ACA premiums to rise 13% as 19.2 million shoppers face higher costs
The 2027 open enrollment period begins with a projected 13% price hike and fewer subsidy options for millions of Americans.
By Sanjay Caldwell ·
Average health insurance premiums on the Affordable Care Act marketplaces are expected to jump 13% in 2027, according to a new analysis by the healthcare research nonprofit KFF. This sharp increase comes as the annual sign-up window opens for millions of Americans who must secure coverage for the coming year.
The enrollment period started Sunday in most states and runs through January 15. KFF’s analysis of new data from the Centers for Medicare & Medicaid Services shows that prices for marketplace plans will climb across the board. This rise follows a period of stability where pandemic-era subsidies kept costs lower for many enrollees.
Cynthia Cox, a vice president at KFF, explained that rising healthcare costs and hospital market concentration drive the price increase. She noted that the No Surprises Act, which took effect in 2022, and the growing availability of GLP-1 drugs also contribute to higher baseline costs. These factors push up the price of plans even before considering changes to financial assistance.
Financial support for consumers has also changed. Premium tax credits and cost-sharing reductions are now restricted for groups of people who previously qualified for full aid. This shift leaves many individuals without the subsidies that previously offset a large portion of their monthly bills. As a result, the number of people able to afford coverage may shrink.
Those most affected by the new rates are individuals who do not qualify for a subsidy. Cox observed that many of these consumers have already moved into bronze plans, which are the cheapest options available. She warned that some may struggle to afford coverage into next year, potentially leading to a drop in enrollment numbers beyond the 1.2 million people who already left the exchanges after Republicans opposed extending pandemic-era subsidies.
As of February, approximately 19.2 million people were actively enrolled in ACA marketplace health plans, according to the Department of Health and Human Services. That total grew during the pandemic when enhanced subsidies were available. New regulations taking effect in 2027 will limit tax credits for certain lawfully present immigrants, which could leave an additional 1 million individuals uninsured over time.
The Trump administration is also removing enrollees from the program as part of an effort to combat what it calls waste, fraud, and abuse. In September, Vice President JD Vance announced plans to remove 760,000 ACA enrollees who were alleged to be fraudulently enrolled or non-existent. Vance stated that this action would save the government $2.2 billion in subsidy payments.
A CMS fact sheet distributed this Friday claims that Americans using HealthCare.gov will have strong access to low-cost plans. However, Cox predicted that fewer people will be enrolled in the market in 2027 due to higher premiums, immigration eligibility changes, and anti-fraud efforts. She noted that it will be difficult to understand the specific reasons for the decline in enrollment numbers.
