Insurers in the Affordable Care Act marketplace are proposing another year of double-digit premium increases, with rising medical costs, subsidy changes and new federal rules driving requests higher.
By yourNEWS Media Newsroom
Many Americans who buy health insurance through the Affordable Care Act marketplace could see another sharp rise in premiums next year, according to a new KFF analysis showing insurers are seeking a median 14% increase for 2027.
The proposed increase would follow a 20% median premium hike in 2026, adding to affordability pressures for people who rely on the ACA marketplace for coverage. Although subsidies continue to shield many enrollees from paying the full cost of premiums, people with middle-class incomes at or above 400% of the poverty level are expected to face some of the largest cost increases.
KFF, a healthcare research nonprofit, reviewed publicly available rate filings from 77 insurers participating in the ACA marketplace. The filings cover 16 states and Washington, D.C., and provide an early look at what insurers are requesting before regulators finalize next year’s rates later this summer.
The analysis measured proposed premium increases across all marketplace plan categories, including bronze, silver, gold and platinum plans.
Insurers cited several reasons for the requested hikes, with rising healthcare costs listed as the largest factor. Those costs include hospital care, prescription drugs, labor expenses and the cost of covering enrollees with greater medical needs. Broader inflation also contributed to higher prices throughout the healthcare system and the wider economy.
The filings also pointed to the expiration of pandemic-era enhanced federal subsidies, which had lowered costs for many marketplace customers and helped expand ACA enrollment in recent years. When those enhanced tax credits expired in January, many consumers saw plan costs rise sharply.
That change pushed many enrollees out of the marketplace, insurers said, leaving behind a smaller and costlier pool of patients. Federal data posted by the Trump administration shows ACA marketplace enrollment declined by more than 2.5 million people over the past year. In some states, enrollment fell by nearly one-third.
Insurers said the resulting shift in the marketplace population contributed to higher premiums because healthier people were more likely to leave, while sicker enrollees who use more medical care were more likely to remain covered.
Some insurers also said federal regulatory changes affected their premium requests. Those changes included new enrollment and eligibility requirements put in place by the Trump administration, which insurers said could alter the makeup of the ACA marketplace population.
The proposed increases come as policymakers in Washington continue to debate changes to the U.S. healthcare system, which remains expensive for many households. Various federal proposals have been introduced, but no broad healthcare overhaul has gained enough support to pass.
The rising premiums are adding to wider concerns about affordability as voters look toward the November midterm elections.
ACA enrollees represent less than 10% of the U.S. population, but KFF said the same pressures pushing up marketplace premiums are also likely to affect other private insurance plans, including employer-sponsored coverage.
A separate review released last month by Georgetown University’s Center on Health Insurance Reforms also examined preliminary ACA insurer rate filings and reached a similar conclusion, projecting double-digit marketplace premium increases in 2027.
Stacey Pogue, a senior research fellow at the center and the author of that report, said the biggest burden will fall on people who do not qualify for financial assistance. Those enrollees already faced some of the steepest increases in 2026, including cases where premiums doubled or tripled.
“Those are the folks who kind of got a double whammy” this year, Pogue said.
Pogue said the rate filings reflect what many healthcare analysts predicted would happen after the enhanced tax credits ended: healthier consumers would leave the marketplace, leaving a smaller group of enrollees with higher medical costs.
“When the healthy people leave, the prices go up,” she said. “The analysts all predicted that, and now that’s what we’re seeing.”
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