Published June 30, 2026 at 11:58 AM EDT

Health insurers in Maryland are proposing another substantial rate hike for ACA plans next year, asking the Maryland Insurance Administration to increase premiums by an average of 13.4% next year.

The proposal comes after the MIA approved a 13.7% for 2026 plans offered by the state’s insurance marketplace. If the MIA accepts the proposal as is, premiums will have risen by more than 27% over two years.

Maryland Health Insurance Commissioner Marie Grant says the ask is a direct response to Congress allowing the expiration of the premium tax credits.

“Healthy folks who may not be inclined to pay a lot for a premium anyway might be the first ones to drop out of a pool,” Grant told WYPR. “So the pool itself may have more illness and then be more expensive.”

MIA will not make a determination on the rates until the fall. The administration will hold a public hearing on the premium hike on July 23.

Last year, the companies like CareFirst and UnitedHealthcare proposed a 17% spike before the MIA negotiated the rate increase down to 13.7%.

Vincent DeMarco, president of Maryland Healthcare for All!, a health advocacy group, agreed that the lack of premium tax credits is causing prices to rise.

“It's just a fact that when there are less people covered, premiums are going to go up, and so the fault lies with the Trump administration and the Republican Congress for the horrible actions they've taken in not extending the tax credits,” DeMarco said.

Maryland is one of the few states that was able to provide its own credits to some residents.

About 177,000 of the approximately 250,000 people who enrolled were eligible for state funding.

Anyone in the state who is up to 400% of the federal poverty level is able to get assistance.

Additionally, Marylanders aged 18-37 receive assistance as well.

That may have kept some premiums from increasing as much as other states. Washington State insurers are proposing a 22.4% increase and Connecticut insurers are offering a 16.2% increase.

Maryland has seen some disenrollment from ACA plans as the premiums went up last year.

There was an 8% disenrollment rate from people unable to pay for their ACA health care plans from January to the end of March, which translates to about 18,000 residents.

About 500,000 Marylanders get their plans from the ACA marketplace.

With the loss of the credits, the Congressional Budget Office estimates that “the number of uninsured people will rise by 2.2 million in 2026, by 3.7 million in 2027, and by 3.8 million, on average, in each year over the 2026–2034 period.”

Grant noted that companies also play a role in bringing forward feasible price increases.

Carefirst BlueCross BlueShield, the largest provider, reported a $240 million profit in 2024 when the tax credits were in effect. According to ProPublica, Carefirst CEO Brian Pieninck was paid about $4.4 million in compensation last year.

UnitedHealthcare notched $14.4 billion in profits in 2024, its CEO Stephen Hemsley brings in $1 million a year, plus $60 million in non-qualified stock options.