ACA Premiums 2027: Benchmark Plans Rise 13% After a 26% Jump in 2026

A second straight year of double-digit increases

Open enrollment for 2027 Affordable Care Act coverage started on November 1 in most states. Shoppers will again find much higher prices on the marketplaces. KFF's analysis of finalized rates shows the average benchmark silver premium rising 13% for 2027, after a 26% jump from 2025 to 2026.13 Together, the two increases put benchmark silver premiums about 42% higher on average than in 2025.13

This is a different pattern from the years just before. The Commonwealth Fund notes that benchmark premiums grew only about 2% a year over the previous five years. It describes the current back-to-back double-digit increases as the largest the marketplace has seen since 2018.11 For 2026, the Fund puts the average pre-subsidy benchmark premium at $625 a month, up from $497 in 2025.11

The figures for 2027 vary depending on what is being measured. KFF and the Peterson Center on Healthcare reviewed filings from 276 insurers and found a median proposed increase of 15%. Individual requests ranged from a 1% cut to a 54% increase, and 51 insurers asked for more than 25%.1 Families USA weights each state's increase by enrollment and puts the average requested increase at 15.6%. It counts the 2026 increase as 25.5%.2 The finalized benchmark figure of 13% is lower than the proposals because regulators review insurers' requests, and because the benchmark silver plan is a different measure from an insurer's average across all of its plans.131 The figures don't actually conflict. A 13% to 15.6% increase on top of a 20%-plus increase is a heavy burden under any of these measures.

Where people live makes a large difference. Benchmark premiums are rising about 11% in states that use HealthCare.gov and about 16% in states that run their own exchanges. That reverses the 2026 pattern, when HealthCare.gov states saw a 30% increase compared with roughly 17% in state-run markets.13 Proposed average increases range from about 3% in Vermont to nearly 28% in Arizona.16

Why prices keep climbing: medical costs, then policy

The main analyses broadly agree on what is driving the increases. They differ on which cause matters most.

KFF's review of the detailed filings finds that underlying health care prices are still the largest driver. The median medical trend, meaning the expected growth in what insurers pay for care and drugs, is 10% for 2027.1 That is higher than the roughly 8% average of recent years.5 Insurers point to higher provider contract rates, general inflation, health care worker shortages, more complex and costly claims, GLP-1 drugs, and the payment-dispute process under the No Surprises Act. KFF reports that providers have started most of those disputes and won most of them.1 KFF's Cynthia Cox also cites hospital market concentration as a main cause.14 These pressures affect more than the ACA market. Forbes reports that employer health benefit costs are expected to rise 8.2%, the fastest increase since 2003.10

The rest of the increase comes from Washington, and it applies only to the individual market. Congress let the enhanced premium tax credits expire at the end of 2025. As coverage became more expensive, healthier people dropped out, leaving a sicker and more costly group of enrollees.1 Insurers estimated that this shift added about four percentage points to 2026 premiums. They expect roughly the same additional effect in 2027, layered on top of the 2026 increase.113 Some insurers are more specific. UnitedHealthcare of New York said the end of the expanded subsidies and the Marketplace Integrity and Affordability rule together account for 12.7% of its requested increase.1

The analyses frame this differently. KFF names medical prices as the main driver and policy as an added factor.4 The Commonwealth Fund and Georgetown's Center on Health Insurance Reforms argue that the filings show federal policy changes are themselves a significant cause of the increases.1112 Families USA goes furthest. It describes the increases as the direct result of a coordinated effort by congressional Republicans and the Trump administration to make coverage harder to afford and keep.2

Our reading is that medical inflation is the baseline cost pressure, and federal policy has made it worse for marketplace buyers. A 10% medical trend alone would not produce a cumulative increase of about 40% over two years. Policy changes that shrink and weaken the pool of enrollees are what turn a difficult year into two very costly ones.

Who bears the cost

Most enrollees are still largely protected. In 2026, 87% of marketplace enrollees received a subsidy. The subsidy is tied to the benchmark plan, so it rises when that plan's premium rises.12 The people hit hardest are those just over the subsidy cutoff of 400% of the federal poverty level. During this enrollment season, that is $63,840 for one person and $132,000 for a family of four.1110

The published examples show how large the increases are for this group:

• Commonwealth Fund: A 40-year-old just over the cutoff who paid $445 a month after subsidies in 2025 could pay $719 a month in 2027.11
• KFF: A 40-year-old non-smoker without subsidies who buys a bronze plan goes from $381 a month in 2025 to $511 in 2027, a 34% increase.16
• Peterson-KFF tracker: Another scenario reaches $546 a month in 2027, an increase of $158, or 41%, over two years.1

It is not only premiums. The annual out-of-pocket maximum for marketplace plans rises from $10,600 to $12,000 for an individual and to $24,000 for a family.20 Under the 2025 budget reconciliation law, enrollees who receive more advance tax credits than they qualify for now have to repay the full excess, with no cap. The first tax returns filed under that rule are due in early 2027, so people choosing 2027 plans have not yet seen how it works in practice.13 Analysts expect more enrollees to move to bronze plans, which have lower premiums but higher deductibles. That could leave more people underinsured.1119

A shrinking market with fewer insurers

The coverage describes a market that is getting smaller. Plan selections fell by 1.2 million in the 2026 open enrollment period.15 The Commonwealth Fund cites projections that 2026 enrollment will fall by 17% to 26%.11 At least seven insurers are leaving the marketplace for 2027: Baylor Scott & White, CareSource, Cigna, Medica, Mending, PacificSource, and Providence. Their customers in 20 states will have to choose new plans.11 Cigna is leaving the individual market in all 11 of its states.13 Analysts link reduced competition to higher premiums.11

Enrollment is also getting harder administratively:

• Immigrant eligibility: New rules will end premium tax credits for some lawfully present immigrants. The Congressional Budget Office estimates this could leave about 1 million more people uninsured by 2035.19
• Broker moratorium: Brokers who were not registered with the federal marketplace in 2026 cannot help with 2027 enrollment until February at the earliest.18
• Identity checks: Consumers classified as high-risk must verify their own identity before authorizing an agent.18
• Enrollee removals: In September, Vice President JD Vance and other administration officials announced plans to remove 760,000 enrollees they say were fraudulently enrolled or did not exist.15

The courts have reversed part of this. A federal judge in Maryland paused eight provisions of the 2027 Notice of Benefit and Payment Parameters, finding that HHS had either exceeded its authority or not justified the changes.17 The paused provisions include a change that would have allowed some bronze plans to exceed the statutory out-of-pocket cap, and an income-based expansion of catastrophic plans.17 Some insurers had already set their 2027 rates before that rule was finalized and said the late timing made pricing uncertain.1 The court ruling adds more uncertainty for a market that is already unstable.

Some states have stepped in. New Mexico fully replaced the lost federal assistance for 2026 and was the exception to the national trend, with marketplace enrollment growing.13

Health insurance is moving opposite to auto and home

Put alongside other household insurance, the ACA picture stands out. Auto and home insurance went through steep increases and are now cooling.

The motor vehicle insurance index in the Consumer Price Index was 5.13% lower in August 2026 than a year earlier.24 LexisNexis Risk Solutions found that 35% of auto rate filings in early 2026 were cuts, slightly fewer than the 39% that were increases.24 Industry forecasts show personal auto net written premiums falling 0.6% in 2026. They show homeowners premium growth slowing to 6.4%, the slowest pace since 2020.26 In Texas, homeowners rate filings since July have averaged a 4.3% decrease, and auto rate cuts affect 4.4 million policyholders.25 Florida's insurance regulator has approved homeowners rate cuts and expects bigger cuts going into 2027.24

The cooling is uneven. Insurify still projects auto rate increases in 32 states by the end of the year.24 Home insurance remains very expensive where disaster risk is high. In Florida, the average annual premium is $9,449.21

The broader pattern is still clear. Property and casualty prices follow an underwriting cycle, and that cycle is easing as insurers' losses improve. ACA marketplace prices respond to medical inflation and to federal decisions about who qualifies for help. In 2026 and 2027, those decisions have pushed premiums up. For households that buy their own health coverage, any relief from cheaper car or home insurance will be small compared with what they are paying for health insurance.