Premiums Could Jump More Than One-Third Over Two Years—Middle-Income Enrollees Face the Full Costs Without Enhanced Credits, Even as Existing Federal Subsidies Shield Most from Further Increases

July 8, 2026 - ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

Across the 77 ACA Marketplace insurers in the 16 states and DC that have submitted rate filings so far, most are requesting premium increases of between 10% and 20% for 2027, with 20 insurers requesting premium increases of more than 20%.  

July 15 is the deadline for health insurance companies to submit their proposed premiums for 2027 ACA Marketplace plans. These preliminary filings provide insight into the factors insurers expect to drive health costs for the coming year. Among the key drivers, insurers cite the rising cost of health services, the expiration of the enhanced premium tax credits, and some federal regulatory changes.

• The rising cost of health services have been driven by the cost of hospitalizations, physician visits, and prescription drugs—including GLP-1s and other specialty medications. Relatedly, labor shortages and general economic inflation have driven up provider wages and costs, increasing the cost of health services as well. The underlying cost of medical care and prescription drugs has risen by 10% for 2027—greater than the 8% average growth seen over the last few years.
• The ACA’s enhanced premium tax credits expired at the end of 2025—leading to a 58% average increase in out-of-pocket premiums in 2026 and deductibles of about $1,000 more per person. Most Marketplace enrollees are largely protected from the premium increases because they still qualify for ACA subsidies, though at a lower level. However, people with incomes at 400% or more of the federal poverty level ($62,600 for a single person in 2026) lost subsidies entirely when the enhanced credits expired and, therefore, face the full increase in premiums. This caused many healthier enrollees to leave the ACA Marketplaces in 2026, leaving behind a smaller number of enrollees who are somewhat sicker and more expensive to cover on average. Further market deterioration is expected heading into 2027. Insurers estimate that the sicker risk pool drove 2026 premiums up by roughly four percentage points and expect another four percentage point increase in 2027.
• Federal regulatory changes, including the recent Notice of Benefit and Payment Parameters and the Marketplace Integrity and Affordability Rule, have also been cited as having an upward effect on premiums.  

The full analysis and other data on health costs are available on the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.
Source: KFF