Iowa's Health Insurance Premiums Expected to Rise in 2027

Health insurance premiums for many Iowans are anticipated to rise in 2027, as insurers have submitted proposals indicating rate hikes. This marks the second consecutive year of potential double-digit increases, driven by the expiration of expanded Affordable Care Act (ACA) subsidies and rising healthcare costs.

The proposed average premium increases range from 4.98% to 16.84% for various ACA-compliant individual plans offered by insurers in Iowa. These adjustments follow significant rate rises in 2026 that ranged from 12.5% upward to over 25%, according to filings with the Iowa Insurance Division.

As expanded ACA subsidies lapsed, nearly 20% of Iowans enrolled in ACA plans discontinued their coverage by February. This change followed the end of enhanced subsidies in January, without congressional extension, as analyzed by the Kaiser Family Foundation.

Iowa is among 16 states, along with the District of Columbia, where 2027 rate filings have been made publicly accessible. Although some Iowans are set for double-digit increases, most rates are predicted to remain below the national average increase projected at 14% across 77 providers.

Insurance companies in Iowa have attributed rising premiums to higher medical care costs, increased provider reimbursements, greater utilization of medical services, and the cessation of expanded ACA premium tax credits, along with certain state and federal taxes and fees.

Upcoming Rate Adjustments

Starting January 1, 2027, the proposed average rate increases from each insurer are as follows:

• Avera Health Plans proposes a 14.82% increase impacting 438 Iowans, with variations from 12.3% to 21.7%.
• Iowa Total Care suggests a 16.84% increase for 6,982 Iowans, with changes between 9.39% and 21.75%.
• Oscar proposes an 11.94% increase affecting 11,971 Iowans, ranging from 4.63% to 28.17%.
• UnitedHealthcare Plan of the River Valley suggests an 11.77% increase for 546 Iowans, with adjustments from 9.66% to 12.53%.
• Wellmark Health Plan of Iowa proposes a 4.98% increase affecting around 80,000 Iowans, with changes from -2.27% to 10.73%.

Recent federal data highlights a 17% decline in ACA enrollment in Iowa as of February, signifying about 21,000 fewer enrollees compared to the previous year. Enrollment initially surged due to enhanced subsidies during the pandemic.

The current trend suggests that the drop-off may primarily involve lower-income, younger, and healthier individuals finding coverage too costly without the subsidies, possibly leading to increased premiums due to a costlier insured population for health insurers.