NEW YORK – As Americans grapple with the financial demands of health insurance under the Affordable Care Act, a new analysis reveals that relief is unlikely in the coming year. Insurers within the marketplace are gearing up for a second consecutive year of double-digit premium increases.
A healthcare research analysis by KFF, released on Wednesday, indicates that among the 77 insurers participating in the ACA program that have made their rate filings public, the median premium increase proposed for 2027 stands at 14%. These companies attribute the hike to escalating healthcare costs, changes in federal regulations, and the cessation of pandemic-induced enhanced subsidies.
This upcoming rise in premiums adds to an already significant increase observed in 2026, when the median rate jumped by 20%, as noted by KFF. Although subsidies protect many Obamacare enrollees from bearing the full brunt of these premiums, those in the middle class, earning 400% above the poverty level or more, will confront a particularly stark rise in their healthcare costs.
These premium increases come amid ongoing deliberations among federal lawmakers who have floated various proposals to reform the costly U.S. healthcare system. However, no comprehensive measure has yet garnered the broad support needed for passage. These rising costs add to American concerns over affordability—a critical issue as the midterm elections in November approach.
Insurers point to the growing expenses and the challenges of serving a smaller, sicker insured population as key factors in the ongoing trend of increasing premiums.
Health insurers must send filings to regulators every year, explaining what they expect to see in premium rate changes for individual market health plans for the coming year.
Next year’s rates will be finalized later in the summer, but KFF’s analysis looked at those in the ACA marketplace that already are public across 16 states and Washington, D.C., to get an early glimpse at what insurers are saying. The report measured insurers’ premium increases as an average across all types of plans — bronze, silver, gold and platinum.
The analysis found that insurers listed rising costs across the healthcare sector — from hospital visits to prescription drugs, the workforce and sicker patients — as the biggest cause of rising premiums. Overall inflation contributed to that pressure, driving prices higher across the entire economy.
Insurers also blamed the expiration of federal subsidies that had offset costs for many people and caused the Affordable Care Act program to balloon in size in recent years. When those tax credits expired in January, many plan costs skyrocketed. That prompted large swaths of enrollees to depart the marketplace, leaving sicker patients who carry higher risks and costs, and driving premiums higher.
New state-by-state data posted by the Trump administration shows that the overall ACA marketplace shrunk by more than 2.5 million people over the past year, with some states seeing declines amounting to nearly a third of their enrollee population.
Some insurers added that federal regulatory changes contributed to their requests for higher premiums. For example, they said new enrollment and eligibility requirements instituted by the Trump administration could affect the overall population of ACA enrollees.
While Affordable Care Act enrollees make up less than 10% of the population, similar cost drivers are likely to make other private plans, including employer-sponsored plans, pricier too, according to KFF’s analysis.
Findings align with other analyses
Georgetown University’s Center on Health Insurance Reforms also published an analysis of preliminary ACA insurer rate filings last month. Like KFF’s, it projected double-digit premium increases in the marketplace next year.
Stacey Pogue, a senior research fellow at the center who authored the report, said the enrollees most affected by the rising premiums will be those who don’t qualify for financial help. She said those people already saw the most significant increases to their premiums in 2026, with some of their premiums doubling or tripling.
“Those are the folks who kind of got a double whammy” this year, she said.
Pogue said the rate filings are demonstrating what many analysts had expected: that the expiration of enhanced tax credits would cause healthy Americans to flee the marketplace and leave a sicker patient population that relies more heavily on insurance.
“When the healthy people leave, the prices go up,” she said. “The analysts all predicted that, and now that’s what we’re seeing.”
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