Many Mainers will likely see the cost of their health insurance increase by double-digits next year in what regulators are calling historic premium hikes.
Filings with Maine’s Bureau of Insurance reveal that proposed increases for individual and small group plans being offered in the state range from 8 percent to 32 percent.
Although these rate increases are currently under review by the state regulator, individuals can expect to see an average increase of 26 percent, while small groups will experience an average hike of 19 percent.
Bob Carey, Superintendent of the Maine Bureau of Insurance, told the Portland Press Herald that these “are eye-popping numbers.” He went on to explain that despite having worked in insurance for 25 years, he does not remember another time when carriers were requesting such large rate increases.
These proposed rate increases will impact anyone who participates in the “merged market,” which includes both individuals and small groups. A Maine Public article from 2022 explained that the state received a waiver to allow for this merger in order to “keep costs down.”
The Bureau estimates that around 115,000 Mainers will be affected by the more substantial rate increases proposed this year.
Although this is a relatively small number of people, Carey said that all Mainers will likely experience price hikes of a similar magnitude, even if they are not part of the merged market.
“There are a lot of bad things happening in the market all at once,” he said, according to News Center Maine.
Carey suggested that rising prescription drug costs and the lack of competition within Maine’s health care market are two major factors contributing to the proposed premium hikes.
Public reports shared by the State of Maine detail how much revenue insurers receive in premiums, as well as how much is spent paying claims.
Taken together, these figures show insurers’ underwriting gains or losses, which the Bureau explains are distinct from profit because they do not “reflect certain items, primarily income from investments, capital gains and losses, and federal income taxes.”
Overall, small group insurers were shown in 2023 to have an underwriting gain of nearly $19 million, while individual insurers reported a total underwriting loss of roughly $1.2 million.
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A Maine Morning Star article published at about this same time last year reported that premium rates were increased by an average of about 8.6 percent for individuals and 9.4 percent for small employers for 2025.
This was down from providers’ initial requests of 14.2 percent and 14.5 percent respectively.
The Bureau of Insurance is set to hold a virtual public forum on August 15 at 9am regarding this year’s proposed price hikes. Information about the rate increases will be shared and those who attend will be given the opportunity to offer public comment.
Pre-registration is required to attend, and the link to sign up can be found here. Written comments and questions about registration can be sent to [email protected].
Following this event, the Bureau will complete its review of the proposed increases and determine “whether and how much of an increase is actuarially justified.”
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Rates for 2026 are expected to be finalized at some point later this month after the Bureau has completed its review and considered the comments received from members of the public.
