NJ Residents Bracing For Health Insurance Spikes: See New Cost Estimates

As health insurance enrollment for 2026 has opened across New Jersey, residents seeking coverage under the state's Health Insurance Marketplace are facing skyrocketing premiums — ones that could mean some forgo health insurance.

The New Jersey Department of Banking and Insurance released rate increases for the five insurance companies offering policies through the state's marketplace and said they will increase an average of 16.6 percent over 2025.

The increases will be worsened by the expiration of federal enhanced premium tax credits that Congress has not agreed to extend, causing some to see increases of as much as 175 percent, state insurance officials said.

If the tax credits are not extended, New Jersey will lose more than half a billion dollars in direct support to residents, state officials said. Of those enrolled in a plan through Get Covered New Jersey, 91 percent — more than 466,000 residents — receive the credits that make the insurance affordable.

Nationwide, health insurers for Affordable Care Act-regulated plans reported a median 18 percent premium increase in a recent Kaiser Family Foundation survey.

Based on an initial analysis by the state Department of Banking and Insurance released in May, the average New Jersey resident receiving tax credits would see their costs go up by 110 percent, more than doubling their current premium, with costs increasing by $1,260 per person, per year on average. For a family of four, it's $4,168, state officials said.

The largest increases are for those nearing the age of Medicare eligibility, with an average of $1,860 per person if expanded tax credits expire, state officials said.

"When you take into account this loss of financial help, along with rates, as well as other federal changes, the average premium increase for all enrollees skyrockets to more than $2,780 annually, an increase of 174 percent," state officials said.

For the population of enrollees receiving financial help, the average premium rises by 163 percent, jumping from $1,260 more each year on average to $1,850 more annually.

"The enhanced premium subsidies were first enacted as part of the federal pandemic emergency declaration and have been critical in maintaining broad access to healthcare services," said Cathy Bennett, president and CEO of the New Jersey Hospital Association. The association offers professionals to help residents work through the enrollment process.

With the impending expiration of the subsidies "people are concerned — and justifiably so," Bennett said.

State officials offered these examples of the impact of the loss of federal subsidies:

• A family of four in Ocean County, with a household income of approximately $131,000 would see a premium increase of $26,000 for the year without the enhanced tax credits, which would consume 26 percent of their income.
• A couple in their early 60s in Middlesex County with a household income of approximately $94,000 would see a premium increase of more than $22,000 for the year without the enhanced tax credits, consuming 31 percent of their income.

"There is still some financial assistance available from other funding sources," Bennett said, "and we advise people to review all available plans and prices — plans and networks change each year. Priorities such as price, covered services, and in-network providers should guide selection. The best option may be a plan that’s different from what you currently have."

Get Covered New Jersey offers federal and state financial help to qualifying residents to help lower their monthly premiums and out-of-pocket expenses and is estimated to provide $215 million this year to support state subsidies. Federal advanced premium tax credits will also remain available for those eligible, though not at the same levels as 2025.

“For the upcoming plan year, it is essential for all consumers to carefully shop and compare health plans to secure coverage that best meets their needs and budgets," state Health Commissioner JustinZimmerman said.

Bennett said the hospital association's COVERNJ offers both in-person and virtual assistance with the enrollment process.

Enrollment for Get Covered New Jersey opened Nov. 1 and state officials said the program offers free support from professionals who can help guide customers through the process.

They are hoping that guidance will help prevent people from dropping coverage over the surge in premiums.

"Despite new hurdles, enrolling in coverage can mean access to essential healthcare, protection from unexpected costs, and peace of mind for you and your family," Bennett said.

Zimmerman said the state is "ready to act as quickly as possible, at any time, if and when Congress takes action to ensure New Jersey consumers continue to have access to quality, affordable health insurance with enhanced premium tax credits."

Consumers can begin to look at plans using the Get Covered New Jersey Shop and Compare Tool.

Those who want assistance in the enrollment process can find it through the "We Can Help" section at GetCovered.NJ.gov or calling the Customer Call Center at 1-833-677-1010 TTY 711.

The final rates for the Individual Market (on-exchange and off-exchange) are below.

• AmeriHealth, up 15.5 percent
• Horizon+, up 18.1 percent
• Oscar, up 4.6 percent
• United Healthcare, up 18.4 percent
• Ambetter from WellCare of New Jersey, up 17.1 percent