Why Should Delaware Care?
The percentage of Delawareans purchasing their own insurance coverage through the open marketplace may be relatively low, but the rates they are now paying are not. Recent federal changes have paved the way for another rate increase to impact healthcare affordability for the second year in a row.
Health insurance premiums are set to rise yet again, even after Delaware officials have spent the better part of the past two years on legislation aimed at reducing healthcare costs.
Earlier this week, the Delaware Department of Insurance announced rate changes for health plans purchased through the open marketplace, also known as Affordable Care Act (ACA) or Obamacare plans. The adjustments are connected, in part, to reductions in health insurance subsidies at the federal level.
Plans for two of the state’s primary insurers, Highmark and AmeriHealth Caritas, will both jump by double-digit percentages in 2027, according to the announcement.
The ACA marketplace makes up only a small percentage of insured Delawareans. Most are either covered by a governmental plan like Medicaid or Medicare, while others receive private coverage through their employer.
Still, a jump in rates represents additional financial strain for patients who are often left to cover the entirety of their coverage plans without additional support from the government or an employer, such as small business owners.
Plans through Highmark Blue Cross Blue Shield, Delaware’s largest commercial insurer, will see rates increase by 17.2%. Initially, the insurer was seeking a hike of more than 20%.
Plans for AmeriHealth Caritas, the state’s other primary insurer, are set to jump 13.9%.
This year’s hikes may be far lower than when premiums rose between 25-35% ahead of the 2026 coverage year. But together, the back-to-back changes could add up to a nearly 50% increase for some ratepayers.
In an emailed statement, AmeriHealth officials said the company is “balancing affordability with access to high-quality care.”
“We appreciate our collaboration with the Delaware Department of Insurance to finalize rates that reflect the cost of health care and broader market dynamics in Delaware, including changes at the federal level,” a spokesperson for the insurer said.
A spokesperson for Highmark did not respond to a request for comment.
Local impact
Jenny Trefzger was diagnosed with stage-four colon cancer in 2017, when she was just 23.
Over the better part of a decade, Trefzger has battled cancer; as of this week, she will have been in remission for five years. But now she has a new challenge to face in figuring out how she will continue to afford her insurance coverage.
When she was first diagnosed, she was living in Maryland and enrolled in her family’s Kaiser Permanente plan, since she was still younger than 26. When she aged out, she said she purchased a plan through the ACA marketplace, and paid about $70-$80 monthly for her premiums.
With financial assistance from Kaiser Permanente, she said she didn’t pay any cancer treatment copays.
When she moved to Lewes in 2023, she switched to a Highmark plan, which initially wasn’t much different in cost. But last year, following large spikes in ACA plans, her premium jumped 10 times — to some $750 a month.
Trefzger technically could downgrade her “Gold” plan to opt for lower premiums. But if she paid for a lower coverage health plan, it could mean backsliding on some of her long-term pain and migraine management.
Trefzger is currently prescribed four name-brand medications, some of which cost $2,000 each without insurance, to manage debilitating migraines. Before those prescriptions, she would have about 20 migraines a month, some of which would send her to the hospital.
“I’m down to three to five migraines a month now,” Trefzger said. “That’s a huge reduction.”
Leigh Ann Tona, who owns Sleeping Bird Coffee in Wilmington, said she pays a little more than $2,000 a month to insure herself, her husband and their son. Tona said she’s been a business owner since she was 22, and has enrolled in ACA plans ever since she stopped being covered by her parents’ insurance.
Since taking over insurance needs for her own family, she said insurance costs have “gotten out of control.”
Tona used to apply for tax credits that can reduce premium costs through the marketplace, but they were dependent on how well her business did. If she saw a more successful year, she might have to pay those savings back at the end of the year.
Tona added she and her family already live frugally, and they don’t intend to make any budget cuts to make their health insurance plan work. But Tona said she often thinks about the other ways she could use her money, instead of spending so much on insurance premiums.
Still, each year she sees another increase, she searches for lower-cost options to cover her full-time employees, as well as herself and her family. And each time, she comes to realize she’d be paying more for those plans because she doesn’t have the number of employees to offset the costs, so she stays with her own ACA plan.
“We just kind of feel like we’re stuck,” Tona said.
ACA tax credit fight
In late 2025, following the passage of the One Big Beautiful Bill Act, Gov. Matt Meyer and 17 other Democratic governors sent a letter to Congress pleading with them to extend a boosted form of ACA tax credits.
Congress increased those credits — which essentially subsidize monthly bills for enrollees in the health insurance marketplace — during the COVID pandemic, but that increase was set to expire at the end of 2025.
In their letter, Meyer and the other governors said that if Congress acted quickly to extend the boosted credits, “states can lock in lower premiums and spare families a wave of sticker shock this fall.”
“If not, the damage will be felt for years,” the letter stated.
It led to a stalemate in Congress, causing the longest government shutdown in U.S. history. Earlier this year, after the shutdown, the House of Representatives passed a three-year extension for the tax credits that has since stalled in the Senate.
In a September 2025 press release that accompanied the governors’ letter, Meyer’s office said the health care premiums could increase an average of $700 if the boosted credits weren’t renewed.
At the time, several Delaware lawmakers joined Meyer for a press conference highlighting their cost concerns. Delaware’s former health secretary, Josette Manning, said more than 50,000 people in the state could lose their coverage if the boosted credits are not extended.
She also asserted that if people delay or lack access to adequate care as a result of the credits going away, it could stress Delaware’s “already stretched healthcare system and significantly increase the cost of care.”
More than 90% of people on ACA plans in Delaware receive some form of subsidy, Tanisha Merced, Delaware’s deputy insurance commissioner, said last fall.
The marketplace will open Nov. 1, and close before the end of the year. For more general information about how to navigate the insurance market, see Spotlight Delaware’s guide.
High healthcare costs
Insurance premiums are set to rise at the same time Delaware tries to rein in the cost of healthcare not only for individual patients, but for the state overall. Earlier this year, Meyer signed Senate Bill 1, which aims to improve primary care access for patients while also phasing in price caps for hospitals.
Delaware’s insurance commissioner, Trinidad Navarro, pointed to Senate Bill 1 as a step toward bringing down prices, but acknowledged Delaware is home to one of the most expensive health systems in the nation.
“Our team has worked to limit increases wherever actuarially possible, while ensuring carriers have sufficient funds to pay the high healthcare costs of our state,” Navarro said in a statement. “We will continue advocating for policy solutions that keep coverage within reach for Delaware families.”
Brian Frazee, CEO of the Delaware Healthcare Association, a lobbying group for state hospitals, said hospitals in recent years have supported multiple pieces of legislation aimed at bringing their costs down.
He also pointed to rising workforce, pharmaceutical and supply costs that come with running a hospital. Additionally, he said hospitals have “stepped up to lead solutions to healthcare affordability,” and that other sectors of healthcare like pharmaceuticals and insurers should do their part to bring down costs.
“In order to achieve true reform, we need other sectors to step up to make real system change for everyday Delawareans because hospitals are only one piece of the puzzle,” Frazee said in an interview on Friday.
