ACA Premiums Rise 13% for 2027 as Subsidy Loss Shrinks Marketplace

A second double-digit year

Open enrollment for 2027 Affordable Care Act coverage starts November 1 in most states, and shoppers are again facing large price increases. In their rate filings, insurers proposed a median premium increase of 15%. Once rates were finalized, the average benchmark silver premium rose 13%. That follows a 26% jump from 2025 to 2026, so this is the second straight year of double-digit increases.12 Combined, KFF calculates that benchmark silver premiums rose about 42% on average between 2025 and 2027.12

The Washington Post gave one example of what that looks like for a household. A 40-year-old in Arizona earning $65,000 could see a Blue Cross Blue Shield marketplace premium go from $300 a month in 2025 to $555 in 2027.20 Arizona sits at the top of the state rankings, with approved increases near 28%. Vermont is at the bottom, at roughly 3%.19

People who don't get coverage through an employer are hit hardest. That includes self-employed workers and employees of small businesses.20 The jump comes as auto insurance prices have largely stopped climbing and home insurance increases have slowed. Health coverage is now the part of household insurance spending that is still rising fastest.

Why prices keep climbing

Most of the coverage agrees on the causes. The Center on Budget and Policy Priorities says insurers attribute about 10 percentage points of the proposed 15% increase to rising medical costs. They attribute about 4 points to fallout from the expiration of the enhanced premium tax credits.14 KFF's review of insurer filings found the same pattern. Changes in who is enrolled added about four points to premiums in 2026, and insurers expect a similar added effect in 2027.12 Insurers also cite inflation, shortages of medical workers and higher prices for medical services.7 KFF notes that cost growth is not limited to the marketplaces, since some employer plans have also seen steep increases.12

The enrollment effect works like this. When prices rise, younger and healthier people are more likely to drop coverage, which leaves a sicker and more expensive group behind. Georgetown researcher Stacey Pogue describes that shift as a direct driver of higher premiums.11 Political scientist Simon Haeder puts it more bluntly: people with serious conditions such as diabetes or cancer will keep paying, while healthier people leave.17

The 2026 enrollment data show this happening. Young adults ages 18 to 34 made up 46% of the drop in sign-ups. People earning above the subsidy cutoff made up just 7% of 2025 enrollment but nearly half of the decline.2

In this reading, 2027 is not a temporary spike. It is the second year of a cycle in which each price increase pushes out healthier customers and sets up the next increase. KFF warns that the 2027 increases could lead still more healthy enrollees to leave.12

How many people have left

The size of the drop depends on what is being counted, and different outlets use different numbers.

• Marketplace enrollees who paid premiums: KFF reports 19.2 million in February 2026, down 12% or 2.6 million from a year earlier.12
• Other versions of the same comparison: Some coverage measures from a 2025 peak of 22.1 million and reports a loss of about 2.9 million.8 AARP and the Associated Press round the drop to about 3 million.115
• The broader individual market, which also includes plans bought directly from insurers: enrollment fell 18%, from 25.2 million in June 2025 to 20.5 million in June 2026, a loss of more than 4.6 million.3

The projections for what comes next differ more. In May, KFF projected that average paid marketplace enrollment for 2026 could fall to about 17.5 million.2 The Congressional Budget Office's latest estimate goes much further, with marketplace enrollment falling from a 2025 peak of 22.4 million to 13.1 million in 2027.12

The reports also disagree about why people left. The Trump administration credits its anti-fraud efforts. KFF links the drop mainly to the expired subsidies, and no published figure separates the two effects.8 One analysis notes that federal enforcement ended subsidies or coverage for nearly 1.5 million HealthCare.gov enrollees in 2025. It argues that blaming the full decline on prices would overstate the subsidy effect.7

That is a fair caution. Still, the pattern of who left points mainly to cost. Losses were concentrated among people above the income cutoff and among young adults. And New Mexico, which fully replaced the lost federal help with state money, was the only state where enrollment did not fall.12

Who pays more

The sticker price is not what most enrollees pay. Subsidies are tied to the benchmark silver plan, the second-cheapest silver plan in an area, so when that plan gets more expensive, subsidies grow too.15 Last year the subsidy formula itself changed. This year it doesn't, so CBPP expects subsidized enrollees to see smaller increases in what they actually pay than they saw going into 2026.14 Louise Norris of HealthInsurance.org says people who could afford their coverage this year will probably find 2027 costs about the same.15

That cushion has limits. When the enhanced credits expired, KFF found that what enrollees actually paid each month rose 58% on average, from $113 to $178.2 Average deductibles rose 37%, from $2,759 to $3,786, as people moved from silver plans to cheaper bronze plans that require more spending before coverage starts.2

The old income cutoff is also back. Households earning more than 400% of the federal poverty level get no subsidy and pay the full premium.12 For this enrollment season, that cutoff is $63,840 for a single person and $109,280 for a family of three.15 Community Catalyst estimates the 15% increase will cost the average person without a tax credit about $1,300 more a year.16

Older adults not yet eligible for Medicare face the steepest bills. Insurers can charge them up to three times what younger adults pay. They are also less likely to qualify for the remaining subsidies, because they tend to earn more.11

There are other new costs. The cap on out-of-pocket spending is rising 13%, to $12,000 for an individual and $24,000 for a family.15 Starting with the 2026 tax year, the 2025 budget law also removed the limit on how much enrollees must repay if they received too much in tax credits. Because those 2026 tax returns won't be filed until early 2027, people will pick their plans before seeing how the change plays out.12

Insurers leave, and Washington doesn't act

Shoppers will also have fewer insurers to choose from. Eleven insurers plan to leave some state marketplaces in 2027.13 Cigna is leaving the individual market in all 11 states where it sells plans.12 HealthInsurance.org's count has insurers exiting in more than 20 states.19 KFF counts seven carriers entering new state marketplaces.17 Overall, KFF says insurer exits outnumber new entrants.12

Congress has not brought the subsidies back. The House passed a three-year extension 230–196 in January 2026, but the Senate version did not get the 60 votes it needed.9 Republicans who blocked an extension late last year argued the credits were so generous that insurers could charge more and that they encouraged fraudulent sign-ups.1

The administration's main direct help has been a one-time $500 payment to a small group of enrollees. CBPP says that will do little to offset the coverage losses.14 CBPP also expects more sales of short-term plans and other limited coverage that can exclude or charge more for people with pre-existing conditions.14

Some states are stepping in. Virginia is starting a state premium program for households between 138% and 250% of the poverty level. Rhode Island has set aside $19 million to replace part of the lost federal help.19 These efforts may matter. In the first year without the enhanced credits, states with their own subsidies and strong outreach kept more of their enrollees.2

Auto and home insurance are cooling

Health coverage is now moving in the opposite direction from other household insurance. NerdWallet found that auto premiums rose 32.3% from January 2023 to January 2026, but only 2.6% in the most recent year.22 The median rate change auto insurers filed from January 2025 through mid-August 2026 was 0%.22 Beinsure projects an average increase of about 1% for 2026, with more than half of states possibly seeing decreases.26

Some measures show auto prices turning up again. Insurify reports that full-coverage premiums rose 1% in the first half of 2026 and expects 32 states to end the year with increases. Connecticut leads its projections at 15%.29

Home insurance looks similar. NerdWallet puts the three-year increase at 24% but the latest annual increase at just 4.6%. The median rate change insurers requested in 2026 filings was 1%.21 Insurify projects a 4% national increase, the fifth straight year of hikes.

In places with heavy storm losses, though, insurers are still paying out more than they collect. State Farm is raising Illinois homeowners rates about 8%. It says it has paid $1.22 in claims and expenses for every $1 in premiums there over three years.28 In Texas, the state announced that home rates are falling. But State Farm Lloyds' filing raises premiums for 751,000 policyholders and cuts them for 234,000.25

The takeaway

Auto and home insurance increases come mostly from repair costs, weather and claims, and those pressures move in cycles. Insurers can recover once their losses ease, and the latest filings suggest that is happening. The ACA's second year of double-digit increases is different, because a policy choice is driving part of it. Enrollment losses are shrinking the customer base and making the remaining group sicker, and insurers expect that effect to keep adding to rates.12

Unless Congress restores the enhanced credits or more states replace them, rising prices, fewer enrollees and fewer insurers will likely keep pushing premiums up. For shoppers, KFF and others offer simple advice: review the options in the marketplace instead of relying on the renewal notice. The premiums and subsidies they're actually offered may differ from what the letters say.13