People who buy their health insurance on the individual market could see increases of nearly 175% due to higher premiums and the expiration of federal subsidies that significantly lowered the cost of insurance purchased through the Affordable Care Act, the state said Monday.
The Department of Banking & Insurance (DOBI) on Monday announced final 2026 rates for health insurance carriers operating in the individual market, which includes Get Covered New Jersey, the state’s official health insurance marketplace.
Rates will rise 16.6% on average compared to 2025 rates in the individual market, which includes on-exchange and off-exchange plans (sold directly by insurance companies). However, the loss of enhanced federal tax credits at the end of 2025, which subsidized the cost of the plans, and federal changes to the program would cause about 60,000 consumers enrolled in coverage through Get Covered New Jersey to lose federal financial help, DOBI said.
DOBI said its analysis of the loss of this financial help, along with rates, as well as other federal changes, would cause the average premium increase for enrollees to jump to more than $2,780 annually, an increase of 174%.
“Consumers will soon be shopping and comparing health plans, and without these enhanced tax credits, they will be confronted by startlingly higher prices for coverage. We are significantly concerned that many households will be forced to choose plans with lesser coverage or choose no coverage at all as a result,” said Commissioner Justin Zimmerman.
Open enrollment for Get Covered New Jersey for 2026 plans is set to begin on Nov. 1.
Currently, 91% of consumers enrolled in a plan through Get Covered New Jersey — over 466,000 residents — receive enhanced financial help from the federal government that subsidizes the cost of premiums.
Congress still has time to act to renew the enhanced premium tax credits, which have boosted the program’s access and affordability, to avoid consumers dropping their coverage over premium sticker shock, DOBI said.
A record 513,217 residents enrolled in a health plan through Get Covered New Jersey for plan year 2025 – a 108% increase in enrollment since the state first launched its marketplace.
By law, rate filings in the individual and small employer markets are informational and not subject to prior approval; the Department may only disapprove an informational filing if the Department finds that the filing is incomplete and not in compliance with relevant laws or that the rates are inadequate or unfairly discriminatory.
