by Karla Ciaglo The New Haven independent
Connecticut residents who rely on the state’s Affordable Care Act marketplace and small group health plans may soon face sharp increases in 2026 premiums, with insurers seeking double-digit hikes that regulators and lawmakers say could rival recent utility “rate shocks.”
Insurance Commissioner Andrew Mais laid out what’s at stake at Monday’s Insurance Department hearing. Seven carriers submitted eight filings affecting about 224,000 residents, including 70,000 small business employees.
The companies seeking increases include Anthem Health Plans, CTCare Benefits Inc., Oxford Health Plans/Insurance Inc., and UnitedHealthcare Insurance Co. Together, they cover the slice of the population that is too young for Medicare, earns too much for Medicaid, and often falls into the working- and middle-class families least able to absorb another surge in household bills.
The requests range from 5.9% to 26.1%, averaging 17.1% for individuals and 13.1% for small groups. About one-third of enrollees are between ages 55 and 64, a group already paying some of the steepest premiums in the market.
The increases don’t apply to the majority of Connecticut residents covered by employer-sponsored insurance regulated under federal ERISA law, but they could hit freelancers, self-employed workers and small businesses particularly hard.
Mais warned that the numbers on the table don’t even include the potential expiration of enhanced federal subsidies at the end of 2025. If Congress doesn’t act, carriers estimate premiums would rise another 3.5% to 6.8%. For many households, the loss of those subsidies would amount to an average of $1,700 per enrollee, affecting roughly 140,000 Connecticut residents who now receive assistance. For a family of three, officials said, the loss would equal about half a month’s income.
James Michel, CEO of Access Health Connecticut, painted an even starker picture. He said the combination of federal policy changes—including the Trump administration’s new Medicaid rules, a recent HHS “Marketplace Integrity and Affordability” regulation, and the expiration of premium tax credits—could push 30% to 35% of exchange customers off coverage by 2034.
One Fairfield family, Michel noted, currently pays $991 a month with subsidies. If those subsidies disappear, the premium would spike to $4,140—a 307% increase.
Hospitals told regulators they face relentless inflation, supply chain costs, workforce shortages, and prescription drug spikes, but argued that the underlying problem is government underpayment.
“If government payers don’t pay their fair share, there is no other way to balance the books but to shift costs to the commercial sector,” said Mark Schaefer, vice president of system innovation and financing at the Connecticut Hospital Association.
With Republican Medicaid eligibility changes threatening to push 100,000 to 200,000 people off the rolls in coming years, hospitals warned of a surge in uncompensated emergency care that would again land on private payers and their customers.
Insurers countered that they are caught in the middle. Anthem, which covers more than 1.2 million people in Connecticut across all markets, cited surging demand for behavioral health and addiction services, inflation in both medical and drug costs, and hospitals leveraging consolidation to extract above-benchmark rates.
Smaller community hospitals, meanwhile, are demanding outsized increases to stabilize finances, further pushing rates upward.
Pharmacy benefit managers sought to shift the focus.
Sam Hollmire of the Pharmaceutical Care Management Association emphasized that PBMs don’t set drug prices—manufacturers do—and stressed that 98.9% of rebates negotiated in Connecticut last year were passed back to health plans. Hollmire cautioned lawmakers against attempting state-level drug price controls, warning manufacturers would likely sue.
The Office of Health Strategy reported insurers’ cost trends for 2026 between 8% and 10%, far above the state’s new 2.8% benchmark through 2030. Mais acknowledged what he called a “structural mismatch” between what families can afford and what the system demands.
State Sen. Jorge Cabrera, D-Hamden, co-chair of the Insurance and Real Estate Committee, compared the increases to utility rate shocks: “Health insurance premiums for the working class and small businesses have become the new electric rate shock. It’s that bad.”
For Connecticut, the overall impact is a mounting multi-million dollar financial loss: higher premiums for tens of thousands, reduced federal aid, and more residents pushed into the ranks of the uninsured.
The Insurance Department expects to issue final rate decisions in early December, but the message from Monday’s hearing was clear—families are bracing for bills rivaling mortgage payments, while insurers, hospitals, and PBMs continue to point fingers over who shoulders the blame.