Health insurers offering plans under the Affordable Care Act (ACA) have proposed a 14% median premium increase for 2027, according to a new analysis by the healthcare research nonprofit KFF. This follows a 20% median increase in 2026, marking the second consecutive year of significant rate hikes. The proposed 2027 rates represent the second-highest increase since 2018, KFF reported.
Part 1: Immediate Action & Core Facts
- 77 insurers across 16 states and Washington, D.C., submitted rate filings showing a 14% median premium increase for 2027.
- The 2026 median increase was 20%, driven by rising healthcare costs, regulatory changes, and the expiration of pandemic-era subsidies.
Part 2: Deeper Dive & Context
Factors Driving Premium Increases
Insurers cited several key factors for the proposed hikes:
- Rising healthcare costs, including inflation, higher medication prices, and consolidation of medical providers.
- A shift in enrollment demographics, with more high-risk, sicker patients enrolling and healthier members dropping coverage.
- Federal policy changes, particularly the expiration of enhanced subsidies that had lowered premiums during the COVID-19 pandemic.
Impact on Enrollees
- Subsidized enrollees making less than 400% of the federal poverty level will continue to receive financial assistance, but middle-class enrollees (earning above 400% of the poverty level) will face the full brunt of the increases.
- Enrollment declined by 13% in 2026, dropping from 22.1 million to 19.2 million, after the subsidies expired.
- Premiums rose 58% in 2026, and deductibles increased by about $1,000 per person, according to KFF data.
Political and Policy Context
The premium hikes come amid ongoing debates over healthcare policy, particularly the failure of Congress to reauthorize the pandemic-era subsidies. Democrats and Republicans have clashed over the issue, with Democrats arguing for extended subsidies and Republicans emphasizing cost control. The policy fight contributed to the longest government shutdown in U.S. history in late 2025.
Insurer-Specific Data
- 47 of the 77 insurers analyzed by KFF expect increases between 10% and 20% in 2027.
- 20 insurers are projecting increases of more than 20%.
- Major insurers like Centene and UnitedHealth have reported elevated medical costs in their ACA businesses.
Long-Term Implications
Between 2025 and 2027, premiums are on track to increase by more than 33%, based on the latest projections. The rising costs could influence voter priorities ahead of the 2026 midterm elections, where healthcare affordability is a top concern.