Obamacare Premiums Rise 13% for 2027 as Insurers Exit Markets

A second straight year of double-digit increases

Open enrollment for Affordable Care Act marketplace plans began November 1 in most states. People shopping for 2027 coverage are again facing much higher prices. KFF found that finalized premiums for benchmark silver plans are rising 13% on average for 2027. That follows a 26% increase from 2025 to 2026, and the two years together add up to roughly a 42% rise1. Insurers had originally asked for a median increase of 15% across 276 carriers12. That makes this the second year in a row of double-digit requests, and the second-highest requested rate change since 201816.

The headline number changes with the measure being used, and that has shaped how the story has been told. One report based on federal documents said the most popular plans sold on HealthCare.gov will rise 11%, compared with 30% last year. It presented this as a sign that the federal marketplaces are steadier20. KFF's numbers show the split. Benchmark premiums are up 11% in the states that use HealthCare.gov, but 16% in states that run their own exchanges1. A Peterson-KFF tracker report put the two-year increase at about 33%, using proposed rates18. KFF's 42% figure uses finalized benchmark premiums1. All of these numbers support the same conclusion: two years of large increases with no clear sign of relief.

The increases also vary widely by state. Vermont's finalized increase is 3%. Arizona's weighted average request is close to 28% to 29%24. In ten states, including New Mexico, Kansas, Alaska, Montana, Washington, South Carolina, Mississippi and Wisconsin, full-price premiums are rising between 21.7% and 27.9%17. Washington's insurance commissioner approved an average increase of 22.2% for its exchange market17. In New York, regulators approved less than a third of the 20.6% that insurers had asked for17.

Why insurers say they need more money

The reporting agrees on two main causes. The first is the general rise in medical costs. KFF found that the median increase in the underlying cost of hospital stays, physician visits and prescription drugs was 10% for 202716. Insurers' filings point to higher provider prices, more expensive drugs, heavier use of services, staff shortages and general inflation5. Analysts have also named consolidation among hospitals and medical practices, along with GLP-1 weight-loss drugs129. These pressures affect more than the ACA market. WTW expects employer health costs to rise 11.1% next year, the largest jump in more than 20 years12.

The second cause comes from federal policy decisions. Enhanced premium tax credits ran from 2021 to 2025 and pushed enrollment to record highs. Congress let them expire at the end of 20255. Many insurer filings name that expiration, and the falling enrollment that followed, as reasons for higher 2027 rates on top of the 2026 increases5. KFF's review of filings found that insurers believe changes in who stays enrolled added about four percentage points to premiums in 2026. They expect about the same additional effect in 20271.

The reason is that the people who leave tend to be younger and healthier. The people who stay are more likely to need care, so insurers expect to pay more in claims per member312. In practice, insurers are raising prices because they expect higher claims costs. Those higher prices then push out more healthy customers, and KFF warns that this cycle could put still more upward pressure on premiums1.

Who actually pays the increase

The sticker price is not what most enrollees pay. Subsidies are tied to the benchmark silver plan, so they grow when that plan's premium rises. Many subsidized enrollees will be fully or partly protected4. At the start of 2026, 87% of marketplace enrollees received premium subsidies4. CMS says more than 75% of HealthCare.gov shoppers can find a plan costing $50 a month or less after tax credits15. Those low-premium plans, however, often have the highest deductibles15.

People who earn too much to qualify pay the full increase. For 2027 the cutoff is $63,840 for a single person and $132,000 for a family of four5. A 40-year-old without subsidies buying a bronze plan has seen the monthly premium go from $381 in 2025 to $511 in 2027, an increase of 34%2. Older adults not yet eligible for Medicare are especially exposed. Insurers can charge them up to three times what younger adults pay, and they are less likely to qualify for the subsidies that remain3. One Colorado couple saw their monthly premium go from just over $900 to about $2,300 this year and had to draw on retirement savings7.

Even before the 2027 increases, KFF found that what ACA enrollees actually paid had risen 58% on average, from $113 to $178 a month in 2026. Average deductibles reached a record $3,78612. The federal cap on out-of-pocket costs is also rising, from $10,600 per person in 2026 to $12,000 in 202715. Taken together, this shows a market where many people can still find a low monthly premium but carry more of the cost when they get sick. Commonwealth Fund analysts warn that this trend could leave more enrollees underinsured and at risk of medical debt5.

A thinning market

The marketplace is also losing insurers. NBC News counts 11 insurers leaving some state marketplaces for 20277. The Commonwealth Fund named at least seven, including Cigna, CareSource, Medica and Providence Health Plan, whose exits will force people in 20 states to choose new plans5. Cigna is leaving the individual market in all 11 states where it sells coverage1. Its CEO called it a small business that has been shrinking2. HealthCare.gov will have 152 insurers in 2027, 14% fewer than this year, although the typical enrollee will still be able to choose from five or six20.

Enrollment has already dropped. Paid marketplace enrollment fell 12%, or 2.6 million people, to 19.2 million by February 2026. The wider individual market lost more than 4.6 million people by June1. The Congressional Budget Office expects marketplace enrollment to fall from a peak of 22.4 million in 2025 to 13.1 million in 20271. Other changes will push enrollment down further. These include new limits on tax credits for some lawfully present immigrants, anti-fraud efforts that have already removed enrollees, a pause on registering new brokers until February 2027, and the end of caps on how much excess tax credit people must repay1910.

Outlets describe this differently. The CMS fact sheet says HealthCare.gov users will have strong access to low-cost plans6. Advocates and some analysts argue that federal policy has made coverage less affordable5. One researcher told NBC that the law could be weakened without ever being repealed7. The evidence supports the more worried view. Subsidies still protect most enrollees from sticker prices, but a shrinking, sicker and less competitive market is the condition that has historically pushed premiums higher.

Auto and home insurance are moving the other way

The ACA increases stand out because other kinds of insurance appear to be leveling off. NerdWallet found that median auto premiums rose 32.3% from January 2023 to January 2026, to $2,359 a year, much faster than incomes grew. The increase in the latest year, however, was only 2.6%21. The median filed auto rate change from January 2025 through mid-August 2026 was 0%. GEICO's median filing was a 1.2% cut21. Beinsure projects a national average auto increase of about 1% in 2026, with more than half of states possibly seeing rates fall. New Jersey, at 10.46%, is an exception. Large auto insurers are still reporting high claim costs, which could limit further relief.

Home insurance shows a similar pattern. Typical premiums rose 24% over three years to $2,564, but only 4.6% in the most recent year. Rates fell in 18 states and Washington, D.C.22. The Midwest has been hit hardest after years of wind and hail claims, with Wisconsin up 40.9%22. Filing a single claim can raise a homeowner's rate by as much as 36%22.

Texas shows how official claims of relief can be misleading. Regulators said homeowners rate filings averaged a 4.3% decrease affecting about 700,000 policyholders24. Reporting by ABC13 found that the average was not weighted by the number of policyholders. It also found that State Farm Lloyds filed a 4% increase that reaches more homeowners than all the announced cuts combined, and that more auto filings were increases than decreases27.

The takeaway

In property and auto insurance, prices are easing because claims costs and weather losses are no longer rising as fast. In the ACA market, the opposite is happening. The pool of insured people is getting sicker and smaller, so expected claims per member are going up, on top of medical inflation that is affecting all health coverage. Unless Congress restores the enhanced subsidies, which AARP and other groups are calling for, filings for 2028 are likely to cite the same causes again3.