Premiums for individual health insurance plans in Arkansas, including those offered through healthcare.gov, would increase an average of 26.2% in 2026 under proposed rates filed by the insurers with the Arkansas Insurance Department.

The plans include those covering about 227,000 people through the state’s Medicaid expansion program, ARHOME, which stands for Arkansas Health and Opportunity for Me, as of May 1 as well as about 166,000 people who were enrolled through healthcare.gov at the end of the most recent open enrollment period.

ARHOME uses state and federal Medicaid funding to provide coverage for low-income Arkansans through commercial health plans.

Carriers are required to submit proposed rate increases to the Insurance Department, which uses an external actuary to determine whether the rate is considered to be “actuarially sound,” which the American Academy of Actuaries defines as “projected to provide for all reasonable, appropriate, and attainable costs that are required under the terms of the contract.”

Once that process is completed, Insurance Commissioner Alan McClain must approve the increases before they take effect on Jan. 1.

Open enrollment in the plans offered through healthcare.gov begins Nov. 1.

If greenlit, the prospective rate hikes would be historically high — last year’s average increase, weighted to account for the number of enrollees with each insurer, was just 6.2%, which itself was the largest rise for at least five years.

Of the submitted proposals, an increase affecting about 85,000 customers covered by a group of Centene plans was the lowest at 20.1%, while a hike for a group of Arkansas Blue Cross and Blue Shield plans covering almost 40,000 people was the highest at 34.3%.

According to a blog post by the Arkansas Center for Health Improvement, in addition to typical adjustments, filings from all six insurance companies attribute the steeper proposed increases on individual plans to recent federal and state policy actions.

Each company cited the expiration of enhanced premium tax credits, established as part of the American Rescue Plan Act of 2020 and later extended through 2025. The enhanced subsidies are scheduled to end in 2026 unless they are extended again by Congress.

Since the enhanced subsidies became available, Arkansas’ enrollment in plans offered through healthcare.gov has more than doubled, from 66,094 people in 2021 to 166,639 this year.

Without the enhanced subsidies, health policy organization KFF estimates an Arkansas family of four with two 40-year-old parents and two children earning the state’s median household income would go from paying $75 to $257 per month for a “silver plan” — a plan which requires the insurance company to pay for 70% of all covered medical services, on average.

“To account for (the enhanced premium tax credit) expiration prior to the 2026 benefit year, we have assumed rates will increase due to anticipated reductions in enrollment, both at the issuer and single risk pool level,” Centene wrote in its filings. “As (the enhanced premium tax credits) expire and enrollees subsequently face increased out-of-pocket premiums, we assume healthier individuals who tend to be more price sensitive will leave the market, worsening the average morbidity of the individual risk pool.”

Arkansas Blue Cross and Blue Shield also mentioned the potential for a work requirement to be added to the state’s Medicaid expansion program as a reason the higher rates are needed.

Under the “One Big Beautiful Bill Act” signed by President Donald Trump this month, such a requirement is scheduled to take effect nationwide no later than the end of next year, although Arkansas has applied for federal approval to implement a requirement that would start Jan. 1.

Blue Cross also mentioned several Arkansas laws passed in the 2025 legislative session as contributing factors, such as mandating certain benefits, limiting prior authorizations and regulating pharmacy benefit managers.

Arkansas Department of Human Services spokesman Gavin Lesnick confirmed via email that the department had yet to complete a review of potential impacts to ARHOME resulting from the proposed increases.

“It is important to note that the overall program cost for ARHOME cannot exceed the budget neutrality cap in the waiver” authorizing the program, Lesnick said.

In a list of various factors contributing to the need for higher rates, Centene cited “morbidity and risk adjustment” as the single biggest component.

For Arkansas Blue Cross and Blue Shield plans covering more than 107,000 people, as well as plans offered by its affiliate, Health Advantage, covering more than 28,000 people, the biggest factor was “medical price changes,” a category that includes renegotiated provider contracts.

Other states are also seeing proposed increases in the double digits.

An analysis from KFF examining 105 marketplace insurers in 19 states and the District of Columbia found a median 2026 proposed increase of 15%, more than twice as much as 2025.

The expiration of the enhanced premium tax credits are “expected to cause healthier enrollees to drop their coverage and create a sicker risk pool,” the authors said.

Another reason cited by some of the insurers include tariffs causing costs of drugs and medical equipment to climb, the authors wrote.