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Health insurance premium increases for 2027: Proposed rates by state and what consumers should know

by TheAdviserMagazine
3 weeks ago
in Medicare
Reading Time: 5 mins read
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Health insurance premium increases for 2027: Proposed rates by state and what consumers should know
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Proposed individual market premium increases for 2027 have been published in about a third of the states as of mid-July, with a median proposed increase of about 14%.

Basic details of initial 2027 rate filings will be available for every state on ratereview.healthcare.gov starting on July 31, 2026.

After last year’s increases, another round of double-digit rate increases may sound alarming. But proposed rate increases do not necessarily reflect what Marketplace enrollees will ultimately pay, and several key factors make the outlook for 2027 very different than what we saw for 2026.

Here are the proposed weighted average health insurance rate increases that are available at this point:

* Market share details are not available in Hawaii or Kentucky, so a straight average has been calculated rather than a weighted average that accounts for each carrier’s enrollment.

Proposed 2027 individual market rate increases by state

State
Average proposed increase

Vermont
6.5%

Iowa
6.7%

Washington, DC
9.5%

Hawaii
11.1%*

Minnesota
11.9%

Massachusetts
12.9%

Maryland
13.7%

Illinois
14.1%

Michigan
14.2%

Connecticut
16.2%

Maine
16.8%

Oregon
17.5%

Indiana
19.3%

Kentucky
19.6%*

Rhode Island
20.1%

Georgia
20.7%

New York
20.7%

Washington
22.4%

Federal subsidy enhancements expired last year, driving up the average net (after-subsidy) Marketplace premiums by 58% in 2026, even though many people downgraded to lower-priced Bronze plans.

Had the subsidy enhancements had been extended, premium subsidies would have been larger, offsetting the last year’s underlying premium growth – which was significantly larger than we had seen for the last several years.

(Premium subsidies are actually larger in 2026 than they were in 2025. In 2026, the average premium subsidy is $650/month, up from $550/month in 2025. But the average full-price premium grew by even more: It was $619/month in 2025, and increased to $741/month in 2026, despite all the people who downgraded their coverage.)

Here’s why 2027 will be different, despite the double-digit rate increase proposals that we’re seeing so far:

Most Marketplace enrollees still get premium subsidies, even after the subsidy enhancements expired. During the open enrollment period for 2026 coverage, 87% of enrollees qualified for premium subsidies.
The subsidies are designed to keep pace with the cost of the benchmark (second-lowest-cost) Silver plan in each area. So as premiums rise, so should subsidies. The reason people are paying much higher premiums this year, even if they’re still getting a subsidy, is because the expiration of the subsidy enhancements resulted in a significant increase in the percentage of income that people have to pay for their coverage.
For 2027, the percentage of income that people have to pay themselves will be indexed just the way it was each year from 2015 to 2021, but it won’t be the sort of drastic change that we saw for 2026.

The short story: For most Marketplace enrollees, larger subsidies will likely offset some or all of the premium increases for 2027. But the full brunt of the premium increases will mostly impact Marketplace enrollees who aren’t eligible for a subsidy, plus anyone who buys individual market coverage outside the Marketplace, where subsidies aren’t available.

Why Marketplace premiums are increasing

The factors driving full-price premiums higher for 2027 include some usual culprits and some that stem from recent federal changes. As is typically the case, the largest driver of higher premiums is the ever-increasing cost of healthcare. This includes a variety of factors, including higher hospital and drug costs (including the cost of GLP-1 medications), higher labor costs, and increased utilization of medical services.

Insurers also point to general economic inflation as a factor that has pushed prices higher across the board in recent years, including the price of healthcare.

Insurers also note that the expiration of the federal subsidy enhancements is expected to result in continued deterioration of the health of the overall risk pool in 2027, as healthier enrollees drop their coverage, leaving a sicker risk pool that costs more to insure on a per-person basis. Insurers also point to some other recent federal rule changes that are projected to result in lower enrollment (and thus a sicker risk pool), including the 2025 Marketplace Integrity rule, the “One Big Beautiful Bill,” and the 2027 Notice of Benefit and Payment Parameters.

Will I qualify for a subsidy in 2027 if I don’t qualify in 2026?

Because the subsidy enhancements were allowed to expire, the “subsidy cliff” returned in 2026. This means subsidy eligibility ends abruptly if household income goes above 400% of the federal poverty level (FPL), regardless of how much the household has to spend on health insurance.

During the open enrollment period for 2025 coverage, 92% of Marketplace enrollees qualified for a subsidy, but that dropped to 87% in 2026, largely because of the return of the subsidy cliff.

The subsidy cliff will still exist in 2027, so subsidies will not be available if household income is more than 400% FPL. But because of annual increases in the FPL, the income level at which subsidy eligibility ends will be a little higher in 2027:

A single person in the continental U.S. will qualify for a subsidy with an income as high as $63,840, up from $62,600 in 2026.
A household of four in the continental U.S. will qualify for a subsidy with a household income as high as $132,000, up from $128,600 in 2026.

Make sure you understand how household income is calculated under the ACA, as it’s a unique version of MAGI. And keep in mind that contributions to a health savings account or pre-tax retirement account will reduce your ACA-specific MAGI.

If I get a premium subsidy, will my subsidy increase in 2027?

If the cost of the benchmark plan in your area increases, your subsidy amount will generally increase too, assuming your income remains fairly steady.

But the benchmark plan is just one plan, and there are dozens of plans available in most areas. So it’s important to understand that the size of your subsidy is tied to the price of the benchmark plan, not the price of your specific plan.

Depending on the discrepancy between how much your plan’s premium changes and how much the benchmark plan’s premium changes, you may find that your subsidy doesn’t keep pace with your premium. But it’s also possible for the subsidy amount to increase by more than the premium increase for your plan, making your plan more affordable in the coming year.

Either way, it’s always a good idea to carefully comparison shop during open enrollment, which starts on November 1 in most states.

Should I switch to a different Marketplace plan for 2027?

Renewing your current plan for 2027 – if it’s still available – might be the best option, or you might be better served by switching to a different plan. You won’t know until you compare the plans available in your area during open enrollment.

Pay close attention to any notifications you get from your health plan and the Marketplace as we get closer to the start of open enrollment. If your net health insurance premium is increasing for 2027, you might prefer a different plan. But choosing a health insurance policy involves a lot more than just premiums, so be sure you consider all aspects of the various plans before picking the one you want for 2027.

Note: Roughly 700,000 people will need to select new plans for 2027 because of carriers exiting the Marketplace at the end of 2026. If your carrier is leaving the Marketplace and you pick a new plan by December 31, it will take effect on January 1, ensuring that you have seamless coverage.

Final rates could differ from proposed rates

The proposed rate increases listed above are initial proposals, so they could change before they’re finalized. In nearly all states, the rate review process is done by the state, and there’s significant variation in terms of how much approved rates tend to differ from the rates that the insurers initially file.

Last year, for example, New York regulators approved an overall average rate increase of 7.1% for 2026 individual market plans, which was significantly smaller than the 13.5% average rate increase the insurers had proposed.

But in Idaho, the approved health insurance rates were nearly identical to the insurers’ proposals, except for two carriers, one of which ended up with a larger-than-proposed rate increase, and one of which ended up with a smaller-than-proposed rate increase.



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