Health plan sticker shock arriving for 643,000 Tennesseans

Nearly 643,000 Tennesseans are now learning what they will have to pay if they want to keep their same health plan through the Affordable Care Act Marketplace in 2026.

“I couldn’t financially afford life with a different plan, quite frankly. I’m at the doctor so, so much,” says Kimberly Daft, owner of Lawrence & Clarke Cacti Co, who recently went home from the hospital after a six-day stay and expects to have surgery later this year.

Daft is covered by Cigna, which offers a plan on the state’s Marketplace. This week, she went online to find her new rate since she hadn’t seen anything come in the mail.

The monthly premium to cover herself and her husband is jumping from $60 a month to more than $360. If not for a downturn in income from her houseplant business in Old Hickory, she says she could be paying $2,000 a month for her plan.

“It’s hard. I think we’re all in a tough chapter of our personal stories and histories,” Daft says. “But I also know that a lot of beautiful things can come from really hard chapters.”

What to know about ACA Marketplace price hikes in Tennessee

• In 2025, the average premium for an ACA Marketplace plan in Tennessee was $634 without tax credits. But with the federal subsidies, the average amount paid by beneficiaries was $72.
• Of the 643,000 Tennesseans with ACA Marketplace plans, 611,000 (95%) receive the tax credits set to expire at the end of the year.
• Proposed rate hikes for 2026 are the highest since 2018 nationally, and they’re even higher in states like Tennessee that use Healthcare.gov — rising an average of 30%.
• According to federal guidance issued in July, health plans do not have to send notices about premium increases in the coming year.
• BlueCross BlueShield of Tennessee, the state’s largest health insurer, tells WPLN it is sending out letters the week of Nov. 3 with premiums for 2026 and explaining the effect of changing tax credits.
• Oscar Health says it has sent out renewal notices but that they are “not designed to provide details on subsidy amounts.”

Preparing for a ‘double whammy’

Roughly 4 points of the rate increase nationwide is related to insurers expecting that younger, healthier people will drop coverage altogether, making everyone else more expensive to cover.

When additional subsidies were offered during the pandemic, the number of Tennesseans buying coverage through the Marketplace spiked. The biggest gains were from people who barely live above the poverty line.

“These are folks who don’t necessarily have a lot of money so they’re going to be a lot more price sensitive,” says Mandy Spears, executive vice president of the nonpartisan Sycamore Institute. “When the prices of these premiums go up, they are going to be more likely to probably drop that coverage altogether, and they may not have an affordable alternative option.”

As many as 200,000 Tennesseans are projected to opt out of coverage rather than pay the higher premiums in 2026, according to Sycamore Institute analysis.

Open enrollment runs through Dec. 15 for coverage that would start on Jan. 1. Experts are recommending a variety of approaches, captured here by NPR and KFF.  They suggest making sure your plan isn’t set to auto enroll for 2026 and paying attention to news coming out of Congress about a potential extension.