Why Your 2027 Health Insurance Rates Are Going Up — and What to Do About It

The Short Version

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027, according to a July 2026 analysis from KFF. That comes on top of a 58% jump in 2026 — meaning typical premiums could climb by more than one-third over just two years.

If you're a healthy individual or family, you're the one absorbing that increase. Here's why — and what you can do about it.

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What's Driving the 2027 Increases

Four main factors, according to insurers' own rate filings:

1. The Enhanced Subsidies Expired

The American Rescue Plan and Inflation Reduction Act expanded premium tax credits to make ACA coverage more affordable. Those enhanced credits expired at the end of 2025. The result? Average out-of-pocket premiums surged 58% in 2026, and deductibles jumped about $1,000 per person.

Most Marketplace enrollees still qualify for some subsidies, but people earning 400% or more of the federal poverty level — that's $62,600 for a single person, about $127,000 for a family of four — lost subsidies entirely. They're paying the full sticker price.

2. Healthier People Are Leaving

When premiums spiked in 2026, many healthy enrollees dropped their coverage. That left behind a smaller, sicker, more expensive risk pool. Insurers estimate this drove premiums up about 4 percentage points in 2026 — and they expect another 4-point bump in 2027 for the same reason.

It's a cycle: premiums go up, healthy people leave, the pool gets sicker, premiums go up again.

3. Medical Costs Are Rising Faster

The underlying cost of medical care and prescription drugs rose 10% heading into 2027 — well above the 8% average from recent years. Hospitalizations, physician visits, and specialty medications (including GLP-1s) are all contributing. Labor shortages and general inflation have pushed provider wages higher, and those costs get passed through to premiums.

4. Federal Regulatory Changes

Recent federal rule changes — including the Notice of Benefit and Payment Parameters and the Marketplace Integrity and Affordability Rule — have added upward pressure on premiums as well.

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Why This Hits Healthy People Hardest

If you rarely go to the doctor, don't take expensive medications, and generally use your insurance as a safety net rather than a regular tool — you're effectively subsidizing the cost of covering a sicker pool.

In the ACA Marketplace, premiums are community-rated. Everyone in the same age bracket pays the same base rate, regardless of health status. That's designed to protect people with pre-existing conditions, but it means healthy enrollees pay more than their actual healthcare costs would justify.

When the risk pool deteriorates (as it has), that gap widens. You're not just paying for your own coverage — you're absorbing the cost of a pool that's getting sicker every year.

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What Healthy Individuals and Families Can Do

Check Your Actual Costs

Pull your last 12 months of healthcare spending. Premiums plus out-of-pocket costs. If you're like most healthy people, you're paying significantly more in premiums than you're using in care.

Explore Private Plan Alternatives

Private plans aren't subject to the same community-rating rules as ACA Marketplace plans. For healthy individuals and families, they can often offer:

• Comparable or broader doctor networks — including specialists you actually want to see
• Lower monthly premiums — because you're not subsidizing a deteriorating risk pool
• Better out-of-pocket caps — protecting you if something unexpected happens
• Plan structure flexibility — tailored to how you actually use healthcare

Move Before Open Enrollment

Open enrollment for 2027 coverage runs November 1 through January 15. But switching from an ACA plan to a private plan structure takes 2-3 weeks of lead time. If you want coverage effective January 1, you need to start the process by early December.

Wait too long, and you're locked into the higher ACA rates for all of 2027.

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The Bottom Line

A 14% increase on top of a 58% increase means 2027 premiums could be more than a third higher than what you were paying in 2025. If you're healthy, you're bearing the cost of a system designed around a sicker risk pool.

You have options. The key is exploring them before the window closes.

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Want to see your actual numbers? Get a free 2027 Rate Assessment at coveredbykeith.com/2027-rate-assessment.

This article is for informational purposes only and does not constitute plan recommendations. Coverage availability and eligibility vary by state and applicant.