rule) as a factor cited in filings, adding operational uncertainty for vertically integrated insurers/PBMs.

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Sources:

1. KFF, Health System Tracker. ' How much and why ACA Marketplace premiums are going up in 2026 ,' by J. Ortaliza, M. McGough, K. Vu, I. Telesford, S. Rakshit, E. Wager, L. Cotter, C. Cox. 6 Aug. 2026. 

2. CMS.gov. ' Over 24 Million Consumers Selected Affordable Health Coverage in ACA Marketplace for 2025 .' 17 Jan. 2025.

3. The Commonwealth Fund. ' Proposed Rule Will Make Consumers Pay More for Health Insurance and Care in ACA Marketplaces ,' by Sara Collins. 7 May 2025.

4. Fierce Healthcare. ' KFF Analysis finds a median ACA premium hike of 18% for 2026 ,' by Paige Minemyer. 8 Aug. 2025.

5. PwC Health Research Institute.  Medical Cost Trend: Behind the Numbers 2026 .  PwC , 16 July 2025,  https://www.pwc.com/us/en/industries/health-industries/library/behind-the-numbers.html .

Other reources:

1. New York State Department of Financial Services. “Summary of 2026 Requested Rate Actions.”  DFS Portal , 2 June 2025,  https://myportal.dfs.ny.gov/web/prior-approval/ind-and-sg-medical/summary-of-2026-requested-rate-actions .

2. Centers for Medicare & Medicaid Services (CMS).  Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability  (Final Rule). 18 June 2025, PDF,  https://www.cms.gov/files/document/cms-9884-f-2025-pi-rule-master-5cr-062025.pdf .

3. Minemyer, Paige. “Aetna to Exit the ACA Exchanges in 2026.”  Fierce Healthcare , 1 May 2025,  https://www.fiercehealthcare.com/payers/aetna-exit-aca-exchanges-2026 .
Pages/Sections referenced:  Article body noting ~1 million exchange members and the 2026 exit (single web page; n. pag.).