ACA insurers are proposing a median 14% premium increase for 2027, marking a second consecutive year of double-digit rate hikes for Affordable Care Act marketplace plans, according to preliminary rate filings analyzed by KFF and the Peterson-KFF Health System Tracker.
The proposed increase is slightly lower than the 18% insurers initially sought for 2026, which ultimately settled at a 20% median increase when final numbers were analyzed. The 2027 filings reviewed preliminary rate proposals from 77 insurers across 16 states and Washington, D.C., with proposed increases ranging from 7% in Vermont to 25% in Indiana.
The loss of enhanced premium tax credits at the end of 2025 continues to reverberate through the market. These credits, which had provided additional financial assistance to millions of ACA enrollees, expired after a partisan standoff in Congress. The expiration forced approximately 5 million people to drop or lose ACA coverage in 2026, according to health policy analysis. Those who remained in the marketplace faced dramatically higher out-of-pocket costs.
The main driver of the 2027 premium increases will be higher healthcare costs, according to KFF. Insurers also cited increased labor costs, the expense of GLP-1 drugs used primarily for diabetes treatment, more complex medical cases in provider billing, and general inflation. Additionally, because the healthiest people were most likely to drop coverage following the 2026 rate shocks, the remaining ACA insurance pool is proportionally sicker and requires more costly care, which insurers said will push premiums higher.
When 2026 rates spiked at 20%, the surge disrupted health coverage for millions of people. Many enrollees faced annual premium costs thousands of dollars higher than the previous year, particularly those who lost access to enhanced subsidies. The current 14% proposed increase for 2027 suggests the market is stabilizing after the shock, though premiums remain significantly elevated compared to historical trends.
Insurers have until July 15, 2026, to submit final proposed premiums for 2027 plans. State insurance regulators will then review and approve, modify, or reject the filings before rates are finalized.
Sources
- Peterson-KFF Health System Tracker — confirmed median 14% proposed premium increase for 2027 across 77 insurers in 16 states and D.C.
- KFF — preliminary rate filing analysis and identification of main drivers (healthcare costs, labor costs, GLP-1 drugs, inflation)
- The Washington Post — reporting on 2027 rate proposals, 2026 increase details, EPTC expiration impact, and sicker insurance pool effect
- PBS — confirmation of 20% median 2026 rate increase and comparison to 2027 projections
