Average proposed healthcare premiums for Affordable Care Act (ACA) plans in 16 US states and the District of Columbia are about to jump 14% in 2027, with many insurers seeking permission to boost prices by double digits for the second year running.
Double-Digit Increases Become the Norm
For the second consecutive year, many Affordable Care Act insurers are asking for double-digit premium increases, citing rising medical costs and policy changes as the primary drivers. The proposals, which cover 16 states and the District of Columbia, represent a median 14% increase in premiums. This follows a 13% median hike in 2026 and a 14% median hike in 2025.
Peterson-KFF Analysis Uncovers Key Factors
A new Peterson-KFF analysis found that rising medical costs, policy changes introduced by the Trump administration, and subsequent Congressional adjustments are responsible for the proposed premium hikes. Insurers claim that these factors have increased their costs and are now pushing them to raise premiums to maintain profitability.
Among the factors driving premium increases are the Trump administration’s elimination of reinsurance and cost-sharing reduction payments, which aimed to offset the financial burden on insurers. The elimination of these programs in 2019 was largely reversed by the Biden administration, but the impact of the initial change remains a significant contributor to the current premium increases.
What this means
The proposed premium increases will have a direct impact on ACA plan subscribers, who may see their premium costs rise significantly in 2027. According to a KFF report, more than 14.5 million people obtained health insurance coverage through the Affordable Care Act marketplaces in 2021. With median premium increases exceeding 10% for the second consecutive year, subscribers can expect to pay more for their coverage in the coming year.
The proposed increases also underscore the ongoing challenges faced by the US healthcare system, where rising medical costs continue to outpace economic growth. As policymakers grapple with the implications of ACA premium increases, they must consider the broader picture of healthcare affordability and accessibility in the US.
