ACA premiums to jump 13 percent as enrollment window opens Sunday
The sign-up period for marketplace insurance begins this weekend in most states, bringing higher costs and tighter eligibility rules for 2027.
By Nathan Brooks ·
The average price of health insurance purchased through federal marketplaces is expected to rise by 13 percent in 2027. This projection comes from an analysis of new data by the Centers for Medicare and Medicaid Services, conducted by the healthcare research nonprofit KFF. The open enrollment period for the Affordable Care Act starts Sunday in most states. The window remains open through Jan. 15.
Several factors are driving the price increases. Cynthia Cox, a vice president and director of the ACA program at KFF, identified rising healthcare costs and hospital market concentration as primary causes. She also pointed to the No Surprises Act, which took effect in 2022, and the growing availability of GLP-1 drugs as contributing elements. These changes affect the cost structure for all marketplace plans.
Financial assistance rules have also changed. Premium tax credits and cost-sharing reductions are now restricted for many groups of people who were previously eligible. This shift limits the number of individuals who can afford coverage without paying higher out-of-pocket costs. The people most affected by these new increases are those who do not qualify for a subsidy.
Cox noted that many unsubsidized enrollees have already moved into bronze plans, which are the cheapest options available. She said, “They may or may not be able to afford to continue to keep their coverage into next year.” This financial pressure may lead more people to drop coverage or switch to less comprehensive plans.
The number of people enrolled in ACA marketplace plans has fluctuated in recent years. As of February, roughly 19.2 million people in the United States were actively enrolled, according to the Department of Health and Human Services. That number grew during the pandemic when enhanced subsidies were available. However, 1.2 million fewer people signed up for coverage in the exchanges during the current administration compared to previous periods.
New regulations starting in 2027 will also limit tax credits for certain lawfully present immigrants. These changes could result in an additional 1 million uninsured individuals over time. Meanwhile, the administration has been removing enrollees from the program as part of a campaign against waste, fraud, and abuse. In September, Vice President JD Vance and other officials announced plans to remove 760,000 ACA enrollees. They alleged these individuals were fraudulently enrolled or did not exist.
Vance stated that the discovery and canceled subsidy payments would result in $2.2 billion in cost savings. A CMS fact sheet distributed Friday says Americans using HealthCare.gov will have access to low-cost plans. However, Cox said it is unclear how many more people will drop off of ACA coverage in 2027. She added, “I think there’s going to be fewer people enrolled in this market, but it’s going to be harder to understand why.”
