ACA Insurance Premium Hikes: Insurers Seek Steep Rate Increases for 2027

For the second consecutive year, health insurers selling plans on the Affordable Care Act marketplace are requesting substantial rate increases, and this time the median ask is 14% for 2027. That figure comes from an analysis of preliminary filings across 16 states and Washington, D.C., conducted by the Peterson-KFF Health System Tracker. If regulators approve rates anywhere close to what’s been requested, 2027 would mark the second-largest annual increase since 2018.
The proposed hikes come on the heels of an already difficult stretch for marketplace enrollees. Consumers absorbed higher premiums in 2026, and at the end of last year they also lost access to the more generous federal tax credits that had been softening the blow. Cynthia Cox, senior vice president and director of KFF’s Program on the ACA, described the situation as a “triple whammy,” pointing to consecutive years of rising sticker prices combined with the loss of subsidies that once made coverage more affordable.
Insurers point to several factors driving the new requests. Medical costs continue climbing, and several carriers say the claims they’re now paying tend to reflect more intensive, costlier episodes of care than in prior years. Policy changes out of Washington are also playing a role. UnitedHealthcare, in its New York rate filing, indicated that new federal program rules account for a meaningful share of its requested increase, layering on top of the effects of expiring subsidies.
The political backdrop has grown contentious as well. A White House spokesperson pushed back on insurer complaints, framing new federal restrictions as an effort to crack down on fraudulent enrollment practices from prior years and suggesting the administration would hold large insurance companies accountable rather than continue what it characterized as taxpayer-funded giveaways to the industry.
The stakes for consumers are considerable. Marketplace enrollment had climbed to 24.3 million people in 2025 under the more generous subsidy structure, but with those enhanced credits gone and premiums rising again, affordability concerns are mounting. Estimates suggest millions of enrollees could be at risk of dropping coverage altogether if rates land anywhere near what’s currently being proposed.
It’s worth noting these filings are still preliminary. State insurance regulators will review and can adjust the requested rates before they take effect, a process that plays out over the coming months. Historically, approved increases have sometimes landed below what insurers initially sought, though the direction of travel — up, not down — appears consistent across most of the states reviewed so far.
For now, the message from industry analysts is clear: unless something changes at the federal or state level, ACA marketplace shoppers should brace for another expensive year in 2027.