By Rep. Kristi Mathieson
Many Maine families are bracing for steep health insurance increases in 2026 as enhanced federal tax credits under the Affordable Care Act (ACA) are set to expire. These credits have capped premiums at 8.5% of household income, but unless Congress acts, families will face full-price premiums often exceeding $1,000 a month. A Kittery couple with two children could see costs jump nearly 60%, while older Mainers may face premiums in the tens of thousands. One couple in their 60s currently pays $7,225 annually for coverage; without subsidies, that same plan could soar to $25,000.
The Maine Bureau of Insurance has already announced average premium increases of 23.9% for individual plans and 17.5% for small employer coverage in 2026. Rising medical and prescription drug costs, combined with unstable federal policy, are driving these hikes. Specialty drug spending alone has more than doubled since 2016. Some Mainers may qualify for catastrophic plans, but these come with deductibles of $9,000–$10,000 and little coverage for routine care. Families would still pay thousands out of pocket for ER visits, prescriptions, or hospital stays. Even these plans are expected to rise 10–40% due to medical inflation.
The stakes are high. If families can’t afford insurance, more will go uninsured, leaving hospitals to absorb uncompensated care and driving costs higher for everyone. Making health insurance unaffordable isn’t just cruel. It’s bad policy.
In the Legislature, we’ve worked to expand access to affordable, high-quality coverage. That progress is now at risk. Congress must extend the enhanced tax credits and take real steps to lower costs. For Mainers enrolled in ACA plans, open enrollment runs through Dec. 15, 2025, for coverage beginning in January 2026. Affordable health insurance is not a bargaining chip – it’s a lifeline.
You can reach me by email at Kristi.Mathieson@legislature.maine.gov or by phone at (603) 969-7496 with questions and concerns, or if you need assistance navigating state services. I can best represent our community by hearing from you about the issues you care about, both in our district and across the state.
Mathieson is serving her third term in the Maine House representing Kittery and is House chair of the Legislature’s Health Coverage, Insurance and Financial Services Committee.