Millions of Americans relying on the Affordable Care Act (ACA) marketplaces are expected to face another significant rise in health insurance premiums in 2027, continuing a trend that has already pushed many to drop coverage. According to an analysis by the health research group KFF, average premiums will increase by 13 percent next year.
This latest premium hike stems primarily from rising medical costs nationwide, including higher hospital prices, increased payments linked to consumer protection laws affecting physician compensation, and expanding use of artificial intelligence in healthcare settings. Specialty prescription drug expenses have also contributed to overall cost growth, according to industry analysts and benefits consultants.
The Trump administration released 2027 premium data on Friday for 30 states where the federal government manages ACA marketplaces. Incorporating state-reported figures, KFF calculated the national average increase. The premium adjustments for ACA plans slightly exceed those projected for employer-sponsored insurance and federal employee plans, which are expected to rise by roughly 10 percent in 2027.
Many consumers are feeling the financial strain. Kate and Mark Dwyer, a couple in rural Oregon, shared that their least expensive ACA plan next year will cost nearly $3,000 in premiums — more than a third of Ms. Dwyer’s nonprofit salary — representing an increase of over $500 per month from current costs. The Dwyers have already moved to the most affordable coverage option but face substantial out-of-pocket expenses and are considering going without insurance entirely.
While the federal government provided one-time $500 payments to many ACA enrollees ahead of the 2020 election to alleviate costs, ongoing affordability remains a challenge, particularly for those without income-based subsidies. The subsidies remain available for most participants earning under $64,000 annually and are expected to cover the bulk of premium increases for these individuals. However, many households with tight budgets are struggling to manage their share of rising costs and have shifted to plans with higher deductibles—the average deductible for bronze plans reached nearly $4,000 in 2026.
The expiration of enhanced temporary subsidies in 2026, a result of Republican-led congressional action, contributed to a previous average premium increase of 26 percent that year and a decline in enrollment by an estimated five million individuals as of June. Government officials note efforts to curb fraudulent enrollment may have influenced the enrollment drop, but recent survey data from the Commonwealth Fund indicates a rise in the uninsured rate among working-age adults, suggesting some formerly insured individuals remain without coverage.
Democrats have pledged to seek restoration of extra subsidies early in the next congressional term if they secure the majority in upcoming midterm elections. In the meantime, experts urge eligible consumers to actively compare plans during the enrollment period, which runs from November 1 through January 15, as individual renewal increases could exceed the average jump.
Caroline Pearson, executive director of the Peterson Center on Healthcare, described the forthcoming increases as consistent with broader trends in the insurance market. Anthony Wright of Families USA emphasized the importance of shopping among available plans to mitigate financial impact.
As premium prices climb, millions of Americans navigating the ACA marketplace face difficult decisions about maintaining coverage amid rising healthcare costs and evolving policy landscapes.