Five health insurance companies offering plans on Maryland’s ACA marketplace are proposing significant increases to premiums next year.

The companies say the premiums are due to the potential loss of the federal premium tax credit in the Republican budget.

Federal and state lawmakers are looking for ways to alleviate that burden if the credit disappears. However, the companies, which include CareFirst, Kaiser Permanente, UnitedHealthCare and Wellpoint Maryland, have been mostly mum on their role in keeping down costs in the face of dramatic change.

The companies have proposed premium increases from 8% to nearly 19%. At the same time hundreds of thousands of Marylanders may lose healthcare because of cost or because of slashes to Medicaid in the federal budget bill.

The increases have economic and medical experts questioning the role of profit in the health system.

“it's incredibly clear that the profits have been skyrocketing,” said Marceline White, the executive director of Economic Action Maryland. “This is what happens when we treat healthcare as a business rather than a public good. And, you know, shareholder interest notwithstanding, these large healthcare companies could afford to not make as many profits.”

Carefirst BlueCross BlueShield, the largest provider, reported a $240 million profit in 2024 when the tax credits were in effect. According to ProPublica, Carefirst CEO Brian Pieninck was paid about $4.4 million in compensation last year.

UnitedHealthCare notched $14.4 billion in profits in 2024, its CEO Stephen Hemsley brings in $1 million a year, plus $60 million in non-qualified stock options.

“What you're talking about is really sort of a structural violence, if you're throwing people out of a health care system,” White said. “There are very short and long term consequences in raising the premiums at this level. And there are lots of things that corporations can do looking into inside their own house.”

WYPR reached out to all of the companies. Only Kaiser responded.

“Like others in the health care sector, we have seen significantly higher demands for care in recent years, particularly for outpatient services, and we expect this trend to continue in 2026. We also expect higher costs for pharmacy and supplies to continue in 2026,” Kaiser said in an emailed statement. “Our integrated care delivery system is uniquely positioned to deliver high-quality, affordable health care to our members and the communities we serve, even in these uncertain times. We will continue to look for new ways to control costs while maintaining our high standards for quality and service.”

Benjamin Orr, the president and CEO of the Maryland Center of Economic Policy, says the premium hikes are a reminder of deep issues in the American health system.

“We need to have a larger conversation about how we deliver health coverage, how it should be more affordable for people,” he said. “We should be focused on making the system better, not worse. We should extend the premium tax credits.”

Maryland’s government says it is trying to negotiate some of the prices.

“The Maryland Insurance Administration is closely working with the Maryland Health Benefit Exchange on designing a state subsidy to help mitigate the impact of these losses,” said Maryland Insurance Commissioner Marie Grant. “Recent actions by Congress have the potential to further lower tax credits for Marylanders to help purchase health coverage and further increase rates in this critical market. We will be examining rates filed by carriers closely in the coming months and urge Congress to take action to address affordability of health coverage.”

According to the Medicare Rights Center, the credit, which reduces the cost of health premiums, is responsible for giving 44 million people in the nation health insurance.

With the loss of the credits, the Congressional Budget Office estimates that “the number of uninsured people will rise by 2.2 million in 2026, by 3.7 million in 2027, and by 3.8 million, on average, in each year over the 2026–2034 period.”

If Congress does not get rid of the credits, premium rates in Maryland will increase an average of 8%, according to the Maryland Insurance Administration. That number is more in line with years past.

About 500,000 Marylanders use ACA plans for insurance.