Commercial health insurance in Rhode Island is about to become much more expensive in 2026 following state approval of substantial rate hikes.
People who buy their health insurance through the individual market will face a 21% rate increase. Those with employer-sponsored health insurance will see rate increases of 17% if they work for small companies (typically 50 employees or fewer) or 19.3% if their employer is larger and buys coverage through the large group market.
The rate increases will take effect on Jan. 1, 2026, and will affect 174,858 Rhode Islanders, according to a press release from the state’s Office of the Health Insurance Commissioner (OHIC).
“There’s no sugar-coating this,” Health Insurance Commissioner Cory King told the Rhode Island Current. “It’s going to produce financial hardship for people. Unless we can get the costs of hospitals and physicians and drugs under control, I worry we’re going to see more of this.”
In its release announcing the approved rate increases, the OHIC noted that the hikes won’t affect employees of companies that self-fund their health insurance. Approximately 65% of Rhode Islanders with health insurance through their employers have coverage under these self-funded plans, the OHIC said.
Why are costs rising?
The approved rate hikes represent the largest increase to premiums in more than a decade. But, the commissioner’s office pointed out, these approved hikes are still $59 million less than what insurers sought. The OHIC rejected all insurer requests for administrative cost hikes.
The OHIC cites the rising cost and usage of healthcare services as a key reason for the increase in rates, a reality that is affecting several other states in addition to Rhode Island.
And new fees, approved by the state’s General Assembly, will also increase costs for consumers, the OHIC said. The annual fees amount to $50 per person, or $200 per family, and will appear on insurance premiums. The money is earmarked to fund Medicaid rate increases.
The pending end of enhanced tax credits for the Affordable Care Act will also increase health insurance costs. The credits are set to expire Dec. 31.
Healthsource RI, which runs the state’s individual health marketplace, estimates household costs will rise by 85% for around 40,000 people across the state. This would mean an increase of $1,250 per family, per year, on average.
What’s next? Insurance as a choice
The OHIC projects that elevated commercial health insurance rates for 2026 will push some people away from the marketplace and health insurance in general.
Instead, it forecasts that young, healthy people may choose to go it alone, while older, more sickly people will still seek coverage through the marketplace. This will, in turn, raise payout rates for insurers and increase future premiums, according to the OHIC.
Healthsource RI forecasts that 13,000 people in Rhode Island will be unable to afford coverage or will choose to forgo it once the new rates take effect in 2026.
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