AUGUSTA, ME – The Maine Bureau of Insurance today released the finalized 2027 health insurance rates for Maine’s individual and small group market to take effect on January 1, 2027.
Following a careful review of proposals from Maine’s insurers, the Bureau has approved an average rate increase of 14.8 percent for the individual market and 13.5 percent for the small employer market (those with 50 or fewer employees).
These average final rates are slightly lower than those initially requested by health insurers – which were 16.8 percent for individuals and 15.7 percent for small employers. Higher rates are reflective of higher healthcare costs (which includes increased utilization of services, increasing costs for prescription medications, and more expensive provider contracts), and inflation-driven price increases throughout the economy. A recent analysis by nonpartisan KFF (formerly the Kaiser Family Foundation) found that insurers have proposed a median rate increase of 15 percent nationally.
“The rising cost of health care is making health coverage more expensive for consumers in Maine and across the country,” said Timothy Schott, Acting Superintendent of the Maine Bureau of Insurance. “While these final increases are lower than insurers initially requested, we know they will still be difficult for Maine people and small businesses. We encourage consumers to carefully compare their options and choose the coverage that best meets their needs and budget.”
The Bureau is limited in what it can do to control proposed rate increases. Under State law, the Bureau examines each insurer’s experience and projected costs and is charged with determining whether rates are excessive, inadequate, or unfairly discriminatory. In this context, “excessive” is measured by the amount of premium needed to cover the expected cost. Federal law requires insurers to spend at least 80 cents of every premium dollar on health care services to ensure that health insurer profits do not drive premium increases.
The individual market covers roughly 65,000 Maine residents who purchase health plans on their own, primarily through CoverME.gov, the state’s health insurance marketplace. More than 70% of people purchasing individual coverage through CoverME.gov receive advance premium tax credits, which substantially reduces the premium amounts they pay.
More than 36,000 Maine people currently obtain health insurance through a small employer. The vast majority of Maine people obtain health insurance coverage through other sources, including MaineCare, Medicare, and employer-sponsored large group plans. Rates in the large group market are not subject to review and approval by the Bureau.
Consumers should also be aware of two significant changes to Maine’s health insurance marketplace in 2027. Mending Health, formerly known as Taro Health, is leaving the health insurance market and will no longer offer coverage. Anthem will no longer offer individual preferred provider organization (PPO) plans through CoverME.gov, although it will continue to sell PPO plans directly to individuals outside the marketplace and to small groups. Marketplace consumers enrolled in Anthem PPO or Mending Health plans at the start of Open Enrollment will be automatically re-enrolled in another plan available for 2027. However, they are encouraged to actively shop and compare their options through CoverME.gov to ensure the plan they select best meets their health care needs and budget, and to determine whether they qualify for financial assistance to lower the cost of coverage.
Health insurance premiums vary by health insurer and plan. The Bureau urges consumers to shop for a policy that best meets their needs.
For more information about the 2027 ACA rates visit the Bureau of Insurance website at: https://www.maine.gov/pfr/insurance/legal/upcoming-hearings/public-access-to-aca-filings.
To learn more about individual and small group health insurance options in Maine, please visit https://www.maine.gov/pfr/insurance/consumers/life-health-disability, and to compare plans and enroll in coverage visit https://www.CoverME.gov.
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Consumers with questions about insurance matters can obtain information and assistance from the Maine Bureau of Insurance by visiting www.maine.gov/insurance, calling 800-300-5000 (TTY call Maine Relay 711), or e-mailing Insurance.PFR@maine.gov. See more about how the Bureau can help.