Projected Premium Increases in ACA Marketplace for 2027

Health insurance consumers in the U.S. are preparing for another increase in premiums under the Affordable Care Act (ACA) Marketplace, with a projected average rise of 13% in benchmark silver premiums for 2027.

This expected increase comes on the heels of a significant 26% surge recorded for 2026, according to recent analysis by KFF. As open enrollment starts for the 2027 plan year, individuals face critical decisions about whether to renew their existing plans, seek more affordable options, or opt out of coverage entirely. These premium hikes shine a light on the impacts of national health policy changes on personal finances, offering an opportunity to delve into the differences between states operating their own ACA marketplaces and those utilizing the federal platform.

Differences in State Premium Increases

In states using the federal Healthcare.gov exchange, benchmark silver premiums are set to increase by 11%. This is notably five percentage points lower than the 16% increase expected in states with independently managed marketplaces. Understanding these distinctions is crucial for insurance professionals who must navigate varying regulatory landscapes and market conditions to advise clients effectively.

Implications of Coverage and Affordability

The Commonwealth Fund has identified broader financial struggles linked to rising premiums. Their findings suggest that the uninsured rate could climb to 37 million Americans by 2036, a level similar to pre-ACA implementation. With a notable segment of adults aged 19 to 64 either uninsured or underinsured, the financial barriers to care extend beyond premiums to include out-of-pocket expenses and plan deductibles.

"Rising health care costs, including hospital and prescription expenses, are pushing consumers towards lower-cost plans with significant out-of-pocket costs," according to industry observations.

Premium Tax Credits End and Enrollment Impact

The Enhanced Premium Tax Credits, which were initially introduced during the COVID-19 pandemic to reduce monthly premiums, significantly boosted enrollments between 2022 and 2025. However, their expiration has led to decreased affordability, contributing to a decline of over 4.6 million ACA plan enrollees from June 2025 to June 2026. This shift presents an important consideration for professionals in the insurance sector, highlighting how subsidy changes can affect the market.

Industry Considerations and Next Steps

Insurance professionals must remain vigilant to these trends and their implications. By exploring local and state differences, brokers, regulators, and policy researchers can uncover valuable insights to help clients navigate changes. Addressing consumer experiences during open enrollment and understanding affordability challenges is crucial as the landscape of health insurance coverage evolves. These insights not only inform strategic decision-making but also underscore the significance of proactive adaptation in a shifting market.