ACA 2027: Premiums jump 13% as enrollment window opens

The sign-up window for Affordable Care Act marketplace plans opens Sunday in most states and runs through Jan. 15. Individuals purchasing coverage for the 2027 plan year will face an average premium increase of 13%, according to an analysis of new CMS data by the healthcare research nonprofit KFF. This price hike represents the steepest jump in recent years for the exchanges.

Cynthia Cox, a vice president and director of the ACA program at KFF, attributed the rate increases to rising healthcare costs and increased market concentration among hospitals. She also pointed to factors such as the No Surprises Act, which took effect in 2022, and the growing availability of GLP-1 drugs as contributing elements. The financial burden falls most heavily on individuals who do not qualify for subsidies. "They may or may not be able to afford to continue to keep their coverage into next year," Cox said. She noted that many of these consumers have already shifted to bronze plans, which are the least expensive tier available.

The average premium increase is the primary factor driving market shifts this year, but administrative changes will also affect access. New regulations taking effect in 2027 limit tax credits for certain lawfully present immigrants. KFF projects this change could leave an additional 1 million people uninsured over time. Furthermore, the administration is actively removing enrollees it deems ineligible or fraudulent. In September, Vice President JD Vance announced plans to remove 760,000 individuals from the exchanges. Vance stated that the discovery and cancellation of subsidy payments for these enrollees would save the government $2.2 billion.

These developments follow a period of heightened cost and reduced enrollment during the current presidential term. Republicans opposed extending the temporary subsidies enacted under the previous administration, which had helped offset costs for most buyers. Consequently, 1.2 million fewer people signed up for coverage in recent exchanges. As of February, the Department of Health and Human Services reported that approximately 19.2 million people in the United States were actively enrolled in ACA marketplace plans. A CMS fact sheet distributed Friday stated that Americans using HealthCare.gov would have access to low-cost plans, a claim that contrasts with the projected 13% average price rise for 2027.