Health insurers filing 2027 Affordable Care Act Marketplace rates are proposing a median premium increase of 15 percent, according to an analysis of 276 insurers across all 50 states and the District of Columbia from the Peterson-KFF Health System Tracker. The increase follows the December 31, 2025 expiration of the enhanced premium tax credits that had capped enrollee costs for four years, a change insurers say pushed healthier customers out of the marketplace and left a costlier group behind. Insurers are now pricing 2027 plans on top of that thinner, sicker pool, adding roughly four percentage points to rates for morbidity alone. The filings are proposals only; states finalize rates in late summer.
The Subsidy Cliff Reshaping the Risk Pool
The enhanced premium tax credits were created under the American Rescue Plan Act in 2021, later extended through 2025 by the Inflation Reduction Act, and allowed millions of marketplace enrollees to pay a capped share of income toward their premiums regardless of how much a plan actually cost. When Congress let the credits lapse at the end of 2025 without extending them, the change did not just raise monthly bills; it changed who stayed enrolled in the first place. Younger and healthier customers, facing the steepest jump in net premiums, dropped coverage at far higher rates than older or sicker enrollees, who typically need the coverage regardless of price.
That shift showed up quickly in federal enrollment data. Marketplace plan sign-ups fell by more than a million people to 23.1 million during the 2026 open enrollment period, the sharpest single-year drop since the marketplaces launched in 2014. Consumers with incomes just above 400 percent of the poverty line, who lost eligibility for any subsidy once the enhanced credits expired, accounted for a disproportionate share of that decline even though they represented a small fraction of prior enrollment.
Insurers had already flagged this dynamic before it happened. Peterson-KFF’s review of early 2026 rate filings found that the anticipated expiration of the enhanced credits was adding roughly four percentage points to premiums on top of ordinary cost growth, as actuaries assumed healthier members would leave and drive up average claims per remaining enrollee. Kaiser Foundation Health Plan of the Mid-Atlantic States, in its District of Columbia filing for 2027, told regulators that the relative cost of new members entering the pool is expected to run lower than that of members who stay continuously enrolled, meaning the remaining pool gets costlier each year the pattern continues.
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A Median 15% Increase Across 276 Insurers
Building on that deteriorating risk pool, the 276 insurers Peterson-KFF tracked proposed a median 2027 rate increase of 15 percent, with individual filings ranging from a 1 percent decrease to a 54 percent jump. Fifty-one insurers requested increases above 25 percent, while 63 percent of filings clustered between 10 and 25 percent. The filings are proposals only; state insurance regulators will review and finalize actual 2027 rates in late summer, and the finalized number has historically landed higher than what insurers first request.
The dollar impact of two consecutive years of double-digit increases is concrete for individual households. Peterson-KFF calculated that a 40-year-old in Indianapolis earning $65,000 and enrolled in Anthem’s Heart Healthy Silver Essential 4500 plan paid $316 a month with enhanced credits in 2025, watched that payment climb to $477 in 2026 once the credits expired, and would pay $546 a month in 2027 if the proposed rate holds. That is a $158 increase in monthly payments, or 41 percent, over two years for someone who kept the exact same plan.
The increase is not isolated to net premiums. Average marketplace deductibles jumped 37 percent to a record $3,786 in 2026 as buyers shifted toward bronze plans with lower premiums and higher out-of-pocket costs, while the share of enrollees receiving any subsidy fell from 92 percent to 87 percent, the first such decline since 2020. Combined with rising 2027 premiums, that leaves a growing number of older marketplace enrollees paying more for coverage that pays for less before it starts covering costs.
Federal Rules Layered Onto the 2027 Filings
Several federal actions besides the credits’ expiration are shaping 2027 filings. The Department of Health and Human Services did not finalize its 2027 Notice of Benefit and Payment Parameters until May 15, 2026, after many insurers had already built their rate filings, forcing some plans to submit incomplete cost-sharing data and flag that final numbers could shift once guidance caught up. Coordinated Care Corporation, filing in Washington state, told regulators outright that its report’s accuracy could not be confirmed until the final rule’s provisions on de minimis actuarial-value ranges were locked in.
The Working Families Tax Cut Act, the budget reconciliation law also known as H.R. 1 that took effect in 2026, layered on additional eligibility restrictions insurers are now pricing into 2027. Enrollees who sign up outside a qualifying life event through a special enrollment period, along with low-income immigrants ineligible for Medicaid because of their immigration status, lost access to premium tax credits under the law. Mass General Brigham Health Plan, in its Massachusetts filing, told regulators the law is driving significant shifts in how families qualify for coverage and what they pay, on top of the enhanced credits’ expiration.
The overall trend leaves little room for relief before 2027 open enrollment begins. Peterson-KFF researchers Cynthia Cox, Matt McGough and their co-authors note that the double-digit increases proposed for two straight years would push typical marketplace premiums more than a third higher between 2025 and 2027 if the pattern holds, compounding a market that already lost millions of healthier, lower-cost enrollees. Because most marketplace shoppers still receive some subsidy, the size of any relief will depend on whether Congress revisits the credits before insurers lock in final 2027 rates this summer.
Premiums Rising on Both Sides of 65
Marketplace premiums are not the only side of the ledger climbing as insurers price in a sicker, smaller risk pool. Medicare enrollees carry a parallel version of the same math: Part B and Part D premiums move with projected program costs, and an income bump that pushes a household over an IRMAA threshold adds a separate surcharge that is not printed on the annual premium notice. Prior-authorization denials on the drug side add another cost households have to track and appeal on their own timeline.
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This article was researched and drafted with the assistance of AI and reviewed by The Money Overview editorial team.
