Health Insurance Rates for Mainers to Increase (Again)

Health insurance rates for Mainers are going up, again, according to guidance published by the Maine Bureau of Insurance.

If you buy your own plan, the average premium rises 14.8 percent on Jan. 1, 2027. If you get coverage through a small business with 50 or fewer workers, the average hike is 13.5 percent.

The Maine Bureau of Insurance approved those numbers on Aug. 14, offering the insurance companies a trimmed-down version of the larger rate increases they had asked for.

It is the second straight year of double-digit increases.

Last year individual rates jumped 24.2 percent and small-business rates jumped 17.7 percent. Two years of hikes add up to about 43 percent more for people who buy their own coverage, and about 34 percent more for small businesses.

Acting Superintendent Timothy Schott blamed higher utilization, prescription-drug prices, more expensive provider contracts, and inflation.

Schott did not point to any pieces of legislation enacted since 2019 that might have caused health insurance rates to continue increasing.

Whose rates are going up?

The MBI letter concerns only a small segment of Maine’s health insurance market, though it may be representative of health insurance costs for the ~700k Maine residents still paying for their own insurance in some manner.

Together, the individual and small-group markets account for just under 100,000 individuals, and it’s these individuals who will experience the cost increases. The bureau says about 65,000 people buy their own coverage, mostly on CoverME.gov, and more than 36,000 get it through a small employer. The 2027 filings count about 98,600 people in that whole market.

Everyone else is on MaineCare, Medicare, a large-employer plan, or a self-funded job plan the bureau cannot price. DHHS says MaineCare covers about 1 in 4 Mainers and about half of Maine children. 

Insurers asked for larger rate increases than they got, but that will provide little solace to Mainers feeling the pinch of ever-increasing health insurance costs.

MBI cut the individual-market request from a membership-weighted 16.8 percent to 14.8 percent, and the small-group request from 15.7 percent to 13.5 percent.

A KFF analysis cited in the bureau’s notice found a national median proposed increase of 15 percent. Maine’s approved individual average is already in that neighborhood, after the cut.

Approved 2027 individual increases, per the bureau:

• Anthem Health Plans of Maine, HMO: 15.8 percent (requested 17.9 percent), 31,134 lives. Plan-level range: 7.0 percent to 21.1 percent.
• Maine Community Health Options, HMO/PPO: 19.5 percent (requested 20.9 percent), 17,313 lives. Range: 12.0 percent to 33.2 percent.
• Harvard Pilgrim Health Care, HMO: 6.6 percent (requested 9.2 percent), 13,374 lives. Range: minus 2.9 percent to 13.4 percent.
• HPHC Insurance Company, off-exchange PPO: 7.6 percent, 212 lives.

Approved 2027 small-group increases:

• Anthem: 14.2 percent, 22,441 lives.
• Maine Community Health Options: 23.8 percent, 4,683 lives.
• Harvard Pilgrim: 5.6 percent, 6,273 lives.
• HPHC Insurance Company: 5.5 percent, 1,687 lives.
• UnitedHealthcare Insurance: 12.2 percent, 1,169 lives.
• UnitedHealthcare of New England: 12.7 percent, 297 lives.

Shrinking market

In addition to rising costs, the other trend in Maine’s small-group and individual health insurance markets is the declining customer base.

Last year’s MBI tables counted 70,925 individual customers and 45,129 small-business customers. This year’s tables count 62,033 and 36,550.

“The rising cost of health care is making health coverage more expensive for consumers in Maine and across the country,” Schott said. “While these final increases are lower than insurers initially requested, we know they will still be difficult for Maine people and small businesses.”

CoverME.gov already lost paying customers this year.

Sign-ups fell from about 64,700 for 2025 to about 58,500 for 2026.

By May, 14,300 returning customers had canceled — 29 percent, up from 18 percent a year earlier.

People with no subsidy, people just over the subsidy cutoff, and people under 35 left fastest.

More than half of remaining customers bought cheaper bronze plans with deductibles as high as $8,000 for one person.