ACA Premium Hikes of 15% Loom for 2027 as Auto, Home Rates Cool

A second straight year of double-digit health insurance increases

People who buy their own health coverage under the Affordable Care Act are heading into another expensive year. Insurers selling Marketplace plans have asked for a median premium increase of about 15% for 2027. KFF's review of filings from all 50 states and Washington, D.C., produced that figure, and it follows a median finalized increase of 20% for 2026.2427 It would be the second double-digit increase in a row. Although the request is smaller than last year's, it is still the second-largest requested rate change since 2018.2426

As more filings came in, the estimate rose a little. KFF's first look in early July covered 77 insurers in 16 states and D.C. and found a median request of 14%.2123 By early August, with filings from every state included, the figure had reached 15%.28 A later count put the total at 276 insurers.30 The early sample showed requests ranging from 1% to 52%. Most fell between 10% and 20%, 20 insurers asked for more than 20%, and none asked to cut rates.2526

If requests of that size are approved, typical Marketplace premiums would rise by more than a third between 2025 and 2027.2126

The rest of the insurance market looks different. Auto and homeowners premiums rose sharply in recent years, but both are now slowing. Health coverage on the ACA exchanges is the clear exception in 2026, and federal policy is a big reason why.

Why ACA premiums keep rising

Insurers cite three groups of causes.

Medical costs. The first is the steady rise in medical spending. KFF found a median medical trend of 10% in the 2027 filings, meaning underlying costs for hospital stays, doctor visits and prescriptions were expected to grow about that much before any other factor.2425 The filings list general inflation, labor shortages, more severe claims, GLP-1 drugs, consolidation among providers and disputes under the No Surprises Act.25 NBC News also pointed to heavier use of expensive drugs, including GLP-1 weight-loss medications, as a cost driver for both insurers and employers.27

Expired subsidies and a sicker risk pool. The second cause is policy, and this is what sets the ACA market apart. The enhanced premium tax credits expired at the end of 2025. As a result, what enrollees actually paid in premiums rose 58% on average in 2026, and deductibles went up by about $1,000 per person.21 Enrollees earning 400% or more of the federal poverty level, which is $62,600 for a single person in 2026, lost their subsidies entirely and now pay the full price.21

Healthier people dropped coverage more readily, leaving a smaller and sicker group behind. Insurers estimate that this change in the risk pool added about four percentage points to 2026 premiums and will add about four more in 2027.21 Total individual-market enrollment fell from 25.2 million to 20.5 million between June 2025 and June 2026.30

The enrollment drop is not only about cost. Federal enforcement of eligibility rules also removed people from coverage, and the available data do not show how much of the decline came from each cause.30

Federal rule changes. The third cause is regulation. Insurers point to the latest Notice of Benefit and Payment Parameters, the Marketplace Integrity and Affordability Rule, and the law known as HR 1 as factors pushing premiums up.2125 Some told regulators that new enrollment and eligibility requirements from the Trump administration could change who stays in the market.23

The coverage broadly agrees on these causes but weighs them differently. Trade and policy outlets lead with the medical-cost trend.2526 Analysts focused on affordability put more weight on the subsidy expiration. Stacey Pogue of Georgetown University's Center on Health Insurance Reforms said the filings confirm what was expected: losing the enhanced credits would push healthy people out and leave a sicker population behind.23

The most reasonable reading is that medical inflation sets a high starting point and the subsidy cliff adds to it. Without the policy change, insurers would probably still be asking for increases near the 10% medical trend. The deteriorating risk pool is what moves many filings well above that.

Who pays the higher prices

The 15% figure overstates what most enrollees will pay. Most still qualify for subsidies, now at the smaller pre-enhancement levels, and those subsidies absorb much of any increase in the sticker price.2123 For 2027, subsidized enrollees will be expected to pay between 2.15% and 10.22% of household income for the benchmark plan, up slightly from 2.1% to 9.96% in 2026.22

Middle-income buyers above the subsidy cutoff pay the full increase. KFF gave the example of a 40-year-old in Indianapolis earning $65,000. That person's monthly premium payment could go from $316 in 2025 to $546 in 2027 if the proposed rates are approved.26 Pogue said this group took a "double whammy," since some of them saw premiums double or triple in 2026 even before the next increase.23

Local reporting shows the human side. In Iowa, an Ankeny mother of three told the Iowa Capital Dispatch that her Wellmark premium rose 17% in 2026 and that she had received notice of a proposed 5% increase for 2027.29 A retired health administrator in Norwalk expected to add about $500 to her yearly budget.29

Final rates differ widely by state

The proposals are only a starting point. State regulators review most filings, and the results so far vary a lot.22 As of mid-October, about two-thirds of states had finalized rates. The weighted average increase was still about 15%.22

• New York cut insurers' average request of 20.6% to an approved 6%.22
• New Mexico approved 24.4%, close to the 25.6% insurers had requested.22
• Pennsylvania ended at 16%, revised from an initial 17.1% request.22
• Across states, finalized or proposed increases range from 3% in Vermont to about 25% in Alabama.22

One expert warned against expecting regulators to lower the national total. Adam Block of New York Medical College told Forbes Advisor that, based on past years, final rates are more likely to come in a few points above early projections.28 Last year supports him: the median proposal for 2026 was 18%, and the median approved increase was 20%.2528

New York shows that strong state review can reduce increases, but the overall direction is up.

Auto insurance: back to small increases

Car insurance has moved the other way. After the steep increases earlier in the decade, prices are close to flat. Insurify says the national average for full coverage rose 1% in the first half of 2026 to $2,237 a year. It expects the year to end at $2,242, up 1% after a 6% drop in 2025.1118

Forecasts differ on the size of the increase. ValuePenguin projected 0.67%, the smallest since 2022.1316 Other forecasters put national growth closer to 4%.1219 All of them describe a much slower pace than the early-2020s increases.

More states are seeing increases, though. Rates rose in 27 states during the first half of 2026, compared with just nine in the second half of 2025. Insurify expects increases in 32 states by year-end, led by Connecticut at about 15%.1118 Washington, D.C., New Jersey and New York all saw prices fall at least 5% over the same period.11 Possible tariffs on auto parts are the main risk to the outlook. One analysis estimated that a sustained 25% tariff could add about 7% to premiums.17

Home insurance: still rising, but more slowly

Homeowners insurance is somewhere in between. Insurify projects a 4% national increase in 2026, to about $3,057, after a 12% increase in 2025. That would be the fifth straight annual increase, with premiums up about 46% since 2021.17 Cotality forecasts 8% increases in both 2026 and 2027.910 NerdWallet measured 4.6% growth from early 2025 to early 2026. It also found that the median rate change insurers requested in 2026 filings was just 1%, which suggests some carriers are slowing increases to win customers.4

Some markets are still under heavy pressure. Insurify expects California premiums to rise 16% after the Los Angeles wildfires.13 California's FAIR Plan, the state's insurer of last resort, put in place a 29.1% average rate increase on October 15.5 Midwestern homeowners saw premiums rise 25% over three years after repeated wind and hail losses.4 Cheaper reinsurance, meaning the insurance that insurers buy for themselves, and AM Best's upgrade of the homeowners market outlook to stable explain why most forecasters expect further slowing.56

What it means

Auto and home insurers raised prices sharply to catch up with inflation and disaster losses, and they are now easing off. ACA premiums are moving the other way, and policy choices are a large part of the reason.

The filings point to a self-reinforcing cycle. Higher prices push healthier people out, the remaining pool gets sicker, and insurers raise rates again. One analysis described this as a risk, not a certainty.30 One policy analyst warned that further increases could come in 2028.29 KFF's Matthew Rae noted high projected increases for small-group employer plans as well, which could lead some small firms to drop coverage.24 KFF expects similar cost pressures to affect employer-sponsored plans more broadly.23

The timing is also political. The increases arrive with the November midterms close, while voters already worry about affordability and no broad health-care legislation has enough support to pass.2324 The rates set for the fall open-enrollment window will show what this year's policy decisions cost Marketplace households.