Rhode Island Insurers Propose Record Premium Increases for 2026

News Summary

Rhode Island health insurers are requesting unprecedented premium increases for 2026, with individual plan hikes projected between 21.2% and 28.9%. This follows a smaller average rise of 7.8% last year and could affect over 170,000 residents. Public hearings are set for late June and July to discuss these changes as concerns grow regarding healthcare affordability amidst rising costs and potential federal tax credit expirations.

Rhode Island health insurers are seeking the steepest premium increases in over a decade for 2026, with proposed rate hikes for individual plans ranging from 21.2% to 28.9%. This marks a significant rise from the average 7.8% increase approved in the previous year. Meanwhile, proposed rate increases for employer-sponsored plans vary between 13.5% and 26.4%, depending on the type of plan. These proposed increases could impact over 170,000 Rhode Islanders who are covered under individual, small, and large group plans, raising concerns about affordability and access to healthcare in the state.

The Rhode Island Office of Health Insurance Commissioner (OHIC) is currently reviewing these requests, with final decisions expected in September. Unlike in previous years, the Rhode Island Office of Attorney General will not conduct an independent actuarial review of the insurance rate filings for the first time in three years. However, the Attorney General’s office will continue to advocate for consumers during the administrative hearing process.

Public hearings are scheduled for June 30 and July 1 for Blue Cross Blue Shield of Rhode Island (BCBSRI), and July 15 and 16 for the Neighborhood Health Plan. Additionally, a virtual town hall on July 24 will offer an opportunity for the public to provide comments on the proposed rate increases.

In recent months, health insurers have attributed these substantial rate hikes to several contributing factors. These include higher payments to hospitals and providers, increased claims for GLP-1 weight loss drugs, and tariffs on drugs and ingredients. There is also a notable focus on building reserve margins for future claims, which is impacting the affordability of premiums.

BCBSRI, in particular, has reported a 20% increase in healthcare spending over the last two years, leading to a record net loss of $115 million in 2024. The request for increased rates has been compounded by new OHIC requirements that mandate a 30% increase in primary care provider payments. Insurers claim these developments are necessary to sustain their operations amidst rising healthcare costs.

Another significant issue affecting the proposed rate increases is the impending expiration of enhanced federal premium tax credits. This situation is projected to impact approximately 30,000 Rhode Islanders, accounting for roughly a third of the proposed increases in premiums. This could place additional strain on families who rely on these tax credits to afford their health insurance.

The trends reflected in Rhode Island’s proposed rate increases mirror national healthcare cost trends. Recent studies suggest that private insurers, such as those in Rhode Island, pay hospitals significantly more than Medicare rates. This discrepancy raises questions about the sustainability of healthcare financing in the U.S., especially in light of ongoing economic changes.

Despite the significant proposed changes, approximately 65% of Rhode Islanders with employer-sponsored coverage have self-funded plans, which are not regulated by OHIC. The federal regulations limit state oversight of self-funded plans, which helps to explain why these plans are currently excluded from OHIC reviews.

As the OHIC conducts a thorough review of the pricing assumptions and data supporting each insurer’s rate filings, stakeholders are keenly awaiting their decisions. This examination aims to provide clarity on whether the proposed increases are justified and to ensure that Rhode Islanders have access to equitable and affordable healthcare options.

Deeper Dive: News & Info About This Topic

• Providence Journal: Rhode Island Health Insurers Seek Highest Premium Rate Hikes in Over a Decade
• Wikipedia: Health Insurance in the United States
• Rhode Island Current: R.I. Health Insurers Seek Highest Rate Increases in Over a Decade
• Google Search: Health Insurance Premium Hikes
• GoLocalProv: RI Health Insurance Companies Requesting Rate Increases of 20% to 28%
• Google Scholar: Healthcare Costs Rhode Island
• WPRI: UHC Medicare Advantage Patients Will Lose Coverage at Brown Health Hospitals on July 1
• Encyclopedia Britannica: Health Insurance
• Verywell Health: Obamacare Penalty for Being Uninsured
• Google News: Rhode Island Healthcare Insurance