Affordable Care Act health insurance premiums will rise by an average of 13 percent in 2027, marking a second consecutive year of double-digit rate hikes following a 26 percent increase for 2026. Data published by the Trump administration and analyzed by KFF attributes the spike to rising medical expenses and the expiration of pandemic-era enhanced tax credits. Overall marketplace enrollment dropped from 24 million to 19 million as major insurers exit exchanges, making health costs a central campaign focus ahead of the 2026 midterms.
2027 Affordable Care Act premium hikes
- ▪The 13 percent increase in Affordable Care Act marketplace premiums for 2027 represents the second consecutive year of double-digit rate hikes, following a 26 percent increase for 2026.
- ▪An average monthly premium for a 40-year-old buying an Affordable Care Act benchmark plan will rise from $624 in 2026 to about $704 for 2027.
- ▪Average health insurance plan premiums on the Affordable Care Act marketplaces will increase by 13 percent in 2027 based on Trump administration price data analyzed by KFF on October 30, 2026.
Federal marketplace announcements for 2027
- ▪The Centers for Medicare and Medicaid Services stated on October 30, 2026, that roughly three-quarters of Americans purchasing HealthCare.gov coverage will find 2027 plans with premiums at or below $50.
- ▪The Trump administration published 2027 premium pricing for the 30 states using federally managed health insurance marketplaces
Drivers of rising premium costs
- ▪Insurers and health policy analysts cited the expiration of pandemic-era enhanced premium tax credits as a primary driver pushing healthier enrollees out of the Affordable Care Act marketplace risk pool.
- ▪Insurers attribute the 2027 Affordable Care Act premium increases to higher underlying medical costs across the country, including labor shortages and increased use of GLP-1 medications.
Unsubsidized Affordable Care Act enrollees
- ▪Roughly 2.5 million Affordable Care Act enrollees across the United States did not receive premium tax credits based on federal enrollment data from February 2026.
- ▪Affordable Care Act plan policyholders earning more than 400 percent of the federal poverty level do not receive premium tax credits and face the full price increases for 2027.
Declining Affordable Care Act enrollment
- ▪Roughly 5 million additional enrollees could lose or drop Affordable Care Act insurance by the end of 2026 due to rising costs, loss of subsidies, and federal restrictions.
- ▪Affordable Care Act marketplace enrollment fell from over 24 million during the Biden administration to roughly 19 million enrollees in 2026 following subsidy expirations and new rules.
Insurance carrier departures from Affordable Care Act marketplaces
- ▪Cigna Group announced in April 2026 that it would exit the Affordable Care Act marketplace after insuring roughly 369,000 policyholders across 11 states.
- ▪At least 12 health insurance carriers, including Cigna Group and Aetna, announced exits from state Affordable Care Act marketplaces for 2026 and 2027.
Efforts to restore Affordable Care Act subsidies
- ▪Disagreements over restoring expired Affordable Care Act marketplace subsidies contributed to an extended federal government shutdown in 2025.
- ▪Congressional Democrats pushed to restore the expired Affordable Care Act marketplace subsidies that Republicans allowed to expire in the One Big Beautiful Bill legislation.
Federal health care rebate check distributions
- ▪The federal distribution of $90 checks to more than 20 million Medicare Part B enrollees carries a total cost of approximately $2 billion.
- ▪President Donald Trump announced federal distribution of one-time $500 rebate checks to unsubsidized Affordable Care Act customers and $90 checks to over 20 million Medicare Part B enrollees in October 2026.
Trump administration record on the Affordable Care Act
- ▪President Donald Trump attempted to repeal the Affordable Care Act in 2017 before successfully eliminating the law's individual mandate penalty for uninsured individuals.
- ▪The Trump administration implemented new enrollment verification barriers and removed approximately 760,000 enrollees from the Affordable Care Act marketplace as part of a fraud crackdown last month.
Health insurance rate hikes beyond the marketplace
- ▪Health insurance premiums for federal government workers are projected to increase by more than 10 percent in 2027.
- ▪Employer-sponsored health plan premiums covering roughly 150 million Americans are projected to rise by 8.2 to 10 percent in 2027.
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