ACA marketplace premiums are on track for a second consecutive year of double-digit increases, according to a June 18 analysis of early rate filings from Georgetown University’s Center on Health Insurance Reforms.
Researchers reviewed publicly available filings from 10 states and the District of Columbia and examined 40 insurer justifications from eight states.
Five notes:
1. Statewide average proposed increases from early filings range from 6.5% in Vermont to 22.4% in Washington state. The report said the figures are broadly comparable to those seen in last year’s filings, when the nationwide median proposed increase of 18% was the highest in nearly a decade and nearly triple the medians from 2024 (6%) and 2025 (7%).
2. Washington insurers are requesting the sharpest increases, with a statewide average increase of 22.4% across 13 insurers. Enrollment on the state’s exchange has fallen 13% since 2025, a decline the state attributes primarily to the expiration of enhanced premium tax credits.
3. The expiration of the enhanced premium tax credits at the end of 2025 has continued pushing healthier enrollees out of the individual market, leaving a smaller and sicker risk pool. The individual market is projected to shrink 17% to 26% this year. MVP Health Plan in Vermont quantified the impact in its filing, saying increased morbidity from expired credits translates to an additional $48 per member per month in claims costs.
4. CMS finalized the 2027 Notice of Benefit and Payment Parameters rule in late May, after rates were already due in some states. The agency projects the rule will reduce enrollment by an additional 1.2 million to 2 million people next year. A coalition of cities, physicians and small businesses filed a lawsuit on June 3 challenging several provisions.
5. Insurers across the sample cited higher provider reimbursements, increased utilization and specialty drug spending as primary trend drivers. PwC projects the medical cost trend in the individual market will reach 8.5% in 2027. Premera Blue Cross in Washington said limited competition and regional monopolies have reduced downward pricing pressure, while Anthem in Connecticut attributed rising costs in part to provider consolidation and clinical workforce shortages.
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