(Original post published July 17, 2025)
Health insurers in Arkansas are seeking average rate increases of 36.1% for individual health plans for the 2026 plan year. This would represent an unprecedent increase and has drawn opposition from Gov. Sarah Huckabee Sanders.
Insurers in the state originally filed their proposed rates for 2026 in early June, but on Wednesday, Aug. 6, the Arkansas Insurance Department released refiled proposals with changes. Three insurers proposed increases that were larger than the ones they proposed in June, and the other three proposed increases that were smaller than their earlier proposals. The average proposed rate increase across all insurers, weighted for market share, is 36.1% for individual on-market and off-market plans — i.e., individual plans offered through the Arkansas Health Insurance Marketplace and individual plans offered outside the marketplace. In their June proposals, insurers sought an average increase of 26.2%.
Insurers have also proposed an average rate increase of 7.9% for small group off-market plans. The information released Aug. 6 by the Insurance Department regarding small group plans does not show a change from the June proposals.
Insurers file proposed rate adjustments each year in response to market trends, changing healthcare costs, and policy shifts. In addition to these typical adjustments, filings from the insurance companies attribute the high rate increases proposed for 2026 on individual plans to recent federal and state policy changes. All six companies cite the expiration of the enhanced premium tax credits and the pending implementation of work requirements for adults in the Medicaid expansion program, among other federal actions, as reasons for the hikes. Arkansas laws mandating certain benefits, limiting prior authorizations, and regulating pharmacy benefit managers, which passed in the 2025 legislative session, are also cited as major contributing factors. Across all insurers, the rationales for large rate increases in Arkansas broadly align with those of insurance companies across the nation.
The Arkansas insurers that increased their proposed rate changes in August cite worsening assumptions around morbidity and risk adjustment. In their filings, QCA Health Plan Inc. and QualChoice Life and Health Insurance Company Inc. — both subsidiaries of Centene — cite pharmacy dispensing fees as an additional factor, likely in reference to Arkansas’s new rule allowing the state insurance commissioner to require plans to include dispensing fees in pharmacy reimbursements.
Under state law, the Arkansas Insurance Department reviews the proposed rates to ensure that plans are priced appropriately. The state insurance commissioner must deny any rate that is deemed excessive, inadequate, or unfairly discriminatory. In a statement issued on the same day that the Insurance Department released insurers’ refiled proposals, Sanders called on the insurance commissioner to reject the new proposed rates. Approved rate changes are typically announced by the Insurance Department in October.
Below are the proposed rate filings for 2026 plans that comply with the requirements of the federal Affordable Care Act. These include individual plans offered through the Arkansas Health Insurance Marketplace and individual and small group plans offered outside the marketplace.
Individual On- and Off-Market Plans
| Company Name | Enrollees | Market Share | Average Change Requested, Original June Filing | Average Change Requested, August 6 Refiling |
|---|---|---|---|---|
| Celtic Insurance Company (Ambetter) | 85,093 | 24% | 20.1% | 42.5% |
| QCA Health Plan Inc. | 52,505 | 14.8% | 30.1% | 54.2% |
| HMO Partners Inc. d/b/a Health Advantage | 28,447 | 8% | 20.9% | 20.23% |
| QualChoice Life and Health Insurance Company Inc. | 40,415 | 11.4% | 30.7% | 54.4% |
| USAble Mutual Insurance Co. (Arkansas Blue Cross and Blue Shield) | 107,712 | 30.4% | 25.77% | 23.3% |
| USAble HMO Inc. | 39,697 | 11.2% | 34.29% | 25.5% |
| Total | 353,869 | 100% | ||
| Weighted Average | 26.2% | 36.1% |
Small Group Off-Market Plans
| Company Name | Enrollees | Market Share | Average Change Requested |
|---|---|---|---|
| QCA Health Plan Inc. | 6,054 | 10.4% | 12.88% |
| UnitedHealthcare Insurance Company of the River Valley | 3,781 | 6.5% | -0.08% |
| UnitedHealthcare Insurance Company | 711 | 1.2% | 0.1% |
| QualChoice Life and Health Insurance Company | 4,104 | 7% | 13.06% |
| Arkansas Blue Cross and Blue Shield | 43,830 | 74.9% | 7.5% |
| Total | 58,480 | 100% | |
| Weighted Average | 7.9% |
If approved, the 36.1% average rate hike proposed for individual market plans for 2026 would surpass all previous publicly posted rate hikes, including the 6.2% average increase approved for 2025. The 7.9% average rate increase proposed for small group plans in 2026 is lower than the 10.2% rate hike approved in 2025, but it is higher than average increases approved in other recent years, as shown below.
Rate filings for previous years can be found on the federal government’s Rate Review website.
Since 2018, Arkansas has had lower average monthly individual market premiums than any of the surrounding states. In 2025, Arkansas had the 16th-lowest marketplace benchmark premium in the nation.
