Health Insurance Premiums Are Set to Soar in 2026
Buckle Up New Hampshire! Our already sky-high health insurance premiums are about to soar, again. Forecasts for 2026 show double-digit increases for most plans, with some Marketplace plans rising more than forty percent. For employers and families alike, this means higher monthly bills, bigger deductibles, more unpaid medical expenses, and tougher choices across the board.
The timing could not be worse. At the end of 2025, the enhanced federal premium tax credits that have kept insurance costs down for many Granite Staters are set to expire. These credits capped what working families pay and helped more than 70,000 residents afford Marketplace coverage last year. Even without the tax credit, Marketplace plans across the country are seeing rates jump by about 20% on average, and the median rate will be about 11% higher than last year. New Hampshire has worked to control costs on Marketplace plans with the high risk pool, but this kind of sudden increase will set off a chain reaction of higher premiums and lower coverage rates across the state.
Prescription Drug Costs and Hospital Mergers Fuel the Crisis
Prescription drugs are driving up costs with insufficient oversight. Spending on medications in New Hampshire topped $1.3 billion in 2024, with the bulk of that going to high-cost specialty weight loss drugs like Ozempic, Wegovy, and Mounjaro. Employers, insurers, and families are all being squeezed by a relentless rise in drug spending. With the senseless repeal of the Prescription Drug Affordability Board (PDAB) and no policy relief in sight to curb these costs, the financial strain is only growing.
Hospital consolidation and workforce shortages continue to drive up costs. Recent changes in the New Hampshire landscape — from for-profit chains acquiring local hospitals to longstanding partnerships breaking apart — have left patients paying more while services become less predictable. Add in federal tariffs and policy shifts, and it’s a perfect storm for skyrocketing rates.
Families, Employers, and Communities at Risk
For families, the result will be unaffordable coverage. For employers, it will mean shifting costs onto workers or scaling back benefits. For hospitals and providers, it will mean more uncompensated care. For communities, it will mean harder choices and worse outcomes.
The impact in New Hampshire is not abstract. Marketplace enrollees face increases of nine to forty percent. Small businesses will see premiums rise by as much as twenty percent. Households already stretched thin will face impossible trade-offs between health care and housing, child care, groceries, or car repairs. This is what a health care system in crisis looks like — and unless action is taken, it will only get worse.
The year 2026 is shaping up to be one of the most difficult in recent memory for healthcare in New Hampshire. The consequences of shortsighted policy decisions and missed opportunities are beginning to take hold. Without decisive leadership, the results will be stark: families losing their coverage, small businesses unable to offer benefits, and rural communities left with little or no meaningful access to care.
A Call for Accountability to Protect Granite Staters
Hospital consolidation, unchecked prescription drug costs, federal policy changes, workforce shortages, and global economic pressures are all converging, and the system is buckling under the weight of neglect. Yet, this story does not have to end in crisis. There are solutions—tested, practical steps that can begin to ease the strain. Extending premium tax credits at the federal level, fully funding New Hampshire’s health insurance navigators, holding hospital consolidations accountable, and demanding transparency in prescription drug pricing would all make a difference. Granite Staters also have the power to ask questions—of employers, human resource teams, benefits administrators, and healthcare providers—about how care can be made more affordable and accessible.
The NH Attorney General, the NH Insurance Department and the Healthcare Consumer Protection Commission must continue to examine how to control health costs, while holding insurers, hospitals, drug companies and for-profit health care entities accountable for the trends that are pushing families and businesses to the edge. Consumers need a “watchdog” dedicated to protect their interests during such disruptive times.
The challenges of 2026 will test our resilience, but they need not define our future. New Hampshire has shown again and again that collaboration, transparency, and innovation can improve lives. If we meet this moment with determination and creative thinking, we can mitigate the impacts on access and affordability, and strengthen the health and resilience of our communities.
Out of hardship can come a renewed commitment to building a healthcare system worthy of the people it serves.
At the New Hampshire Health Cost Initiative we’re engaging a network of health policy leaders and community stakeholders to advance practical solutions for lower costs and lasting change. For more in-depth insight and analysis from our Board of Contributors, we recommend this timely report from Lucy Hodder: Health Insurance Premiums Are Skyrocketing for 2026–Why?
