The Rhode Island Office of the Health Insurance Commissioner (OHIC) has approved commercial health insurance rates for 2027, substantially reducing the increases originally requested by insurers. The approved weighted-average increases are 12.4% for the individual market, 3.8% for small groups, and 9.5% for large groups. Insurers had requested average increases of 20.1%, 8.7%, and 15.5%, respectively. OHIC estimates its rate review will save Rhode Islanders $86.7 million in 2027 compared with the rates initially requested.
The reductions are significant and demonstrate the importance of Rhode Island's rate-review process. OHIC reports that it reduced insurer assumptions concerning medical utilization and severity trends, limited increases in insurer administrative costs to general inflation, and removed a state health insurance fee that had been included in the original filings.
But there is another message in the numbers that should not be overlooked. Premiums are still going up—substantially in some markets. Large employers purchasing fully insured coverage face an average increase of 9.5%, while individual-market purchasers face an average increase of 12.4%. The experience also varies considerably by insurer: approved large-group increases range from 7.9% for BCBSRI to 17.7% for UnitedHealthcare.
OHIC itself identifies the fundamental problem: “Rates are going up overall primarily due to rising health care costs.” Its release notes that spending on hospitals, physicians, prescription drugs and other healthcare services is the key driver of premium increases. It also cites recent research finding that growth in healthcare spending accounted for 91% of premium growth nationally between 2011 and 2024.
That finding reinforces the message of RIBGH's recent From Premium Shocks to Payment Reform. Rhode Island has experienced repeated years in which commercial premiums have increased far faster than general inflation. Rate review can reduce an insurer's requested increase, but it cannot by itself solve the underlying problem when the cost of delivering healthcare continues to rise faster than the rest of the economy.
That is why the discussion increasingly needs to move from premium increases to healthcare cost growth—and ultimately to how healthcare is paid for and delivered. Rhode Island's participation in the federal AHEAD model provides an opportunity to make that transition. Hospital global budgets and stronger population-based primary care can begin moving the system away from fee-for-service incentives that reward greater volume and toward incentives for prevention, early intervention, coordination and affordability.
OHIC's 2027 rate decisions are welcome news compared with what insurers originally requested. But a 9.5% increase for large employers and a 12.4% increase for individuals should not become the definition of success. The premium shocks remain the warning. The longer-term challenge is changing the underlying healthcare cost trajectory that produces them in the first place.
Source: Rhode Island Office of the Health Insurance Commissioner, “2027 Commercial Health Insurance Rates Approved with Modifications,” September 29, 2026; RIBGH, From Premium Shocks to Payment Reform.