How much and why ACA Marketplace premiums are going up in 2027 - Peterson-KFF Health System Tracker

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How much and why ACA Marketplace premiums are going up in 2027

By Matt McGough, Jared Ortaliza, Ashley Ferguson, Imani Telesford, Shameek Rakshit, Emma Wager Twitter, Lynne Cotter, and Cynthia Cox KFF

July 8, 2026

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Every spring and summer, health insurers submit rate filings to state regulators detailing expectations and premium rate changes for individual market health plans for the coming year. This analysis focuses on individual market filings for plans selling Affordable Care Act (ACA) Marketplace coverage. These filings provide insight into what factors insurers expect will drive health costs for the coming year. The individual market is mostly comprised of people enrolled in Affordable Care Act (ACA)-compliant health plans, particularly those sold through the Marketplaces (Healthcare.gov and state-run platforms like Covered California). While less than 10% of Americans get their health coverage through the individual market, many of the factors driving premiums in this market – like growth in hospital or pharmaceutical costs – are similar across all private plans, and the detailed filings available for ACA-compliant coverage provide insight into these cost drivers. There are also issues unique to ACA Marketplace plans, including federal premium assistance for most purchasers and regulations governing how they operate.

For 2027, across 77 insurers participating in the ACA Marketplaces from the 16 states and the District of Columbia with publicly available filings, this analysis shows a median proposed premium increase of 14%. This is the second consecutive year of double-digit premium hikes. Last year’s median nationwide proposed rate change was 18%, and 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. 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.

ACA Marketplace insurers are proposing a median premium increase of about 14% in 2027

States with publicly available proposed rates included in this analysis are Connecticut, the District of Columbia, Hawaii, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Minnesota, New York, Oregon, Rhode Island, Texas, Vermont, and Washington. Note that Hawaii, Illinois, and Texas only have publicly available filings for a portion of their state’s participating insurers.

Based on a detailed analysis of available documents from insurers in these 16 states and the District of Columbia, growth in underlying healthcare prices, as in prior years, stood out as a key factor driving costs in 2027. As discussed in more detail below, insurers cite the rising cost of health services, general economic inflation, and labor shortages as contributing to cost growth.

Insurers also cite some factors that are unique to the individual market, particularly the expiration of enhanced premium tax credits at the end of 2025 and a related increase in the risk pool’s morbidity, as contributing to rising rates for 2027. 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. Other federal policy changes, such as the Trump administration’s ACA Marketplace Integrity and Affordability Rule, the 2027 Notice of Benefit and Payment Parameters, and H.R. 1 – The Working Families Tax Cut Act were also discussed, though to a lesser extent.<br>Related Content:

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Among the 77 ACA Marketplace participating insurers from 16 states and the District of Columbia, premium changes range from 1% to 52%, but most proposed premium changes for 2027 fall between 10% and 20% (the 25th and 75th percentile are 12% and 21%, respectively). Of the insurers included in this analysis, none proposed decreasing premiums. At the other end of the spectrum, 20 insurers requested premium increases of more than 20%. These filings are preliminary and may change during the rate review process. Rates for 2027 will be finalized in late summer.

There are several ways to assess premium changes in this market. This analysis...