Affordable Care Act Marketplace insurers are proposing a median premium increase of 14% in 2027, according to a KFF analysis of preliminary rate filings.
Health insurers submit rate filings to state regulators every spring and summer that include premium rate changes for individual market health plans for the following year. KFF’s analysis is based on 77 insurers participating in the ACA Marketplaces across the 16 states and the District of Columbia with publicly available filings. It’s important to note that the filings are preliminary and could change during the rate review process, with finalized rates in late summer.
KFF stated that this is the second consecutive year of double-digit premium increases, with last year’s median proposed rate change at 18%. The median finalized rate change was 20%.
“While this proposed rate change is lower than last year, it represents the second-highest requested rate change since 2018, as premium growth had been relatively flat in this market for several years,” KFF said. “If these early indications of median premium increases for 2027 hold, typical premiums for insurers participating in the ACA Marketplaces will have jumped by more than one-third over a two-year period.”
Of the 77 ACA Marketplace insurers in this analysis, premium increases range from 1% to 52%, with most falling between 10% and 20%. None proposed a decrease in premiums.
The rate filings also provide some insight into what insurers believe are driving healthcare costs, with many citing the rising cost of health services, economic inflation and labor shortages. This is similar across all private plans.
“Significant inflation in the cost of goods and services in all sectors of the economy has had a profound impact on the cost of medical services, and BCBSRI expects to see substantial increases in provider unit costs for 2027,” said Blue Cross Blue Shield of Rhode Island in its filing.
However, ACA Marketplace insurers also cited the expiration of enhanced premium tax credits at the end of 2025, as well as an increase in the risk pool’s morbidity, for the rising 2027 premium rates.
“The expiration of these tax credits led to a decrease in enrollment in 2026, with healthier enrollees more likely to drop their coverage. Individual market insurers are expecting the market to continue to deteriorate in 2027 as a result of the expiration of these enhanced tax credits,” KFF said.
For those who lost enhanced subsidies, premium increases have been especially steep. KFF gave the example of a 40-year-old in Indianapolis earning $65,000 whose monthly premium payment could increase from $316 in 2025 (compared with an unsubsidized premium of $388) to $546 in 2027, assuming the proposed rates are approved, after the enhanced premium tax credits expired.
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