ACA Marketplace insurers are proposing a median 14% premium increase for 2027, pointing to a second straight year of double-digit hikes. If approved, typical Marketplace premiums would rise by more than one-third from 2025 to 2027. Of the 77 insurers filing rates so far across 16 states and DC, most are seeking increases of 10% to 20%, and 20 insurers are requesting increases above 20%.
July 15 was the deadline for insurers to file proposed 2027 ACA Marketplace premiums, offering an early look at the cost pressures shaping next year’s rates. Insurers point to rising healthcare costs, the expiration of enhanced premium tax credits, and federal regulatory changes as key drivers.
- Rising healthcare costs are being driven by hospital care, physician visits, and prescription drugs, including GLP-1s and other specialty medications. Labor shortages and inflation are adding to the pressure, pushing projected medical and pharmacy costs up 10% for 2027, above the recent 8% average.
- The expiration of the ACA’s enhanced premium tax credits drove a 58% average increase in out-of-pocket premiums in 2026 and pushed deductibles about $1,000 higher per person. While many enrollees still receive reduced subsidies, higher-income individuals lost eligibility entirely, leading some healthier members to exit the market. As a result, insurers expect a sicker risk pool to add about four percentage points to premium increases again in 2027.
- Federal regulatory changes, including recent Marketplace rules, are also expected to put upward pressure on premiums.
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