Americans who are already feeling the pinch of Affordable Care Act health insurance costs are unlikely to catch a break next year. A new analysis reveals that insurers participating in the ACA marketplace are pushing for a second consecutive year of double-digit premium increases.
The healthcare research nonprofit KFF released its findings Wednesday, examining rate filings submitted by 77 insurers in the ACA program that are currently available to the public. The data shows a median proposed premium increase of 14% for 2027. Insurers pointed to climbing healthcare costs, changes in federal regulations, and the recent end of pandemic-era enhanced subsidies as the primary reasons behind the proposed hikes.
These proposed increases build on what was already a major jump in 2026, when the median rate increase hit 20%, according to KFF. While many ACA enrollees still receive subsidies that shield them from paying full premium costs, middle-class Americans earning 400% of the federal poverty level or above are expected to feel the sharpest financial impact.
The premium increases are unfolding as federal lawmakers debate various proposals to reshape the nation’s costly healthcare system, though no sweeping legislation has gathered enough support to move forward. Rising healthcare costs are adding fuel to broader concerns Americans already have about affordability — an issue that many voters say is top of mind as November’s midterm elections approach.
Each year, health insurers are required to submit filings to regulators outlining anticipated premium changes for individual market plans in the coming year. Final rates for 2027 will be set later this summer, but KFF’s analysis examined publicly available filings across 16 states and Washington, D.C., to offer an early look at the direction premiums are heading. The review covered all plan tiers — bronze, silver, gold, and platinum.
According to the analysis, insurers identified rising costs throughout the healthcare sector — including hospital care, prescription medications, staffing, and a sicker patient population — as the leading drivers of premium growth. Broad economic inflation also contributed, pushing prices upward across the board.
Insurers also cited the January expiration of federal tax credits that had previously helped offset costs for many enrollees and fueled significant growth in ACA participation in recent years. When those enhanced subsidies ended, plan costs shot up for many people, prompting a large number of enrollees to leave the marketplace. That exodus left behind a higher-risk, sicker patient pool, which in turn pushed premiums even higher.
New data released by the Trump administration shows the overall ACA marketplace lost more than 2.5 million enrollees over the past year, with certain states experiencing drops of nearly one-third of their enrolled population.
Some insurers also noted that new enrollment and eligibility rules put in place by the Trump administration played a role in their requests for higher premiums, as those changes could affect the makeup of the ACA enrollee population going forward.
Although ACA enrollees represent less than 10% of the overall population, KFF’s analysis noted that similar cost pressures are likely to make other types of private insurance — including employer-sponsored coverage — more expensive as well.
Georgetown University’s Center on Health Insurance Reforms also released its own review of early ACA insurer rate filings last month, similarly projecting double-digit premium increases in the marketplace for next year.
Stacey Pogue, a senior research fellow at the center and author of that report, said the people hit hardest by rising premiums will be those who don’t qualify for financial assistance. She noted that those individuals already experienced the most dramatic cost increases in 2026, with some premiums doubling or even tripling.
“Those are the folks who kind of got a double whammy” this year, she said.
Pogue said the rate filings are confirming what many analysts had anticipated — that the end of enhanced tax credits would push healthier Americans out of the marketplace, leaving behind a population with greater healthcare needs.
“When the healthy people leave, the prices go up,” she said. “The analysts all predicted that, and now that’s what we’re seeing.”
