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Updated: September 5, 2025

Health premiums set to go up for thousands who buy insurance on Maine marketplace

Stethoscope in a doctor's office Photo / Pixabay.com The Maine Bureau of Insurance announced health premium rate increases for Maine's individual and small group market set to take effect at the start of 2026.
By Renee Cordes

Health premiums for tens of thousands of Maine residents and small businesses who purchase insurance on the state's online marketplace are scheduled to go up in January, according to the Maine Bureau of Insurance.

The regulator has approved an average rate increase of 23.9% for the individual market and an average increase of 17.5% for small businesses staffed by 50 or fewer people. 

The individual market covers roughly 71,000 Maine residents who buy health plans on their own, primarily through the Maine Health Insurance Marketplace, known as CoverME.Gov. At the end of 2024, the small group market covered over 45,000 people insured through a small employer. 

However, the vast majority of Mainers obtain health insurance coverage through their employer through the large group market whose rates are not subject to review and approval by the Maine Bureau of Insurance.

The rate increases for CoverME.Gov, announced Thursday, are scheduled to take effect on Jan. 1.

Bob Carey of Maine Bureau of Insurance
Photo / Courtesy of the Maine Bureau of Insurance
Bob Carey

“These higher rates are being driven by the increasing cost of medical services, the growing cost of prescription drugs, and the instability of federal policies — especially the potential expiration of enhanced premium tax credits at the end of this year,” said Bob Carey, superintendent of the Maine Bureau of Insurance. “While the premium tax credits will continue in 2026, they will be greatly reduced unless Congress and the president act soon.”

The regulator noted that the average rates are slightly lower than those initially requested by insurers — 26% for individuals and 19% for small employers — and are consistent with increasing rates across the nation. 

Carey also underscored that the regulatory body is limited in what it can do to control proposed increases.

State Chamber reaction 

FILE PHOTO
Patrick Woodcock

Patrick Woodcock, president and CEO of the Maine State Chamber of Commerce, said that the approved rate increases will add to business costs that have been mounting over the past four years for labor, energy and materials.

“While we agree there are cost pressures not unique to the state of Maine, the state should review state insurance mandates that further drive up the cost of providing insurance here in Maine,” he said in a statement emailed to Mainebiz.

“Furthermore, we urge policymakers to assess opportunities to lower the cost of health care delivery, including the Rural Health Transformation Program that was recently enacted into federal law."
 

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