ACA insurers seek 14% median rate increase for 2027

Health insurance companies filed requests for a median 14% premium increase on 2027 Affordable Care Act plans, according to a preliminary KFF analysis of 77 filings in 16 states and Washington, DC. Nearly half of the plans seek increases between 10% and 15%.

Twenty plans requested hikes of 20% or more. Insurers have until July 15 to finalize submissions, after which federal and state regulators will review them.

Rate drivers KFF said insurers cited three main factors.

Medical and prescription drug spending rose 10%, driven in part by hospital bills, physician fees, and higher use of GLP-1 anti-obesity drugs and specialty cancer treatments. The end of enhanced premium tax credits in 2026 shifted more costs to enrollees.

Some healthier customers dropped coverage, leaving a smaller and sicker risk pool. Insurers also pointed to changes in marketplace rules under President Donald Trump's administration.

Enrollment drop ACA enrollment stood at 19.2 million as of February, down from 23.1 million in January 2026, the U.S. Department of Health and Human Services reported. A separate Georgetown Center on Health Insurance Reforms analysis of nine states and Washington, DC, found requested increases ranging from 6.5% in Vermont to 22.4% in Washington state.

"Insurance companies who participate in the marketplace are facing a much smaller and sicker pool of people, which drives up premiums for everybody," said Sabrina Corlette, co-director of Georgetown University's Center on Health Insurance Reforms.