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ACA Insurers Propose 14% Median Premium Increase for 2027
Summary
Companies offering health insurance on the Affordable Care Act marketplace are requesting a median premium increase of 14% for 2027, the second-highest proposed rate hike in nearly a decade, according to data from KFF.
Health insurance companies participating in the Affordable Care Act (ACA) marketplace are proposing a median premium increase of 14% for 2027 plans, according to an analysis of early filings by the health policy research group KFF. This represents the second-highest requested rate increase since 2018. Last year, insurers sought an 18% median rate hike for 2026 plans.
Insurers attribute the proposed increases to several factors, including general economic inflation, rising medication costs, and increased consolidation among medical providers. They also project that the pool of enrollees will include a higher proportion of sicker, higher-risk patients, which they estimate will drive premiums up by 4% alone as healthier individuals continue to drop their coverage.
Enrollment in ACA plans, often called Obamacare, declined by 13% in 2026 after the expiration of enhanced subsidies that were introduced during the COVID-19 pandemic. The Department of Health and Human Services estimates 19.2 million people are currently enrolled, down from 22.1 million in 2025. According to KFF data, the loss of these subsidies resulted in an average premium increase of 58% in 2026 for those affected, with deductibles rising by about $1,000 per person.
AdKFF's analysis is based on rate filings from 77 insurers across 16 states and Washington, D.C. Based on the latest proposals, premiums are on a trajectory to increase by more than 33% between 2025 and 2027. However, most marketplace enrollees with incomes below 400% of the federal poverty level remain eligible for federal subsidies to help offset premium costs.