Americans who purchase health insurance through the Affordable Care Act marketplace could face another significant increase in premiums next year, as insurers are proposing a median rate hike of 14 percent, according to an analysis of preliminary filings by KFF.
If those proposed increases are ultimately approved, it would mark the second consecutive year of double-digit premium growth, continuing a trend that could leave many consumers paying thousands of dollars more for health coverage.
The analysis found that Affordable Care Act marketplace premiums would have climbed by roughly one-third between 2025 and 2027 if the proposed increases take effect.
Although the latest proposed increase is smaller than last year’s, it remains one of the largest requested premium hikes in recent years. According to KFF, insurers proposed a median nationwide rate increase of 18 percent for 2026, while the finalized median increase ultimately reached 20 percent.
The proposed 14 percent increase for 2027 would still represent the second-highest requested rate adjustment since 2018, the organization said.
KFF reviewed preliminary filings from 77 insurers submitted ahead of the July 15 filing deadline and found that companies largely cited the same reasons for seeking higher premiums.
Among the primary factors identified were rising healthcare costs and continued health inflation, both of which insurers said are increasing the expense of providing coverage.
Another major factor stems from the expiration of the Affordable Care Act’s enhanced premium tax credits. Republicans in Congress allowed those expanded subsidies to expire at the end of last year, changing how much many consumers pay for marketplace coverage.
Matthew McGough, a policy analyst with KFF’s Program on the ACA, said uncertainty surrounding the insurance market has also contributed to higher proposed premiums.
“When there is so much uncertainty, insurers are raising premiums higher than they otherwise would be, and the end result is that consumers are footing a larger bill for their premiums if they’re not receiving federal tax credits,” McGough said.
The impact is expected to vary depending on a person’s income level.
Individuals with the lowest incomes continue to receive other federal subsidies designed to reduce their out-of-pocket costs. However, enrollees earning at least 400 percent of the federal poverty level lost access to the enhanced premium tax credits after they expired.
For 2026, that threshold is just under $64,000 in annual income for a single person.
As a result, those individuals now face the full cost of premium increases without the additional financial assistance previously available through the enhanced credits.
According to the analysis, the expiration of those subsidies also influenced enrollment patterns during 2026.
Higher insurance costs prompted many healthier consumers to leave the Affordable Care Act exchanges, leaving behind a smaller group of policyholders who, on average, require more medical care and are more expensive for insurers to cover.
That shift resulted in what KFF described as a sicker risk pool, which contributed to premium increases.
The analysis found that the changing makeup of the insurance pool accounted for a 4-percentage-point increase in premiums during 2026. KFF expects a similar effect to contribute to premium increases again in 2027.
The report also noted another consequence of the expiration of the enhanced tax credits.
Although some consumers now pay more for their own coverage, the federal government is also spending more on the remaining premium subsidies. According to KFF, a larger share of marketplace enrollees is now exposed to the full cost of individual health insurance, increasing spending on the existing subsidy structure.
The preliminary filings are still subject to review before final rates are approved, but if the proposed increases remain in place, many Affordable Care Act marketplace customers could once again see their health insurance costs rise substantially in the coming year.