ACA Premiums Set to Jump Again as Subsidies Lapse Ahead of Nov. 1 Enrollment

Open enrollment for Affordable Care Act marketplace health plans begins Nov. 1, and most shoppers will face another year of steep premium increases just as the subsidies that softened costs for millions of enrollees have disappeared.

Insurers nationwide are seeking a median premium increase of 15 percent for 2027 plans, according to an analysis by KFF's review of filings from 276 insurers across all 50 states and the District of Columbia. That makes 2027 the second straight year of double-digit requested hikes, trailing only last year's 18 percent proposed increase, which was ultimately finalized at 20 percent. Proposed increases vary widely by state, from roughly 3 percent in Vermont to 29 percent in Arizona, and are still subject to final approval by state regulators in some places.

The larger shift for many households is the return of a hard cutoff in financial help. Enhanced premium tax credits, first adopted during the pandemic, expired at the end of 2025 after Congress did not renew them. For 2027, subsidies disappear entirely for anyone earning more than 400 percent of the federal poverty level — $63,840 for a single person and about $132,000 for a family of four, according to an analysis from the consumer site healthinsurance.org. Below that threshold, the subsidy formula itself has grown less generous, with enrollees now expected to contribute between 2.15 percent and 10.22 percent of income toward a benchmark plan, up slightly from 2026.

KFF's brief identifies rising underlying health care prices as the primary driver of next year's increases, compounded by general inflation and labor costs. But insurers in the individual market cite an additional factor specific to the exchanges: as healthier people drop coverage rather than pay full price without subsidies, the remaining risk pool skews sicker and more expensive to cover, pushing premiums higher for everyone left behind.

The changes are also reshaping which plans are even available. Several insurers are exiting state exchanges for 2027, including Medica in Iowa, Cigna in Tennessee and Celtic in Delaware, the healthinsurance.org analysis found. Anyone whose current carrier is leaving the market will be automatically reassigned to a new plan if they do not act, which consumer advocates say makes comparison shopping during enrollment more important than usual this year.

Open enrollment runs from Nov. 1 through Jan. 15 in most states, according to federal marketplace guidance, though a plan selected after Dec. 15 will not take effect until Feb. 1 rather than Jan. 1. People currently enrolled through HealthCare.gov or a state-based exchange will generally be auto-renewed into a similar plan if they take no action, but given this year's rate changes and insurer departures, brokers and consumer groups are urging enrollees to log back in and actively compare options rather than let a renewal happen automatically. Shoppers near the subsidy cutoff should also double-check their projected 2027 income, since even a small change can determine whether they qualify for any tax credit at all.

The share of enrollees receiving any subsidy at all has already slipped, from about 92 percent in 2025 to roughly 87 percent in 2026, according to healthinsurance.org's tracking, and that share is expected to fall further for 2027 as the stricter income cutoff and smaller credits push more shoppers, particularly healthier and younger ones who pay closer to full price, toward skipping coverage altogether. Enrollment counselors recommend using the subsidy estimator on HealthCare.gov before the window opens and gathering recent pay stubs or a tax return early, since applications filed with inaccurate income estimates are a common reason subsidy amounts get adjusted or clawed back the following spring.