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Some health insurance premiums may rise sharply in 2027, but the widely cited 15% figure is a median increase insurers have proposed for ACA Marketplace plans—not a prediction that every enrollee’s bill will go up 15%. Final rates, subsidies and what you pay depend on your market and circumstances.
What do the 2027 premium figures actually measure?
The numbers below describe different markets and different kinds of estimates. They are not interchangeable, and none is a universal forecast for an individual household.
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| Figure | Market and measure | Status and what it means |
|---|---|---|
| 15% | ACA Marketplace; median proposed increase among 276 insurers with publicly available filings across all 50 states and Washington, D.C. | KFF’s 2026 analysis of insurer filings for 2027. A proposed median, not a final approved rate or an individual’s expected increase. |
| 14% | Small-group coverage; median proposed increase among nearly 300 insurers. | KFF’s 2026 analysis of 2027 filings. It does not describe an employee’s share of a premium, large-employer coverage or individual Marketplace plans. |
| 9.9% | California ACA Marketplace; preliminary weighted average increase. | Covered California’s 2026 announcement for its 2027 plans. This is a state-specific average, not a national rate. |
| 4.3% in 2026; 7.7% in 2027 | ACA Marketplace; projected increases in gross benchmark premiums. | CBO projections, as reported by Peterson-KFF Health System Tracker in 2026, in the absence of a permanent extension of enhanced premium tax credits. These are projections for benchmark premiums, not insurer medians or a person’s net bill. |
The national 15% result is KFF’s updated analysis, covering filings from all states and Washington, D.C. KFF’s earlier snapshot covered 77 insurers in 16 states and Washington, D.C., and found a 14% median proposed increase; the broader, updated analysis is the more relevant national figure.
Why are insurers proposing higher Marketplace rates?
Medical care and prescription drugs cost more
Insurers cite rising prices and use of health services, including prescription medicines, in their filings. A proposed rate reflects an insurer’s expected costs for the people it covers. It does not mean every enrollee used more care or that every insurer faces the same cost trend. KFF’s analysis collects insurers’ stated explanations.
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Enhanced premium tax credits expired
The enhanced ACA premium tax credits that expanded financial help for Marketplace coverage expired at the end of 2025. That change can increase the amount eligible people pay after assistance, even if their plan’s gross premium does not rise by the same percentage. Insurers set gross rates separately, and regulators review their filings.
Insurers expect changes in who stays enrolled
The Congressional Budget Office says some healthier people who joined nongroup coverage because of the expanded assistance are expected to leave after the credits expire. If the remaining pool is, on average, more costly to insure, premiums may rise faster than they otherwise would. This is a projected market response, not proof that every insurer will see the same enrollment change.
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CMS’s 2027 Payment Notice is a proposed rule affecting Marketplace standards. It is relevant policy context, but a proposal should not be treated as a finalized requirement. Insurers may account for anticipated policy or enrollment changes when setting rates.
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Why isn’t a 15% rate increase the same as a 15% bigger bill?
A plan’s gross premium is its full price before financial assistance. An eligible Marketplace enrollee may receive a premium tax credit that lowers the net monthly payment. The change in that net payment can differ from the change in the gross rate: the credit may change, the plan price may change, or both. Losing enhanced assistance can therefore affect what someone pays even apart from the insurer’s proposed rate increase.
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The CBO figures in the table measure projected changes in gross benchmark premiums, not what a particular household owes after tax credits. Likewise, KFF’s 15% is a median across insurer proposals, not an average increase promised to each customer.
Does the small-business figure apply to employer insurance?
Not necessarily. KFF’s 14% median proposed increase is for insurers offering small-group coverage. It is not a forecast of the employee contribution at a particular workplace, nor does it establish what large employers’ plans will cost. An employer’s total premium and the amount an employee pays can differ because employers and workers may share the cost. The evidence summarized here does not establish a complete 2027 estimate for all employer-sponsored coverage.
How can I find out what my own coverage may cost?
A reliable household estimate requires local plan and subsidy information. The relevant details include your state or ZIP code, age, household size and income, the plan you choose, and whether you qualify for assistance. The national median alone cannot provide a universal dollar estimate.
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- Wait for final local information. Insurer filings are proposals under review; proposed rates can change before approval. Compare plans using the final rates and available subsidy information for your area.
- Compare the coverage, not just the premium. Check whether your doctors and hospitals are in network, whether your prescriptions are covered, and what the deductible and out-of-pocket limits are. A lower monthly premium by itself does not show that a plan is a better fit.
- Recheck your net price. Compare the amount you would pay after any premium tax credit, rather than assuming the change in gross premium is the change in your monthly bill.
What the figures can—and cannot—tell you
The 2027 filings point to substantial proposed increases in both Marketplace and small-group coverage, but they do not settle what any one person or employer will pay. State results, plan rates, approval decisions and financial assistance all matter. Covered California’s preliminary 9.9% weighted average, for example, illustrates why a national insurer median cannot stand in for a specific state’s result.
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