Virginians who buy health insurance on the state’s marketplace could see big premium hikes in 2026, with most insurers proposing average increases of 20% or more — and one requesting twice that.
The State Corporation Commission says 10 insurers plan to sell individual marketplace plans in Virginia next year. Optimum Choice, Inc. has proposed the steepest average increase, 40.2%, according to SCC records. Rates in the small group market, which covers businesses with fewer than 50 workers, could rise an average of 11.2%.
About 388,856 Virginians currently get coverage through the marketplace, formally called Virginia’s Insurance Marketplace. Created under the Affordable Care Act, it’s an option for people who don’t get coverage through an employer — freelancers, small business employees, or contractors.
Why rates are going up
The SCC says insurers point to several reasons for the proposed increases:
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The scheduled end of enhanced federal premium tax credits at the close of 2025.
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Market uncertainty.
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Higher hospital and pharmacy costs.
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Increased use of medical services.
Those enhanced federal subsidies, first boosted during the pandemic under the American Rescue Plan Act and extended in the Inflation Reduction Act, have helped lower monthly premium costs for many. If they expire as scheduled, the state estimates about 100,000 Virginians could lose coverage.
Julian Walker, spokesman for the Virginia Hospital & Healthcare Association, said the potential loss of subsidies isn’t the only pressure on premiums. “Insurance rates for employers and families have been rising rapidly for years,” Walker said, citing state data showing that from 2019 to 2023, average private health insurance premiums in Virginia went up 20.2% for single coverage and 22.1% for families. “What’s happening in the marketplace is a reflection of that, plus the uncertainty of losing federal subsidies.”
What’s keeping rates lower now
Virginia’s Commonwealth Health Reinsurance Program, started in 2023, has kept marketplace premiums about 15% lower than they would be otherwise. Federal savings from reduced premium tax credits, plus a smaller amount of state money mostly fund the program. It’s approved through plan year 2027.
Katha Treanor, spokeswoman for the SCC, said the commission has already told lawmakers that extending the program would require a request to the Centers for Medicare & Medicaid Services by Dec. 31, 2026 — and legislation allowing the SCC to file that request.
What happens next
The SCC’s Bureau of Insurance reviews the rate proposals to confirm premiums are reasonable for the benefits provided and supported by sound actuarial assumptions. It expects to complete its review of 2026 marketplace plans by Aug. 15. Open enrollment for 2026 coverage begins in November.
