NEW YORK – Americans already struggling to afford health coverage through the Affordable Care Act may see little relief next year, with a new analysis indicating that marketplace insurers are seeking double-digit premium increases for the second year in a row.
Among 77 ACA insurers with publicly available rate filings, the median proposed premium increase for 2027 is 14%, according to an analysis released Wednesday by KFF, a nonprofit health policy research organization. Insurers pointed to several pressures behind the proposed hikes, including rising medical costs, changes in federal regulations and the end of enhanced subsidies first introduced during the pandemic.
The projected increases follow an even sharper rise in 2026, when KFF found the median rate hike reached 20%. Although many people enrolled in Obamacare plans continue to receive subsidies that shield them from the full price of premiums, middle-class consumers earning at least 400% of the federal poverty level are expected to feel the impact more directly.
The looming cost increases arrive as members of Congress have floated a range of proposals aimed at reshaping the nation’s costly healthcare system, though no sweeping measure has gained enough support to become law. For many households, the pressure from higher premiums is adding to broader concerns about affordability, an issue expected to weigh heavily on voters as November’s midterm elections approach.
Insurers point to higher costs and a smaller, less healthy pool of enrollees
Each year, health insurers are required to submit filings to regulators outlining the premium rate changes they expect for individual market health plans in the year ahead.
Final rates for next year will be set later this summer, but KFF reviewed the ACA marketplace filings that are already public in 16 states and Washington, D.C., to provide an early look at insurer expectations. The analysis calculated proposed premium increases as an average across all plan tiers, including bronze, silver, gold and platinum coverage.
According to the analysis, insurers most often blamed rising costs throughout the healthcare system, including hospital care, prescription drugs, labor expenses and a population of enrollees with greater medical needs. Broader inflation has intensified those challenges, pushing prices higher across much of the economy.
Insurers also blamed the expiration of federal subsidies that had offset costs for many people and caused the Affordable Care Act program to balloon in size in recent years. When those tax credits expired in January, many plan costs skyrocketed. That prompted large swaths of enrollees to depart the marketplace, leaving sicker patients who carry higher risks and costs, and driving premiums higher.
New state-by-state data posted by the Trump administration shows that the overall ACA marketplace shrunk by more than 2.5 million people over the past year, with some states seeing declines amounting to nearly a third of their enrollee population.
Some insurers added that federal regulatory changes contributed to their requests for higher premiums. For example, they said new enrollment and eligibility requirements instituted by the Trump administration could affect the overall population of ACA enrollees.
While Affordable Care Act enrollees make up less than 10% of the population, similar cost drivers are likely to make other private plans, including employer-sponsored plans, pricier too, according to KFF’s analysis.
Findings align with other analyses
Georgetown University’s Center on Health Insurance Reforms also published an analysis of preliminary ACA insurer rate filings last month. Like KFF’s, it projected double-digit premium increases in the marketplace next year.
Stacey Pogue, a senior research fellow at the center who authored the report, said the enrollees most affected by the rising premiums will be those who don’t qualify for financial help. She said those people already saw the most significant increases to their premiums in 2026, with some of their premiums doubling or tripling.
“Those are the folks who kind of got a double whammy” this year, she said.
Pogue said the rate filings are demonstrating what many analysts had expected: that the expiration of enhanced tax credits would cause healthy Americans to flee the marketplace and leave a sicker patient population that relies more heavily on insurance.
“When the healthy people leave, the prices go up,” she said. “The analysts all predicted that, and now that’s what we’re seeing.”
