Health insurance premiums are set to rise 14% in 2027, according to a new analysis of preliminary rate filings from 77 insurers participating in Affordable Care Act marketplaces across 16 states and Washington, D.C., released by the Kaiser Family Foundation on July 8, 2026. The proposed median increase marks a second consecutive year of double-digit premium hikes, following an 18% median increase in 2026.
Across the insurers analyzed, most are requesting premium increases between 10% and 20%, while 20 insurers are seeking increases exceeding 20%. If the proposed rates are finalized, typical premiums would jump by more than one-third over the two-year period from 2025 to 2027, according to the KFF analysis.
Insurers cite several drivers for the increases. The underlying cost of medical care and prescription drugs has risen by 10% for 2027—greater than the 8% average growth seen over previous years—driven by hospitalizations, physician visits, and specialty medications including GLP-1 weight-loss drugs. Labor shortages and general economic inflation have also driven up provider wages and costs. The expiration of the ACA’s enhanced premium tax credits at the end of 2025 led to a 58% average increase in out-of-pocket premiums in 2026 and deductibles roughly $1,000 higher per person, according to KFF.
The loss of enhanced credits caused many healthier enrollees to leave the ACA marketplaces in 2026, leaving behind a smaller, sicker population that is more expensive to cover on average. Insurers estimate the sicker risk pool drove 2026 premiums up by roughly four percentage points and expect another four percentage point increase in 2027. Most marketplace enrollees remain protected from the full impact of premium increases because they still qualify for federal subsidies, though at lower levels than before. However, people earning 400% or more of the federal poverty level—about $62,600 for a single person in 2026—lost subsidies entirely and face the full increase.
Federal regulatory changes, including recent updates to benefit and payment parameters and marketplace integrity rules, have also been cited as contributing to the upward pressure on premiums. The July 15, 2026 deadline for health insurers to submit their final proposed premiums for 2027 ACA marketplace plans will provide a fuller picture of rate increases across the country.
Sources
- Kaiser Family Foundation (KFF) — Analysis of preliminary rate filings showing 77 insurers across 16 states and D.C. proposing a median 14% premium increase for 2027, with details on drivers including medical costs, expiration of enhanced tax credits, and risk pool changes.
- Peterson-KFF Health System Tracker — Supporting data on ACA marketplace premiums, medical cost trends, and impact of enhanced premium tax credit expiration.
- USA Today — Reporting on the KFF analysis and median 14% rate hike for 2027 ACA plans.
- PBS NewsHour — Coverage of the 77 insurers’ median proposed 14% premium increase for 2027.
