Aug. 6, 2025 – Health care coverage premiums are projected to rise sharply in 2026, marking the most significant increase for insured individuals since 2018.
According to recent analysis by KFF, a nonpartisan health policy research group, anyone purchasing coverage through Healthcare.gov or state-based marketplaces established by the Affordable Care Act (ACA) could see premium costs increase by as much as 75% for the 2026 subsidized market for the same coverage next year. Health care coverage premiums for the non-subsidized coverage market are anticipated to increase in the 8-20% range. Finalized 2026 rates will be available Nov. 1, just before the open enrollment period begins.
Why Are Premiums Increasing?
While rising drug costs and hospital charges have traditionally driven rate hikes, this year’s insurer filings also cite federal policy changes and the scheduled expiration of enhanced premium tax credits in the ACA markets as major factors.
These enhanced subsidies, introduced during the COVID-19 pandemic in 2021, drastically reduced the cost of health care coverage for millions. These subsidies are set to expire at the end of 2025 unless Congress affirmatively acts to extend them.
What Does This Mean for You?
The factors driving premium increases for 2026 could have a dramatic impact on your coverage options for 2026.
This situation is especially concerning for attorneys and staff in law offices that do not offer group health plans. As coverage through Healthcare.gov or state-based marketplaces becomes less affordable, many may find themselves without viable options.
Given these impending changes, it is crucial to begin evaluating your health insurance options as soon as possible.
Key Features of the State Bar Group Health Plan for Law Firms
For law firms, the State Bar’s Group Health Plan for Law Firms may offer a cost-effective alternative. This plan, provided by Wisconsin Physicians Service Insurance Corporation (WPS), is designed to help law firms provide quality health care coverage to State Bar members and their teams. Key features of this plan include:
Eligibility: Your firm is eligible if it employs at least two nonfamily members who work at least 26 hours per week.
Solo practitioners: Pure solo attorneys (without at least one nonfamily employee) are not eligible under current law.
Employee participation: You must offer coverage to every nonfamily employee working 26 hours or more per week (unless your employee handbook defines full-time as 30 hours or more).
Employer contributions: Contributions are optional, allowing flexibility to match federal subsidies or contribute toward premiums as your firm sees fit.
Provider network: Access to both in-state and out-of-state networks, including Mayo Clinic, ensures a wide range of provider options and continuity of care.
Flexible group sizes: Even small firms can access group rates and benefits, making it easier to secure quality health insurance.
Where to Find Out More for Your Situation
With significant premium increases on the horizon, now is the time to review your health care coverage options. You should work with a trusted advisor to consider your current health needs, preferred providers, and budget. Carefully review each plan’s premiums, deductibles, and coverage limits to ensure it meets your requirements.
For more information regarding the State Bar program or personalized assistance, contact the Professional Insurance Programs representatives for rate quotes:
Christine Nadolski, benefits manager
Email: cnadolski@profinsprog.com
Phone: (414) 755-4172
Wendy Block, senior account manager
Email: wblock@profinsprog.com
Phone: (414) 755-4185
