ACA Insurers Propose 14% Median Premium Hike for 2027
6 verified1 unconfirmed1 contested
Insurers are requesting a median premium increase of 14% for 2027 Affordable Care Act Marketplace plans, according to an analysis of preliminary filings in 16 states and Washington, D.C. If approved, this would be the second-highest increase since 2018. The rate requests come a year after the expiration of enhanced premium tax credits, which has led to higher out-of-pocket costs for many enrollees. Insurers cite rising medical costs, including expensive specialty medications, and changes in federal regulations as drivers of the proposed increases. The analysis was conducted by the Peterson Center on Healthcare and KFF. Enrollment in ACA plans has fallen significantly compared to the previous year, though sources report different figures for the decline. The proposed increases primarily affect enrollees with incomes above 400% of the federal poverty level, who are no longer eligible for subsidies following the expiration of enhanced tax credits.
What’s verified
Insurers are proposing a median premium increase of 14% for 2027 ACA Marketplace plans.
The analysis is based on filings in 16 states and Washington, D.C., and was released by the Peterson Center on Healthcare and KFF.
If approved, the increase would be the second-highest since 2018.
Enhanced premium tax credits expired at the end of last year.
Insurers cited rising healthcare costs and changes in federal regulations as reasons for the increases.
ACA enrollment has dropped compared to the same time last year, with sources reporting differing numbers.
Where accounts differ
One source reports that ACA enrollment fell by 2.6 million people in February compared with the same time last year. Another source reports a drop of about 3 million people for the same period. Additionally, sources differ on the primary reason for the enrollment decline: one notes that healthier enrollees left the Marketplace due to higher costs, while another reports that the Trump administration attributes much of the previous enrollment growth to fraud.
Not yet confirmed
The exact number of insurers requesting increases of more than 20% (reported as 20 insurers by one source). The specific percent of the increase attributed to subsidy expiration (reported as about 4 percentage points by one source). The impact of new federal regulations on rate changes (one source cites UnitedHealthcare's estimate of 12.7%). The extent to which artificial intelligence is used by hospitals and doctors to maximize billing (raised by one source).
Key figures
Cynthia Cox (senior vice president and director of the Program on the ACA at KFF), Kush Desai (White House spokesperson), Matthew Fiedler (senior fellow at the Brookings Institution).
Sources: stateline.org, statnews.com
