Many Americans relying on health insurance through the Affordable Care Act (ACA) are facing another year of substantial premium increases, according to a new analysis of insurer rate filings. The projected median premium hike for 2027 stands at 14%, marking the second consecutive year of proposed double-digit increases.
This follows a significant jump in 2026, when the median rate increase was 20%. The analysis, based on publicly available rate filings from 77 insurers in the ACA marketplace across 16 states and Washington D.C., suggests that relief from rising costs is unlikely for many in the coming year. Final rates for 2027 will be confirmed later in the summer.
Insurers have cited several key factors driving these proposed increases. Mounting healthcare costs across the sector, including expenses for hospital visits, prescription drugs, workforce, and sicker patient populations, are primary concerns. Broader economic inflation has also contributed to increased operational expenses.
A significant factor identified is the expiration of pandemic-era enhanced subsidies, which had previously helped to offset costs for many enrollees. When these federal tax credits expired in January, many plan costs increased sharply. This led to a decrease in enrollment, with a substantial number of healthier individuals departing the marketplace. The departure of these lower-cost enrollees has left a riskier, sicker patient pool, thereby driving up premiums for those remaining.
Data indicates that the overall ACA marketplace has shrunk by more than 2.5 million people over the past year, with some states experiencing enrollment declines of nearly one-third. Insurers also pointed to federal regulatory changes, such as new enrollment and eligibility requirements instituted by the Trump administration, as potential contributors to requested premium hikes.
While ACA enrollees represent less than 10% of the U.S. population, similar cost drivers are expected to affect other private insurance plans, including employer-sponsored coverage, according to the analysis.
Experts note that individuals who do not qualify for financial assistance are disproportionately affected by these rising premiums. These enrollees already experienced substantial cost increases in 2026, with some seeing their premiums double or triple. The expiration of enhanced tax credits was predicted by analysts to cause healthier individuals to leave the marketplace, leading to a sicker remaining population and subsequent price increases, a scenario now appearing to materialize.