Jon Godfread, Commissioner | North Dakota Insurance Department
Jon Godfread, Commissioner | North Dakota Insurance Department
North Dakota residents who buy their own health insurance may face higher premiums in 2026 if enhanced federal subsidies are not renewed. Insurance Commissioner Jon Godfread has approved the 2026 rates for Affordable Care Act (ACA) plans, but the expiration of these subsidies could result in consumers paying more, separate from state-approved rate adjustments.
“This year, we asked companies to submit rates based on the assumption that enhanced subsidies would continue,” said Insurance Commissioner Godfread. “They also filed supplemental documentation outlining the potential market impacts if those subsidies were to end. Our approved rates reflect the state’s review and adjustments, but the larger variable for 2026 will be determined at the federal level.”
A notable change for 2026 is that catastrophic plans in the individual market, previously limited to younger people meeting specific criteria, will now be available to anyone who meets new eligibility requirements, regardless of age. This adjustment has led to higher rate increases than previously anticipated for these plans.
Although the state has set rates for 2026, many consumers who currently receive subsidies could see additional costs if federal support is reduced. These additional costs are not set or approved by the state and could be significant.
“We can and should debate the long-term future of these federal subsidies,” Godfread said. “But that debate has to include an honest conversation about health care costs. Hospitals, pharmaceutical companies, and insurers all play a role in affordability. Until those costs come down, or at least stabilize, simply removing the subsidies just leaves consumers exposed.”
The Kaiser Family Foundation (KFF) has developed graphics to show how out-of-pocket premium costs might rise if enhanced ACA premium tax credits are not extended.
For 2026, average base rate changes in the small group market are as follows: UnitedHealthcare Insurance Company at 8.29%, Blue Cross Blue Shield of North Dakota at 6.30%, Sanford Health Plan at 3.91%, and Medica Insurance Company at 7.89%. For individual plans, Blue Cross Blue Shield of North Dakota was approved at 8.30%, Sanford Health Plan at 5.12%, and Medica Health Plan at 23.09%.
To help offset possible subsidy reductions, consumers may consider switching to different plan options, such as lower-premium silver plans, bronze plans, or catastrophic plans. These choices may also impact deductibles, coinsurance, and provider networks.
The Department advises consumers to carefully review their options and contact their insurance company or a licensed agent to understand how changes may affect their coverage and out-of-pocket expenses.
“Our goal is transparency,” Godfread added, “North Dakotans deserve to know what’s driving these potential changes. The discussion in Washington is complex and isn’t just about numbers – it’s about real people who have come to rely on these subsidies to find affordable coverage to protect their families. We want North Dakotans to understand what’s driving potential premium changes and to know they have options to help manage costs.”
More information, including approved rates and subsidy impact graphics, is available online.
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