Buying health insurance on the ACA marketplace? Prepare for Ohio premiums to go up – by quite a bit
By Celia Hack / August 25, 2025
Ohio insurance companies cited expiring federal tax credits and the growing cost of healthcare as reasons to raise the monthly price of insurance.
The approximately 583,000 people in Ohio who buy health insurance from the federal Affordable Care Act marketplace can expect to see their premiums shoot up in 2026.
The 11 companies that sell health insurance to Ohio individuals on the federal marketplace are all proposing increases to their premiums – at rates that far surpass what was requested in 2024 and 2025.
Companies are proposing a median premium increase of about 18% for 2026 – more than double the jump requested in recent years.
Certain companies, like UnitedHealthCare and Paramount, are asking for rate increases of more than 30%.
“It’s going to be a shock to some people in 2026 when they see what their premiums are increasing to,” said Brian O’Rourke, a healthcare policy analyst at the Health Policy Institute of Ohio. “And if people drop their coverage, there may not be good options to find elsewhere.”
The federal health insurance marketplace was set up in 2013 as part of the Obama administration’s Affordable Care Act. It’s a website where people can buy health insurance that isn’t connected to a job.
The rising insurance premiums on the marketplace are part of a nationwide trend. Insurers across the country are requesting the largest change in the cost of premiums since 2018, an analysis by the Peterson-KFF Health System tracker found.
To explain the rising premium prices, companies cited growing healthcare costs and the potential expiration of federal tax credits that make insurance cheaper for individuals to buy.
“We face a significant, new policy uncertainty that could result in steep rate increases in 2026,” wrote Dan Williamson, a spokesperson for the Ohio Association of Health Plans, a nonprofit advocacy group led by leaders of the state’s health insurance companies.
The rates still need to be reviewed by the Ohio Department of Insurance to ensure they are calculated accurately and according to the law. Then, they will be reviewed by the federal government. Individuals can find specific prices for health insurance plans during open enrollment, which begins Nov. 1.
Premium increases proposed by insurance companies on Ohio's ACA marketplace, 2024-2026
What is the ACA marketplace, and who’s using it?
Buying insurance on the federal marketplace can be a resource for people who are unemployed or have jobs that don’t offer insurance, like ride share drivers or service workers. And it’s unlike Medicaid, which requires individuals to have a low income and doesn’t ask individuals to pay any monthly premium.
But the federal government has for more than a decade given out financial incentives for residents to sign up for insurance on the marketplace. Those are called tax credits. Starting in 2014, people with low enough incomes who enrolled in marketplace health insurance could apply for tax credits – which could be paid directly to their health insurance company to lower their monthly premium.
After COVID hit, Congress and the Biden administration made those tax credits more generous and did away with the income limit on who could receive them.
Since then, the number of Ohio residents enrolled in health plans through the Affordable Care Act marketplace has skyrocketed. In 2024, about 480,000 people enrolled – a more than 50% increase from the year before. About 88% of those enrolled received tax credits, according to the health policy organization KFF.
Ohioans enrolled in health insurance from the federal ACA marketplace
The federal marketplace was created in 2013 as part of the Affordable Care Act.
Tax credits set to expire
The tax credits that Biden included in the COVID-era bill are set to expire at the end of 2025. It is still possible for Congress to decide to prolong the tax credits, but NBC News reported in July that Republicans are split on whether or not to do so given the cost of the extension. The offices of Ohio Senators Bernie Moreno and Jon Husted did not respond to an email asking their opinions on an extension of the tax credits.
Most of the companies offering health insurance plans to Ohioans assumed the tax credits would expire when calculating premium adjustments for next year – leading them to request rate increases.
Why? Insurance companies worry that, without the financial incentives of the extra tax credits, healthier people might stop buying marketplace insurance. Average annual premiums could increase anywhere from $387 to $2,914 without the enhanced tax credits, an analysis by the Urban Institute found. The increase in cost would depend on the person’s income.
Insurance companies worry they will be left covering enrollees who are less healthy and more expensive, the spokesperson with the Ohio Association of Health Plans wrote in a statement to Signal Cleveland. That could increase costs.
Tara Britton, director of Public Policy for The Center for Community Solutions, explained it like this: Younger, healthier people who buy insurance to pay for low-cost items like annual physicals may decide it’s not worth it to buy more expensive insurance. But people with chronic health conditions who know they will need medications or appointments with specialists are more likely to keep paying for it.
Some Ohio insurance companies mentioned other policy factors as reasons to request rate increases, too. This summer, the U.S. Department of Health and Human Services changed the rules around how the health insurance marketplace operates in order to “reduce improper enrollments.” For example, companies can now deny health insurance coverage to individuals who have unpaid and overdue premiums. Another change removes an automatic 60-day extension for resolving any income inconsistencies in paperwork. These could have the same impact as the expiration of tax credits, wrote UnitedHealthCare.
“We believe that the changes in the final rule for stricter verification requirements will lead to healthier enrollees leaving the market,” the company wrote in its filing.
Health costs go up
Companies didn’t solely blame federal policy as the reason for jacking up premiums.
Most of them also mentioned rising healthcare costs, and more people with insurance using their healthcare services.
Medical Health Insuring Corp. of Ohio wrote in its briefing that medical and drug costs are projected to increase 5.3% annually. Molina Healthcare of Ohio wrote that “medical inflation” increased claims by 6.9%.
“The cost of things in the healthcare sector grows at a faster rate than things overall, and it has for a while,” Britton said.
A couple of companies mentioned technological advances as one driver of growing cost.
“Improvements to medical technology, clinical practice and new prescription drugs require use of more expensive services — leading to increased health care spending and utilization,” wrote UnitedHealthCare in its briefing.
What will the rising cost of health insurance mean for Cleveland residents?
Local and state health policy groups believe it is likely that fewer Ohioans will buy insurance from the marketplace in 2026 if tax credits expire and premiums rise. How many will lose insurance as a result is an open question, Britton said.
Without insurance, residents may rely on the emergency room for healthcare – which can saddle them with a big bill when they visit, O’Rourke said.
Fewer people with insurance can also strain the healthcare system as a whole, said O’Rourke – especially as other changes to health funding are underway. The Big Beautiful Bill, passed in July, cut billions of dollars from Medicaid by implementing new work requirements and requiring more eligibility checks, among other changes.
Together, this means that hospitals and clinics are less likely to be paid by an insurance company for care they provide.
“I worry about the strain that might be picking up because of some of these marketplace changes, because of the Medicaid changes that we’re seeing and also the uncompensated care levels that are going to put pressure on providers as well,” O’Rourke said.