2027 Obamacare premiums set to rise double digits nationwide as insurers scale back

Health insurance shoppers on the Affordable Care Act marketplaces are facing another round of steep premium increases for 2027, with state regulators finalizing rate hikes averaging around 15 percent nationwide just two weeks before open enrollment begins. In Georgia, insurance regulators this month finalized premium increases of 11 to 29 percent across the eight insurers still selling plans on the state's exchange, pushing the average unsubsidized premium to nearly $932 a month, according to reporting by the Atlanta Journal-Constitution.

The increases follow an even larger jump in 2026, when average full-price marketplace premiums rose from $619 to $741 a month after enhanced federal subsidies that had been in place since the pandemic expired at the end of 2025.

The numbers

A tracking analysis by the Peterson-KFF Health System Tracker found insurers requesting a median rate increase of 14 percent for 2027 in preliminary filings across 16 states and Washington, D.C., with roughly 4 percentage points of that attributed to the lingering effects of the subsidy expiration, as healthier enrollees who can no longer afford coverage drop out and leave a costlier pool behind. State-by-state finalized and proposed increases vary widely: Vermont settled at 3 percent, Texas at about 13 percent, Ohio at 16 percent, South Carolina at 22 percent and Arizona at 29 percent, according to tracking by the health policy site healthinsurance.org.

In Georgia, insurers' own rate filings, posted on the federal government's public rate-review database, show the range behind that average: Blue Cross Blue Shield of Georgia requested roughly a 17 percent increase excluding age-related effects, while UnitedHealthcare's Georgia filing proposed an increase of nearly 54 percent on its individual-market plans, according to the company's actuarial memorandum filed with federal regulators. UnitedHealthcare and Cigna are both exiting Georgia's ACA marketplace entirely as of Jan. 1, 2027, leaving six insurers to absorb their roughly 900,000 enrollees.

How we got here

The driving force behind both this year's and last year's increases is the lapse of the enhanced premium tax credits that Congress first approved in 2021 and extended through 2025. Those credits capped what middle- and lower-income enrollees paid as a share of their income and removed the income cap that had previously barred higher earners from any subsidy at all. When Congress allowed the enhancement to expire at the end of 2025, subsidized enrollees' costs rose sharply, and insurers say they are now pricing in an expectation that the remaining enrollee pool will be sicker and more expensive to cover, a dynamic insurers describe in the detailed rate justifications they file with regulators every spring, including filings available through the federal rate-review system.

Rising medical costs are compounding the subsidy effect. The Peterson-KFF analysis points to growing demand for costly specialty drugs and GLP-1 weight-loss medications as a bigger driver of the increases than the subsidy expiration itself.

Who is affected

Most ACA enrollees will not feel the full force of the increase because federal subsidies, for those who still qualify, rise automatically alongside the benchmark "silver" plan used to calculate them. KFF's analysis found 87 percent of 2026 enrollees received some subsidy. The people most exposed are those earning just above 400 percent of the federal poverty level, who lost subsidy eligibility entirely when the enhanced credits lapsed, and anyone buying a plan off-exchange, where no subsidies apply at all. KFF's own illustrative example: a 40-year-old in Indianapolis earning $65,000 a year could see a monthly payment climb from $316 in 2025 to $546 in 2027 if the proposed rates hold.

Insurance brokers say the conversation with clients has shifted from simply comparing premiums to explaining why coverage options are shrinking at all, as more national carriers scale back their ACA footprints rather than compete for a smaller, costlier pool of enrollees in multiple states this year, not just Georgia.

ACA enrollment nationwide had already fallen by roughly 3 million people as of this past February compared with a year earlier, a decline the current administration attributes largely to crackdowns on improperly enrolled accounts and that outside researchers, including at KFF, attribute at least in part to the higher costs now facing consumers.

Not every state is seeing the same trajectory. New York regulators cut insurers' original rate requests dramatically, finalizing an average increase of just 6 percent after insurers had initially sought more than 20 percent, while New Mexico's final increase of 24 percent came down only slightly from a 25.6 percent proposal. The variation reflects differences in how aggressively state insurance departments negotiate down insurer filings, as well as how competitive each state's marketplace remains after this year's wave of insurer exits.

What happens next

Open enrollment on the federal marketplace, HealthCare.gov, begins Nov. 1 and runs through Jan. 15 for most states, a shortened window compared with prior years under a rule CMS finalized last year, according to the agency's own fact sheet, which also tightened income-verification and re-enrollment rules the administration says are aimed at curbing improper sign-ups. State-run exchanges such as Georgia's, which opens Nov. 1 and runs through Jan. 15, must start by that date and run for at least nine weeks, with several, including Georgia, dropping the "window shopping" preview period they had offered in past years.

With roughly two-thirds of states having finalized their 2027 rates as of mid-October, according to tracking by healthinsurance.org, consumer advocates are urging shoppers to actively compare plans rather than auto-renew, since insurer exits and shifting subsidy eligibility mean last year's plan may no longer be the cheapest, or even available, this time around.