ACA Marketplace Insurers Propose a Median 14% Premium Increase for 2027 After a 20% Rise This Year, KFF Analysis of 77 Insurers Finds, With Proposals Ranging From 1% to 52%

Insurers that sell plans on the Affordable Care Act (ACA) marketplaces are proposing another year of double-digit premium increases for 2027. The headline comes from an analysis by KFF, the health policy research organisation, of preliminary rate filings, reported on July 8, 2026 by MedCity News and by the Associated Press. KFF's own page could not be retrieved for this article, so the figures below are as relayed by those two outlets. Readers who need exact figures should consult KFF's analysis directly. The filings are preliminary, and the sources reviewed do not report the final rates approved by state regulators.

What KFF found

KFF analysed publicly available filings from 77 insurers across 16 states and Washington, D.C. The median proposed increase for 2027 is 14%. Proposals range from 1% to 52%, most fall between 10% and 20%, and none proposes a decrease. The AP report adds that the figures are averages across bronze, silver, gold and platinum plans, and that final rates would be set later in the summer.

One trade outlet's headline reported the median as 15%. The sources reviewed for this article report 14%, and nothing in them explains the difference, so this article uses 14%.

The comparison with 2026

This is the second straight year of double-digit proposed increases. The median proposed change for 2026 was 18%, and the finalized median was 20%. KFF describes the 2027 proposal as lower than last year's but the second-highest requested rate change since 2018. Compounding the finalized 20% and the proposed 14% gives roughly a 37% rise, calculated here, which is consistent with KFF's statement that typical premiums would have risen by more than a third over two years if the early figures hold.

Why insurers say premiums are rising

The insurers' filings cite several reasons. One is the rising cost of health services, including hospital care, prescription drugs and workforce costs, along with inflation and labor shortages. Blue Cross Blue Shield of Rhode Island wrote that it "expects to see substantial increases in provider unit costs for 2027." A second is the expiration of the enhanced premium tax credits at the end of 2025. A third is a rise in morbidity, meaning the enrollee pool is sicker on average relative to healthier enrollees. The AP report also lists federal regulatory changes.

The subsidy link

According to the MedCity summary of KFF's analysis, the expiration of the enhanced credits contributed to lower enrollment in 2026, because healthier enrollees were more likely to drop coverage. KFF says insurers "are expecting the market to continue to deteriorate in 2027" for that reason. The enrollment figures themselves are not given in either report, so this article does not quote any.

KFF gives an illustration. A 40-year-old in Indianapolis earning $65,000 could see a monthly premium rise from $316 in 2025, when the unsubsidised premium was $388, to $546 in 2027 if the proposed rates are approved. That is an increase of $230 a month, or about 73%, calculated here. It is one example, not an average, and results would differ by location, age and income.

Who is most affected

The AP report notes that many enrollees still qualify for subsidies that shield them from the full premium. Middle-class enrollees earning 400% of the poverty level or more, who no longer receive the larger credits, face especially steep increases. The AP report adds that no comprehensive federal health legislation has gained enough support to pass, and that affordability is a concern ahead of the November midterm elections.

What happens next

Preliminary filings go through rate review by state regulators, who can approve, reduce or require changes to the requests. The sources reviewed describe the numbers as preliminary and expected to change. Final rates for 2027 were expected in late summer, and this article has not verified them, so anyone shopping for 2027 coverage should check the rates actually approved in their state and the subsidy they qualify for, using their state marketplace or HealthCare.gov.

A note on the sources

The two reports differ slightly in emphasis. MedCity concentrates on KFF's own numbers, including the range, the comparison with 2025 and the Indianapolis example. The AP report concentrates on the insurers' stated reasons and the political context. Where they overlap, on the 14% median, the 77 insurers and the 16 states, they agree. This article uses each only for the points it reports and does not combine them into figures neither contains.

What the figures do not show

The analysis covers only 16 states and D.C., so it is not a national average, and it covers only insurers whose filings were public when KFF looked. The median is a middle value, so many insurers will be above or below it, as the 1% to 52% range shows. The 52% top of the range is a single proposal, not a typical one. Proposed rates are also not what each person will pay, because subsidies, plan choice and age change the final bill.