ACA premiums are rising again — and sharply. A new KFF analysis of preliminary 2027 rate filings finds a median proposed premium increase of 14%, driven by rising medical costs, inflation, coding intensity shifts, and expiring tax credits. If finalized, premiums on ACA exchanges will have grown by more than a third in just three years.
ACA exchange premiums are on track for yet another significant jump. A KFF analysis of preliminary 2027 rate filings from 77 insurers across 16 states and D.C. found a median proposed premium increase of 14%. Most payers are requesting hikes between 10% and 20%, with 20 insurers asking for increases exceeding 20%. If these proposals hold, premiums will have risen more than a third from 2025 to 2027.
Insurers are pointing to a mix of culprits: rising medical and drug costs (up a median 10%), broader economic inflation, labor shortages, surging GLP-1 demand, and the expiration of enhanced premium tax credits on January 1. Payers like Anthem flagged tariff-related supply chain uncertainty, while Blue Cross Blue Shield of Massachusetts cited accelerating coding intensity — providers billing for higher-acuity services — as a key driver that inflates costs without necessarily improving care.
By the Numbers:
Why it matters: These increases will hit millions of Americans who rely on ACA marketplace plans, potentially pricing out lower-income enrollees — especially with enhanced subsidies now expired. The trend signals mounting strain on the individual insurance market heading into 2027.
