ACA Premiums Set for Double-Digit Hikes in 2027 as Enrollment Shrinks and Risk Pool Sours

Insurers have filed proposed rate increases for 2027 Affordable Care Act plans with a median of 14 percent across 77 issuers in 17 jurisdictions, according to early analyses. This follows sharp 2026 hikes and marks the fifth straight year of rising premiums. The Peterson-KFF Health System Tracker and Georgetown University's Center on Health Insurance Reforms both attribute the trend to a shrinking, sicker enrollee pool after enhanced premium tax credits expired. Enrollment fell by roughly 3 million this year, with healthier individuals more likely to drop coverage, leaving higher-cost claimants behind. Georgetown projects a further 17-26 percent drop in individual market participation. Unsubsidized buyers face the steepest impact; some saw premiums double or triple in 2026. Final rates are due by mid-August, with open enrollment starting November 1. These changes directly raise out-of-pocket costs for millions while subsidies still cushion most current enrollees at an average $96 monthly net premium.