## Maine Bureau of Insurance Announces Final 2026 Health Insurance Premiums
The Maine Bureau of Insurance (BOI) has announced finalized health insurance rates for the 2026 coverage year, effective January 1, 2026, for both the individual and small group markets. Following review of insurer proposals and a public hearing,the BOI approved an average rate increase of 23.9% for the individual market and 17.5% for the small employer market (businesses with 50 or fewer employees).These approved rates are slightly lower than the initial requests submitted by insurers, which proposed increases of 26% for individuals and 19% for small employers. The increases align with a national trend; a recent Kaiser Family Foundation analysis indicates an average rate increase of 20% nationally.
Maine law restricts the BOI’s ability to control rate increases, tasking the Bureau with determining if proposed rates are excessive, inadequate, or unfairly discriminatory. “Excessive” is defined as a premium amount exceeding the expected cost of care. Federal regulations also require insurers to spend at least 80% of premium dollars on healthcare services.
According to BOI Superintendent Bob Carey, the rate hikes are primarily driven by three key factors: the increasing cost of medical services, the growing cost of prescription drugs, and uncertainty surrounding federal policies. Specifically, the potential expiration of enhanced premium tax credits at the end of the current year poses a meaningful concern. While the premium tax credits are scheduled to continue in 2026, their value will be substantially reduced without action from Congress and the President. Carey detailed these factors further in an op-ed published in the Portland Press Herald, available HERE.
Approximately 71,000 Maine residents are covered by individual market plans, primarily through the state’s online marketplace, CoverME.Gov. The small group market covers over 45,000 individuals who receive insurance through a small employer.It’s important to note that rates in the large group market, covering the majority of insured Mainers, are not subject to BOI review.The BOI encourages consumers to compare plans and select coverage that best suits their individual needs. More information on individual and small group health insurance options in Maine can be found at https://www.maine.gov/pfr/insurance/consumers/life-health-disability. enrollment can be completed through https://www.CoverME.gov.
