The Maine Bureau of Insurance approved average increases of 14.8% for the individual market and 13.5% for the small-group market, which covers employers with 50 or fewer people on staff.
Get Instant Access to This Article
Subscribe to Mainebiz and get immediate access to all of our subscriber-only content and much more.
- Critical Maine business news updated daily.
- Immediate access to all subscriber-only content on our website.
- Bi-weekly print or digital editions of our award-winning publication.
- Special bonus issues like the Mainebiz Book of Lists.
- Exclusive ticket prize draws for our in-person events.
Click here to purchase a paywall bypass link for this article
Health insurance rates for more than 100,000 Mainers who buy coverage through the state’s marketplace are set to surge at the start of 2027.
The Maine Bureau of Insurance approved average increases of 14.8% for the individual market and 13.5% for the small-group market, which covers companies with 50 or fewer employees.
About 65,000 Mainers buy individual health plans, primarily through CoverME.gov, the state’s online health insurance marketplace. More than 70% receive advance premium tax credits that substantially reduce their premiums.
More than 36,000 Mainers get health insurance through a small employer. Most Mainers receive coverage through other sources, including MaineCare, Medicare and large-group employer plans. Large-group rates are not subject to review and approval by the bureau.
The rates, which are slightly lower than those initially requested by insurers, reflect higher health care costs, including prescription drug costs, as well as inflation-driven price increases throughout the economy, the Maine Bureau of Insurance said in its announcement.
“The rising cost of health care is making health coverage more expensive for consumers in Maine and across the country,” said Timothy Schott, the agency's outgoing acting superintendent.
“While these final increases are lower than insurers initially requested, we know they will still be difficult for Maine people and small businesses,” he added. “We encourage consumers to carefully compare their options and choose the coverage that best meets their needs and budget.”
Schott, who is joining the Office of the Maine Attorney General, was succeeded this week by Sandra Darby as the bureau's acting superintendent.
Limited powers
The Maine Bureau of Insurance said it is limited in what it can do to control proposed rate increases. Under state law, the agency examines each insurer’s 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 expected costs. Federal law requires insurers to spend at least 80 cents of every premium dollar on health care services, helping ensure that insurer profits do not drive premium increases.
