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Middle-income Americans who do not qualify for government assistance are likely to face another round of steep health insurance costs next year, according to a fresh review of insurers’ filings. The analysis, which looks at proposals already public for 2027, signals rising premiums driven by higher medical costs and the end of pandemic-era financial supports.
Insurers participating in the ACA marketplace have submitted rate requests that, when viewed together, suggest a second consecutive year of double-digit increases. Those filings — collected and analyzed by the healthcare research nonprofit KFF — give an early read on how the individual market may change before regulators finalize rates later this summer.
Numbers that matter
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Here are the key figures from the KFF review and related data:
- Median proposed increase: 14% for 2027 across 77 insurers with public filings.
- Scope of data: Filings available in 16 states plus Washington, D.C.
- By comparison, the median increase for 2026 was about 20%.
- The marketplace has shrunk by more than 2.5 million enrollees over the past year, according to recent federal enrollment data.
- Households at or above 400% of the poverty level — roughly $63,000 for an individual or $129,000 for a family of four — are most exposed to the full premium hikes because they typically do not qualify for subsidies.
Why insurers are asking for higher rates
In their rate filings insurers point to several overlapping pressures. Hospitals and physician services are more expensive, prescription drug prices continue to climb, and workforce shortages are raising operational costs. Insurers also say the overall pool of enrollees has become smaller and sicker, which raises average claims per person.
One major factor cited repeatedly is the end of expanded federal tax credits that helped many Americans afford coverage during the pandemic. When those credits expired earlier this year, premiums rose sharply in many markets and some healthier people left the program, leaving a higher-risk population for insurers that remain in the individual market.
Insurers have also flagged regulatory shifts and new enrollment and eligibility rules as considerations that could alter who signs up and how plans are priced going forward.
Who will feel the impact
Most people who remain in the ACA marketplace continue to be shielded from the full brunt of premium increases through income-based subsidies. However, the group most likely to be squeezed consists of middle-income enrollees who do not qualify for those credits.
Those households are already seeing the steepest changes: many experienced large premium hikes in 2026, and proposed rates for 2027 would add further strain. Analysts say this cohort could face significant year-over-year payment jumps, with some households facing bills that are materially larger than before the pandemic-era policies were put in place.
What analysts are saying
The KFF findings align with other early reviews of insurer filings. Researchers at Georgetown University’s Center on Health Insurance Reforms reached similar conclusions, projecting double-digit increases in aggregate premiums for next year.
Experts note a predictable dynamic: when healthier people exit the pool, average costs per enrollee rise. That shift was widely forecast once the enhanced tax credits ended, and current filings suggest that scenario is unfolding in practice.
While these enrollment changes are concentrated in the individual market, the same inflationary pressures — higher hospital and drug costs, workforce constraints, broader economic inflation — are likely to push up costs for employer-sponsored plans and other private coverage as well.
Political and practical stakes
Lawmakers have proposed a range of policy responses to make coverage more affordable, but no broad legislative fix has yet cleared Congress. Rising premiums have become a prominent concern for voters and are expected to factor into political debates ahead of the fall elections.
For consumers, the near-term reality is clear: regulators will review and finalize the filings in the months ahead, but proposed prices already on the table point to another year of higher renewal notices for many Americans — especially those not receiving subsidies.
What to watch next: finalized statewide rate approvals later this summer, any emergency federal actions to restore or adjust subsidies, and insurer decisions about whether to exit or expand participation in specific markets.
