Navigating Health Insurance in 2026: Trends, Costs, and Rule Changes - AUI

Understanding health insurance is crucial in today’s world. As we approach 2026, we are expecting that the health insurance landscape will undergo significant changes. This blog aims to provide you with the essential information you need to navigate these changes, focusing on emerging trends, projected cost increases, and potential federal rule changes.

Whether you are a small business owner or a solopreneur looking for health insurance coverage for 2026 your choices and your price points look much different than last year. We get it, and navigating these changes is difficult unless you work in the world of health insurance. In this blog we are going to overview what is causing the changes and what options you have for your healthcare needs.

Key Health Insurance Trends in 2026

One of the biggest factors coming in 2026 is the anticipated rise in healthcare costs. Insurers nationwide have requested a median rate increase of 11%-15% for 2026. This increase is driven by rising medical costs and the looming expiration of enhanced premium tax credits according to CMS. The Centers for Medicare & Medicaid Services (CMS) is responding to these rising costs by expanding eligibility for catastrophic health coverage on the ACA Marketplace. Through this expansion CMS aims to provide an affordable option for individuals who may not be eligible for subsidies.

Projected Cost Increases for Healthcare Plans

What is causing the projected cost increases for healthcare plans in 2026? Well, according to the CMS health insurance premiums are expected to rise substantially across the individual market. In addition, the KFF, and independent source for health policy research, polling and journalist, indicated that ACA Marketplace insurers are raising premiums by about 20% in 2026. The expiration of enhanced premium tax credits and rising healthcare costs contribute to the increase in cost. Which means that consumers may face higher premiums, deductibles, and out-of-pocket expenses. CMS is taking steps to address these increases, including expanding access to catastrophic plans to ensure affordable options are available in the ACA Marketplace.

Potential Federal Rule Changes

Another trend is changes to ACA Marketplace enrollment and eligibility. The “One Big Beautiful Bill Act” (OBBBA), signed into law on July 4, 2025, introduces changes to the ACA Marketplace. For instance, there are now stricter eligibility requirements which have been largely controversial and highly contested on both sides of the isle around immigrants with rights to health care. Another big change is the discontinuation of automatic re-enrollment. Additionally, the enhanced premium tax credits, which have helped lower premiums, are scheduled to expire at the end of 2025 unless extended by federal legislation. There is no extension of the tax credit in the OBBBA.

Strategies for Managing Healthcare Costs in 2026

Person with a digital human in the hands surrounded by healthcare icons representing the cost to insure employees.

Given the anticipated changes, it is essential to develop strategies for managing healthcare costs in 2026. Individuals and families should review their healthcare needs and budget, explore different plan options and potential subsidies, and consider cost-saving measures like generic drugs and preventative care. For instance, have you considered an HSA? Would you be open to learning more about a Self-Funded plan?

Our team is here to help you understand all your options as a small business owner, solopreneur, or individual who is just looking at options for themselves and their families. The open enrollment period for 2026 coverage begins November 1, so it is important to be informed and prepared for the changes coming our way. Going to the government website by yourself and trying to navigate it all yourself is cumbersome. You need a partner that is a phone call away from answering your questions, both during open enrollment and throughout the year.

How Can AUI Help You with Health Insurance Benefits?

You are not alone on this rollercoaster of change. And through each up and down the team at AUI is here to help you stay informed about health insurance. Every change is crucial as we approach the deadlines for selecting your 2026 health insurance coverage. Let our team help you with preparing for potential cost increases and rule changes will help you make the best decisions for your healthcare needs. Do not do this alone. Leverage our experience to find the right solutions, not something you feel “stuck” with for the next year. Contact us today to learn more.