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Why Did My Health Insurance Premium Go Up So Much, and What Can I Actually Do About It?
Written and reviewed by Dick Tracy, licensed health insurance broker (NPN 20414610) · Published September 7, 2026
Short answer: it is almost never something you did. In New York your own claims and your own health cannot raise your individual premium, because the law requires everyone on the same plan in the same area to pay the same price. Premiums go up because the cost of care goes up: hospital prices, prescription drugs, an older and sicker pool of people enrolled, and state mandates. Insurers file for an increase every spring, the state cuts it back, and what lands in your mailbox in the fall is the end of that argument. Use the calculator to see what your increase actually costs you in dollars, then read the four things you can do about it. No email, no signup. I educate, you decide.
Which number goes here?
My letter does not give a percentage
What to do about it, in the order I would look
This tool does simple arithmetic on numbers you type in. It does not look up your plan, quote a policy, or send your information anywhere, and nothing you type leaves your browser. It is an estimate to help you see the size of the change, not a quote or an offer of coverage.
Why premiums go up when nothing about you changed
This is the part the renewal letter never explains, so people assume they got singled out. In New York, individual and small group health insurance is community rated. That means the insurer is not allowed to price you based on your health, your claims last year, or whether you had a rough year medically. Everyone on the same plan in the same region pays the same rate. So when your price moves, it moved for all of them too.
What actually drives the number is on the insurer's side of the ledger, and they have to show their math to the state to justify it. The reasons that come up in the filings year after year:
- Hospital and provider prices. The single biggest piece. What hospitals charge insurers goes up under contracts renegotiated every few years, and that flows straight into premiums.
- Prescription drugs. Specialty drugs and, in the last two filing cycles, the weight loss and diabetes drugs in the GLP-1 family, which a lot of people started taking at once.
- Who is left in the pool. When healthy people drop coverage because it got expensive, the people who remain use more care on average, which pushes the price up for them. That is the loop everyone in this business worries about.
- State mandates and taxes. Every benefit the state requires a plan to cover has a cost, and New York adds assessments on top.
Note what is not on that list: you. Which is worth knowing, because it means shopping is not a punishment for having filed claims. You are allowed to look, and looking costs you nothing.
Your 2027 renewal letter, and what the state actually approved
If you are in New York and your letter just arrived, here is the context it did not give you. New York is a prior approval state, which means insurers cannot simply set a price. They file a request in the spring, the Department of Financial Services reviews it, and the state publishes what it approved.
For 2027 the insurers asked for a lot and got considerably less. The state announced its decision on September 4, 2026.
Why your Western New York letter may say a bigger number
Those approved figures are statewide averages, and an average is not a promise about your plan. Rates are filed by region and by product, and Western New York has run above the state average. For 2027, insurers serving this area filed requests in the range of roughly 9 to 24 percent depending on the company and whether the plan was individual or small group, according to their filings with the state as reported by The Buffalo News in June 2026. The Buffalo News reported in September 2026 that approved Western New York increases reach up to 13.5 percent.
So if your letter says something well above 6 percent, that does not mean a mistake was made. It means you live here.
Four years in a row
| Plan year | Insurers asked for | State approved |
|---|---|---|
| 2024 | — | 14% |
| 2025 | — | 13% |
| 2026 | 13.5% | 7.1% |
| 2027 | 20.6% | 6.0% |
The state trimming the request is genuinely good news, and it happens every year. It is also not the same as your cost going down. Four consecutive years of increases compound: a plan that cost $700 a month in 2023 is meaningfully north of $1,000 now without anything about the household changing.
This is not only a New York story
Nationally, KFF reviewed proposed 2027 rates from 276 insurers across all states and found a median proposed increase of about 15 percent, the second straight year of double digit proposals. On the employer side, forecasts published in August 2026 for 2027 landed around 9 to 11 percent: Aon projected 9.5 percent, Willis Towers Watson 11.1 percent before plan design changes, and the International Foundation of Employee Benefit Plans a median of 10 percent. If you have coverage through work and your share went up, that is the same wave.
Four things you can do, in the order I would look at them
Every one of these is something you can check yourself. I am listing them in the order that finds money fastest for most households, not in the order that pays me.
Check whether your income changed what you qualify for
Premium tax credits are based on your household income for the coming year, not last year's. Self employed income moves, a spouse changed jobs, a kid aged off. Any of those can mean you now qualify for help you were not getting, or that you crossed the line and lost it. This is the single most common thing people miss, and it is worth checking before anything else because it can change the answer to everything below.
Run your numbers on the subsidy calculator · The 12 knockouts that disqualify people
Find out whether the cheapest plan in your area is still the plan you are on
This is the one people skip because it feels like it should not matter. It does. The lowest priced plan at a given level changes almost every year as insurers reprice against each other. Auto renewing keeps you on a plan that may have been the best deal two years ago and is not anymore. Same doctors, same level of protection, different price, and the only way to find out is to look at what is actually offered where you live.
If you are self employed or run a small business, ask about the doors that are not on the public menu
This is where the real money usually is, and almost nobody knows these exist. A pre established ERISA group plan is priced completely differently than an individual plan. A medically underwritten private plan can be dramatically cheaper for a healthy household, because unlike the community rated market, being healthy is allowed to count in your favor. Neither of these shows up when you shop on your own. They are not right for everyone and they are not available to everyone, which is exactly why they need a conversation rather than a web form.
How pre established ERISA plans work · If you are self employed in Buffalo · If you have employees
Make sure you are not paying for a plan built for a different life than yours
A lot of people are on a rich plan because they picked it during a year when someone was sick, and nobody ever revisited it. Others are on a bare plan carrying risk they did not realize they took on. The right answer depends on your prescriptions, your doctors, and how much of a bad year you could absorb without it wrecking you. Worth twenty minutes once a year.
The four buckets, explained plainly · Take the 2 minute quiz
And the one option that is not on the list: doing nothing. Letting a plan auto renew is a decision too, and it is the only one that guarantees you pay the full increase. Open enrollment for 2027 coverage generally begins November 1, 2026. Outside that window a price increase by itself does not let you switch a marketplace plan, so the letter arriving in the fall is the moment you have.
Send me your renewal letter and what you pay now. I will tell you whether your increase is in line with everyone else's, whether there is a better fit for the same money, and whether one of the doors above is open to you. If the answer is that you are already on the right plan, I will tell you that too and you will have lost nothing but twenty minutes. I am paid by the carrier when someone enrolls, never by you.
Questions people ask me about premium increases
Why did my health insurance premium go up so much?
Almost never because of anything you did. Individual health premiums are community rated in New York, which means your own claims history and health do not change your price. Increases come from the cost of care itself: hospital prices, prescription drugs including the new weight loss and diabetes drugs, an older and sicker pool of enrolled people, and state mandates and taxes. Insurers file a requested increase with the state each spring, the state reviews it, and an approved number comes back in late summer. Your renewal letter shows you the end of that process, not the reason for it.
How much did health insurance go up for 2027 in New York?
For 2027 the New York Department of Financial Services approved a 6.0 percent average increase on individual plans, against a 20.6 percent increase the insurers had requested, and an 8.0 percent average increase on small group plans against a 23.7 percent request. That was announced September 4, 2026 and covers about 860,000 New Yorkers. Western New York runs higher than the statewide average: local insurers had asked for roughly 9 to 24 percent according to their filings as reported by The Buffalo News in June 2026. It is the fourth straight year of increases, after 14 percent, 13 percent and 7 percent.
Is my increase normal or did I get singled out?
You were not singled out. In New York individual and small group health insurance is community rated, so an insurer cannot raise your price because you had a bad year medically or because you turned a year older. Everyone on your plan in your area got the same percentage. If your dollar increase looks bigger than a neighbor's, it is because you started from a bigger premium, you changed plans or tiers, a family member aged into a different bracket on a plan that allows it, or your household income changed enough to move your tax credit.
What can I actually do when my health insurance goes up?
Four things, in the order most people should look at them. First, check whether your income now qualifies you for a premium tax credit you were not getting, or whether it moved you over the cliff. Second, look at whether a different plan design at the same level of protection costs less, since the cheapest plan in your area changes every single year. Third, if you are self employed or run a small business, find out whether a pre established ERISA group plan or a private medically underwritten plan is open to you, because those are priced completely differently. Fourth, make sure you are not paying for a plan built for someone with different needs. Doing nothing and letting the plan auto renew is the one option that guarantees you pay the increase.
Can I switch health insurance plans because of a price increase?
Yes, during open enrollment, which for 2027 coverage generally runs from November 1, 2026. A price increase by itself does not create a special enrollment period outside those dates, so the renewal letter arriving in the fall is the window to act. If you are on a private or group plan rather than a marketplace plan, the timing depends on the plan, and some private options can be applied for at any time of year subject to health questions.
Will health insurance keep going up every year?
It has gone up every year for a long time, and the 2027 filings across the country point the same direction. KFF reviewed proposed 2027 rates from 276 insurers and found a median proposed increase of about 15 percent, the second straight year of double digit proposals. Employer plan forecasts for 2027 published in August 2026 landed around 9 to 11 percent, with Aon at 9.5 percent and Willis Towers Watson at 11.1 percent before plan changes. Planning on a flat premium is not realistic. Planning on reviewing your options every fall is.
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Pick a slot below and it lands on both our calendars. Bring the renewal letter. No phone tag, no hard sell. I educate, you decide.
Who you'll be talking to: me, Richard "Dick" Tracy. Real name, real job.
Health insurance broker · NPN 20414610 · Licensed in 25 states · 80+ carriers · Buffalo, NY
No call center, and no lead form that sells your name to ten agencies. The person who answers 716-503-1113 is the same person in this photo. I educate, you decide.
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