Health insurers selling Affordable Care Act marketplace plans have requested a median premium increase of about 15% for 2027, according to KFF’s analysis of preliminary rate filings from 276 insurers across all 50 states and the District of Columbia. The proposed increase, still subject to state regulatory review before it is finalized, would mark the second consecutive year of double-digit rate hikes after a median finalized increase of 20% for 2026. The jump will not land evenly across the marketplace: people ages 50 to 64, who already pay the highest premiums in the individual market and are among the least likely to qualify for financial help, are positioned to feel it hardest, layered on top of losses many in that age group absorbed just one year earlier. Marketplace coverage is the main option for millions of workers between the end of an employer plan and the start of Medicare at 65, which is why the size of the increase draws particular attention among near-retirees planning the last stretch before Medicare eligibility.
Why Insurers Are Requesting Roughly 15% More for 2027
Rising healthcare prices remain the primary driver cited in the filings, along with general economic inflation and labor shortages, according to KFF’s review of detailed submissions from 16 states and the District of Columbia. Insurers also point to factors specific to the individual market: the expiration of enhanced premium tax credits at the end of 2025 prompted many healthier enrollees to drop coverage in 2026, leaving a comparatively sicker, more expensive risk pool behind heading into 2027. Even so, the proposed 15% median increase is lower than the prior year’s 18% proposed and 20% finalized median, which KFF attributes in part to the market having already absorbed much of the initial shock from the credits’ expiration during the 2026 pricing cycle.
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Why Ages 50 to 64 Face the Steepest Increases
Marketplace premiums rise with age, and federal rules allow insurers to charge an older enrollee up to three times what they charge a young adult for the same plan. Adults ages 50 to 64 also make up about half of individual-market enrollees with incomes above 400% of the federal poverty line, a group that lost all federal premium assistance once the enhanced tax credits expired at the end of 2025. KFF’s analysis of a 60-year-old earning $65,000 a year, just over four times the poverty level, found that person is now paying roughly $10,389 more annually, or about $865 a month, toward the same bronze-tier coverage that enhanced credits had subsidized in 2025, before any additional 2027 rate increase is applied on top.
What Happened to the Enhanced Premium Tax Credits
Congress first added the enhanced premium tax credits in 2021 and extended them through the end of 2025 as part of the Inflation Reduction Act; the credits were not renewed and lapsed on December 31, 2025. KFF found that enrollees who kept their coverage into 2026 saw average monthly premium payments rise 58%, from $113 to $178, and that average marketplace deductibles grew by roughly $1,000 per person as more people shifted into higher-deductible plans to offset the higher premiums. Those 2026 increases compound with the newly proposed 2027 rate requests rather than resetting, since insurers are pricing 2027 plans against an enrollee base that is already smaller and, on average, sicker than it was two years earlier.
Where the Proposed Increases Are Largest
The size of the proposed jump varies sharply by state. KFF’s review of unsubsidized 2026 bronze-plan premiums for a 60-year-old found the highest costs in Wyoming, West Virginia and Alaska, while Maryland, New York and Massachusetts had the lowest. Older enrollees who lost subsidy eligibility have increasingly shifted toward bronze plans, which carry lower premiums but far higher deductibles, to limit the size of the monthly payment; KFF puts the average 2026 marketplace deductible at $7,476 for a bronze plan compared with $1,722 for a gold plan, meaning premium savings from downgrading a plan can be offset by thousands of dollars in exposure if a serious medical need arises during the year. A smaller group of enrollees who are ineligible for cost-sharing reductions have largely avoided silver-tier plans altogether, since insurers have priced many silver plans close to gold-tier levels, a pattern known as silver loading.
The Rates Are Still Proposals, Not Final Numbers
The filings KFF reviewed are preliminary submissions insurers made to state regulators, not the rates that will ultimately appear on a coverage application during open enrollment. State insurance departments in most states have the authority to negotiate down or reject proposed increases before final rates are locked in, typically in the fall, ahead of the annual open enrollment window that runs from November into January in most states. The scale of the median request, however, signals where insurers believe costs are heading, and consumers who rely on marketplace coverage in the years between a career-ending health issue and Medicare eligibility at 65 have historically seen final rates land close to the initial median proposal in recent pricing cycles, even after state-level negotiation.
This article was produced with the assistance of AI and reviewed by The Financial Wire editorial team.
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Warren Cohen is a finance writer based in Phoenix, Arizona, covering personal finance topics including credit, banking, and beginner investing. He earned his degree in business administration from Arizona State University and began his career working in consumer finance, where he gained direct experience with lending and credit systems. He now writes for personal finance websites and fintech platforms, focusing on clear, practical content that helps readers make informed financial decisions.
