Health insurance could become more expensive again in 2027. Preliminary ACA Marketplace filings analyzed by KFF show insurers requesting a median premium increase of approximately 14 percent for 2027.
The analysis included 77 insurers across 16 states and Washington, D.C. Most insurers requested increases between 10 and 20 percent, while 20 insurers requested increases exceeding 20 percent.
These requests are not final.
State regulators may approve smaller increases, negotiate changes or reject parts of a filing. Individual consumers will also experience different results based on their state, age, plan, household income and premium tax credit.
However, the filings provide an early warning. Health insurance costs are still moving in the wrong direction.
2027 could be the second consecutive year of large increases
KFF estimates that if the preliminary 2027 requests are approved, typical Marketplace premiums could increase by more than one-third between 2025 and 2027.
That does not mean every enrollee's payment will rise by one-third.
Premium tax credits protect many eligible Marketplace members from paying the full price increase. However, people who do not qualify for meaningful subsidies may feel most of the increase directly.
The expiration of the enhanced ACA premium tax credits at the end of 2025 already caused average out-of-pocket Marketplace premium payments to rise approximately 58 percent in 2026, according to KFF. Average deductibles also increased by about $1,000 per person.
A second year of premium increases could create even more pressure for families, entrepreneurs and early retirees who purchase their own insurance.
What is driving the 2027 increases?
There is no single cause. Insurers identified several major cost drivers.
Hospital and physician costs
Hospitals and medical providers are charging more for care.
Healthcare organizations face higher wages, labor shortages, supply expenses, facility costs and technology expenses. Insurers eventually include these higher claim costs in their premiums.
Prescription drug spending
Specialty medications continue to place pressure on insurance costs.
This includes medications used to treat cancer, autoimmune conditions and rare diseases, along with the rapidly expanding use of GLP-1 medications.
Insurers reviewing 2027 costs estimated that underlying medical and prescription expenses were rising by approximately 10 percent, which is higher than the average growth seen during the preceding several years.
A smaller and less healthy insurance pool
Insurance works best when a large group includes healthy people and people who need regular care.
When premiums increase, healthier consumers may decide to leave the Marketplace or go without coverage. People who expect to use healthcare are more likely to remain enrolled.
That leaves insurers covering a smaller and more expensive population.
Insurers estimated that changes in the risk pool added roughly four percentage points to 2026 premiums and could add another four percentage points in 2027.
Carrier exits
Seven carriers had announced plans to leave some or all of their ACA Marketplace service areas for 2027 as of July 2, 2026. Four carriers announced plans to enter new state markets.
An insurer leaving does not automatically increase every premium.
However, fewer competitors can mean fewer plan choices and less pressure on the remaining carriers to compete on price, network or benefits.
Subsidies will still matter
Premium tax credits can reduce the monthly price of a Marketplace plan.
The amount depends on household information, estimated annual income and the cost of benchmark coverage available in the applicant's location. The Marketplace is the only place where eligible consumers can receive the premium tax credit.
Consumers who receive a tax credit should not assume their final 2027 payment will remain unchanged.
A person's subsidy and premium can change at the same time.
The only way to know the actual payment is to update the application and compare the available plans after 2027 prices are released.
Lower premiums can hide higher risk
Some consumers respond to premium increases by moving into a lower-premium Bronze plan.
That may be reasonable for someone who mainly wants protection from a major medical event and can afford the deductible.
However, lower premiums frequently come with greater out-of-pocket exposure.
A consumer should ask:
- How much is the deductible?
- Are doctor visits covered before the deductible?
- What will prescriptions cost?
- What is the maximum out-of-pocket limit?
- Are my doctors and hospitals in-network?
- Can I afford the plan if I actually become sick?
People who qualify for cost-sharing reductions should pay special attention to Silver plans. These reductions can lower deductibles, copayments and coinsurance, but the extra savings generally apply only when the consumer selects an eligible Silver Marketplace plan.
New HSA opportunities may help some consumers
Starting in 2026, federal tax rules treat Bronze and Catastrophic health insurance plans as compatible with Health Savings Accounts.
This expands the number of consumers who may be able to contribute pre-tax money to an HSA while enrolled in qualifying coverage.
An HSA can help a household save for deductibles, prescriptions and other qualified medical expenses.
It does not make medical care free, but the tax advantages can reduce the long-term cost of healthcare spending.
What consumers should do before 2027
First, do not automatically renew a plan without reviewing it.
Second, compare the total cost rather than the premium alone.
Third, verify doctors, hospitals and prescriptions directly with the insurance company.
Fourth, update your projected household income.
Fifth, compare every legitimate category available to you, including Marketplace coverage, employer coverage, COBRA, ACA-compliant coverage outside the Marketplace and other private options when appropriate.
Not every alternative offers the same protections.
Short-term and fixed-indemnity products, for example, are not substitutes for comprehensive health insurance. Federal regulators state that fixed-indemnity coverage is intended to pay specified cash benefits and is not comprehensive major medical coverage.
Should people be worried?
Consumers should be prepared, but they should not panic.
The 14 percent figure represents a median of preliminary requests in the states studied. It is not a guaranteed national increase, and it is not the amount every person will pay.
The real warning is that premiums, deductibles, insurer participation and subsidies are all changing at the same time.
The takeaway in one line: Waiting until the final enrollment deadline could leave you rushing into a decision without checking the details — while premiums, networks, prescriptions and available carriers are all shifting at once.
Final takeaway
Health insurance may cost more in 2027 because hospitals, physicians, medications and insurance claims are becoming more expensive.
The expiration of enhanced subsidies and the departure of healthier members may create additional pressure.
The best defense is not simply finding the lowest advertised premium.
It is choosing the plan that creates the best balance between:
- Monthly cost
- Medical benefits
- Prescription coverage
- Provider access
- Deductible
- Maximum financial exposure