How Much and Why ACA Marketplace Premiums Are Going Up in 2027

Note: This brief was originally published on July 8 and updated on August 3, 2026 to include proposed 2027 rates from all 50 states and the District of Columbia.

ACA Marketplaces insurers are proposing a median premium increase of 15% in 2027, according to KFF’s updated analysis of 276 insurers with publicly available filings across all 50 states and the District of Columbia. This is the second consecutive year of double-digit premium hikes. Last year’s median nationwide proposed rate change was 18%, and the median finalized rate change was 20%. While this proposed rate change is lower than last year, it represents the second-highest requested rate change since 2018, as premium growth had been relatively flat in this market for several years.

Based on detailed filings from 16 states and DC, rising healthcare prices—as in prior years—remain the primary driver of 2027 premium increases. Insurers cite higher costs for health services, general economic inflation, and labor shortages. They also point to factors unique to the individual market: the expiration of enhanced premium tax credits at the end of 2025 and a related increase in the risk pool’s morbidity, as contributing to rising rates for 2027.

The full analysis and other data on health costs are available on the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.