Premium Hikes in ACA Coverage for 2027: Insights and Predictions

Health insurers intend to raise premiums for Affordable Care Act (ACA) coverage by a median of 14% in 2027 compared to 2026, according to research by KFF. This increase marks the second-largest since 2018. Insurers must submit their rate proposals and cost projections to regulators by July 15, delineating anticipated changes for the upcoming year.

In the previous year, insurers requested an 18% median premium hike, citing a projected increase in enrollment among higher-risk individuals that was not counterbalanced by enough healthy enrollees. For 2027, insurers foresee continued premium pressure with a 4% rise due to higher medical needs and a decline in healthier members opting out of coverage. Additional contributors to the premium escalation include economic inflation, rising drug prices, and industry consolidation, as reported by KFF.

ACA enrollment dropped by 13% in 2026 from 22.1 million in 2025, following the cessation of COVID-19 related subsidy supports, with current enrollments estimated at 19.2 million by the Department of Health and Human Services. The removal of subsidies led to a 58% premium rise in 2026, with a $1,000 increase in deductibles per person, as per KFF's analysis of filings from 77 insurers across 16 states and the District of Columbia. Under current proposals, premiums could surge by more than 33% between 2025 and 2027.

Subsidies remain available for individuals earning below 400% of the federal poverty level. However, some insurers, including Centene and UnitedHealth, have reported higher medical costs in their ACA operations this year, impacting their strategies. CVS Health's Aetna division halted ACA plans in 2026, anticipating rising costs.