How Tennessee contractors are dealing with a 37.5% rise in health insurance prices

Sam Jaber, Licensed Health Insurance Advisor · Updated October 2026

NPN 20698748 · Licensed in Tennessee and in more than 30 states in total · Licensing details

Short answer: If this year's jobs leave your profit inside the tax credit range, a HealthCare.gov plan is usually where you pay least. Above that line you pay full price after a 37.5% average increase, on a marketplace where every medical plan is an EPO, so a healthy contractor should price an underwritten nationwide PPO plan. A short call settles it.

• My profit qualifies for a credit
• My jobs put me over the line
• I'm over it and healthy
• Someone needs ongoing care
• My job plan or COBRA is ending
• My spouse has benefits
• Not sure yet

You run your own outfit in Tennessee: a general contracting company, an HVAC or electrical shop, a framing or concrete crew. The money comes by the job. A deposit when the contract is signed, draws as each stage passes inspection, a final payment at the end, and sometimes a slice of retainage that the owner holds until the job is closed out. In between, you front materials and make payroll.

Health insurance is one more bill you carry yourself, and it got heavier this year. Tennessee's marketplace prices rose about 37.5% on average for 2026, and the benchmark silver plan for a 40-year-old went from $516 a month to $711.

Before you decide anything, answer one question: where will this year's jobs leave your income, under the line for a tax credit or over it? That answer sorts you into one of the sections below.

If this year's jobs leave you under the credit line

Tennessee uses HealthCare.gov. When your expected household income for the year sits in the federal credit range, a marketplace plan is usually where you pay the least. The credit applies only to plans bought there, and it comes off your premium each month.

For a contractor, the number that counts is profit, what is left after materials, subs and crew, not the size of the contracts you sign. The risk is timing. A big job's final draw, or retainage released in December, can carry a modest year past the credit cutoff: 400% of the poverty line, or $63,840 of income for someone covering only themselves in 2027, and $62,600 in 2026. Past that point the credit is gone for the year, and what was paid in advance gets settled on your tax return, sometimes all of it. How the subsidy cliff works explains the line.

When you can see a large payment landing this year, update HealthCare.gov then, not after you file.

If your contracts put you past the line

Above the line, you pay the full HealthCare.gov price, and in Tennessee that price climbed steeply. On the benchmark plan, a 40-year-old pays $195 more a month than in 2025, about $2,340 more a year. Owners further into their careers pay more, because marketplace prices rise with age. For a couple who are both 50, the benchmark silver plan in a typical Tennessee county lists at about $2,000 a month in 2026, roughly $24,000 a year that has to come out of job margins.

Those figures are averages and county examples, not a quote. Your price turns on your ages, county and the plan you choose.

For a lot of contractors above the line, that full price is out of reach. The next question is about your health.

If you're past the line and in good health

Tennessee's marketplace has a network limit too. For 2026, every medical plan sold on it is an EPO, and none is a PPO. An EPO generally pays nothing for care outside its own network unless it is an emergency, which matters if you take jobs across the line in Georgia, Mississippi or Virginia, or travel to see family.

What a healthy contractor can look at instead sits outside HealthCare.gov: private plans that use medical underwriting and run on nationwide PPO networks.

Underwriting means the application asks about your health history, and the insurer uses your answers to accept you, decline you, or exclude a condition you already have. Because the insurer is choosing who it covers, it can price a healthier group than a marketplace plan, which has to take everyone. That is how someone in good health can come in below the full Tennessee price. The PPO network means doctors in network in other states, not only near home.

These plans set their own benefits, so go through the coverage before you sign. Our explainer on medical underwriting covers the application step by step.

The way to know whether it works for you is the same way you bid a job: put real numbers side by side. An underwritten price for your household next to the full marketplace price usually makes the call obvious.

If you or someone on your plan needs ongoing treatment

When someone in the household has a chronic condition or a costly prescription, stay with a marketplace plan even without a credit. A HealthCare.gov plan has to accept you and cannot charge more because of your health, while an underwritten plan could decline the application or exclude the condition that needs the care.

Six insurers sold marketplace plans in Tennessee for 2026, and one has announced it will leave at the end of the year, so your choices will shift for 2027. Not every insurer sells in every county. Since the networks are EPOs, confirm that your doctors, hospital and pharmacy are in the plan before you enroll.

If your job plan or COBRA runs out soon

Maybe you are leaving a larger contractor to run your own crew, or the COBRA you kept from that job is close to its last month. Either way there is an end date, and the next plan needs to begin the day after.

Losing job-based coverage, including COBRA that has been used up, gives you 60 days to sign up for a HealthCare.gov plan outside open enrollment. Which plan comes down to the same two questions as above. A first year on your own that lands in the credit range points to the marketplace. If it will not and you are healthy, apply for an underwritten plan early, since it has to approve you before it can start.

If your spouse works somewhere with benefits

Some contracting households have a second option: a spouse with job-based coverage. If that employer offers a family plan, put its cost next to your marketplace price, or next to an underwritten price if you are both healthy.

One tax rule to keep in mind. For any month you are eligible for an employer plan that helps pay the cost, including a spouse's, you cannot take the self-employed health insurance deduction. Our guide to the deduction covers the details, and your tax preparer can confirm how it applies.

Pick the row that sounds like your business

Each row ends the same way. A short conversation with your actual numbers is quicker than working it out alone.

For everything else about coverage in this state, read the Tennessee guide for self-employed buyers. Practice owners a state south saw an even steeper jump; see how Mississippi practice owners are handling it.

Questions from Tennessee contractors