Projected 14% ACA Premium Increase in 2027—Impact Analysis
Insurance providers participating in the Affordable Care Act (ACA) are preparing for a substantial premium increase in 2027, according to a recent report by the healthcare research nonprofit KFF. The report reveals a median proposed increase of 14% among the 77 insurers whose rate filings are publicly accessible. This follows a significant 20% rise seen in 2026.
Insurers attribute the proposed hikes to escalating healthcare costs, changes in federal regulations, and the conclusion of enhanced subsidies introduced during the pandemic. While these premium adjustments are expected to significantly impact middle-class enrollees earning 400% above the poverty line or more, many Americans remain shielded from the full effects through available subsidies.
Each year, health insurers submit their rate change expectations to regulators for individual market plans for the upcoming year. The rates, which KFF analyzed across 16 states and Washington, D.C., will become final during the summer. The increase spans various plans, including bronze, silver, gold, and platinum, as insurers connect the rising premiums to factors such as increased healthcare sector costs, encompassing hospital visits, prescription drugs, and labor.
The expiration of federal subsidies, which had previously expanded the ACA program, is a pivotal factor. These tax credits ended in January, causing plan costs to rise sharply and prompting healthier enrollees to leave the marketplace. This has left a pool of costlier, high-risk members, further driving up premiums.
Newly released data from the federal administration indicates a contraction of the ACA marketplace, with a reduction of over 2.5 million participants, as some states observed declines nearing a third of their enrollees. Several insurers have noted that recent federal regulatory adjustments have impacted their premium rate requests, with changes in enrollment and eligibility criteria potentially altering the ACA enrollee demographic.
According to the KFF analysis, these cost drivers not only affect ACA enrollees—who represent less than 10% of the U.S. population—but could also increase costs for other private insurance plans, including employer-sponsored ones. Georgetown University's Center on Health Insurance Reforms has published similar findings, projecting double-digit premium increases for ACA plans. Stacey Pogue, a senior research fellow at the center, highlighted that those without financial assistance are particularly vulnerable, having already experienced notable premium increases in 2026.
Pogue pointed out that with the cessation of enhanced tax credits, the ACA marketplace has seen a decline in healthier individuals, leaving a heavier reliance on the insurance system by remaining sicker enrollees. "When the healthy people leave, the prices go up," she summarized the current trend.