U.S. — Health insurers are proposing an average premium increase of about 15% for Affordable Care Act plans in 2027. This projection follows a 20% average rate increase for 2026 and comes as enhanced federal subsidies expired at the end of 2025.

An individual earning $80,000 annually who does not qualify for standard ACA subsidies could see their bronze plan cost rise by approximately $80 per month in 2027. The financial impact extends beyond the marketplace to employer-sponsored coverage, where employers expect the cost of providing health benefits to each worker to rise by an average of 8.2% in 2027.

About two-thirds of large employers with 500 or more employees expect to increase employee contributions toward premiums in 2027. Kevin Schulman, professor of medicine at the Stanford University School of Medicine, explained the dynamic driving these shifts. "Because the costs are going up, the employers are trying to reduce the rate of growth, and the easiest way to reduce the rate of growth of healthcare costs is to push more of the costs onto the employee," Schulman said.

Larry Levitt, executive vice president for health policy at KFF, noted the broad nature of the trend. "Healthcare costs are going up faster than they have in years, and open enrollment is when the healthcare affordability crisis is really going to hit home for people," Levitt said. He added that the pressure applies across coverage types. "That’s true for whatever kind of insurance you have," Levitt said.

Miranda Yaver, assistant professor of health policy and management at the University of Pittsburgh, described the disparity between proposed relief measures and actual costs. She said the one-time payment pales in comparison to the increased premiums that marketplace enrollees are facing due to the expiration of the enhanced subsidies.

Concerns about future costs were prevalent in the survey data. A GoodRx survey found that 45% of insured respondents reported anxiety about future healthcare needs or unexpected medical situations. Another 56% of insured respondents worried about affording costs from a serious illness or accident.

Changes in federal programs also affect Medicare beneficiaries. The Centers for Medicare & Medicaid Services projected the baseline monthly cost for Medicare Part D coverage will rise from $38.99 to $41.33 in 2027. The annual out-of-pocket cap on prescription drugs for Medicare enrollees will be $2,400 in 2027. The Trump administration ended a temporary federal program that helped offset premium increases for Medicare Part D plans.

Why It Matters

The proposed 15% average premium increase for 2027 compounds financial strain on enrollees following the expiration of enhanced federal subsidies. With approximately 19 million adults buying health insurance through the Affordable Care Act marketplace, the cost shifts affect a large portion of the population. The decrease of about 3 million in ACA enrollment after the subsidy expiration demonstrates the sensitivity of the market to price changes.

Employers are also adjusting to rising costs, with expectations of an 8.2% increase in benefit costs per worker in 2027. As large employers move to increase employee contributions, the burden of healthcare financing shifts further onto individuals. Survey data indicates that this strain leads to delayed care, with many respondents skipping dental, vision, or prescription services due to financial constraints.

What's New

Research titled Possibilities and Limitations of Third-Party Provision of Health Behavioral Information - Focusing on the Analysis of the GoodRx v. FTC Consent Decree Case - was published in 2026 in Public Land Law Review. The Health and Human Services Department published a rule titled "Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges, Merit-Based Incentive Payment System (MIPS) Eligible Clinicians, and Eligible Hospitals and Critical Access Hospitals in the Medicare Promoting Interoperability Program" on 2024-02-08.

Among insured respondents experiencing financial strain in a GoodRx survey, 52% delayed or skipped dental care. Among insured respondents experiencing financial strain in a GoodRx survey, 37% postponed vision care or doctor visits. Among insured respondents experiencing financial strain in a GoodRx survey, 31% put off or went without prescription medications. A GoodRx survey of 1,887 insured people conducted from May through July 2026 found that about 25% of respondents said they needed care their plan did not cover.

How Sources Differ

Sources differ on details regarding the Affordable Care Act. Federalregister.gov notes that the Health and Human Services Department published a rule titled Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations. A KFF analysis of insurer public filings states that approximately 19 million adults buy health insurance through the Affordable Care Act marketplace.