ACA insurers are pitching a median rate increase of 15% for 2027, the second year in a row of double-digit premium hikes, according to a July 8 Peterson-KFF Health System Tracker analysis that was updated Aug. 3.
The tracker reviewed 276 insurers in marketplaces across the country with publicly filed rates. The tracker’s analysis considered an insurer’s premium increase as the enrollment-weighted average rate change across its offerings in a state. While rates will be finalized in late summer, these filings provide a glimpse of the year ahead.
Here are six notes from the analysis:
1. Insurers cited steeper healthcare costs as informing rates. Looking at a subset of insurers, the median medical trend was 10% for 2027. Insurers mentioned inflation, labor supply issues, claims severity, GLP-1s, provider consolidation and No Surprises Act disputes as drivers.
2. Federal policy shifts were also factors. Insurers more specifically attributed rising rates to the expiration of enhanced premium tax credits and greater morbidity in risk pools. As the expiration prompted an enrollment dip, healthier enrollees were more likely to let go of coverage. After subsidies, premium payments increased 58% on average in 2026.
3. Along with the expiration, regulatory changes and HR 1 played a role, insurers said.
4. Overall, suggested premium changes for 2027 ranged from -1% to 54%, with most between 10% and 25%. Only one insurer proposed a decrease.
5. Fifty-one of the 276 insurers requested premium increases surpassing 25%.
6. For 2026, the median nationwide proposed rate change was 18%. The median finalized rate change was 20%.
Editor’s note: This story initially ran July 8 and was updated to reflect Aug. 3 data.
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