If you buy health insurance through the ACA marketplace, you may have seen headlines about proposed premium increases for 2027. While these are still proposed rates and not final, they give a useful early look at what the coming year could mean for your monthly costs. Here is a plain-English breakdown of what is happening and what you can do about it.
Why Are Premiums Going Up?
Insurance companies submit proposed rate increases to state and federal regulators each year. For 2027, many insurers across the country are asking for higher premiums. The reasons vary by state and insurer, but some common factors include:
- Rising medical costs: The price of hospital care, prescription drugs, and specialist visits continues to climb.
- Higher utilization: More people are using their coverage, which increases overall costs for insurers.
- Uncertainty in federal policy: Changes to cost-sharing rules and subsidy structures can affect how insurers price their plans.
- Expiring enhanced subsidies: The expanded premium tax credits first introduced during the pandemic are currently set to expire after 2025. If Congress does not extend them, millions of enrollees could face much higher out-of-pocket premiums starting in 2026 and beyond.
It is important to remember that proposed rates are not final. State regulators review and sometimes reduce these requests before open enrollment begins in the fall.
How This Affects Your Subsidy and Your Bill
Most marketplace enrollees receive a premium tax credit that lowers their monthly premium. The good news is that this subsidy is tied to the cost of a benchmark plan in your area. If premiums rise, your subsidy amount often rises too, which can offset some or all of the increase.
However, this protection does not apply equally to everyone. If your income is above the subsidy threshold, you will feel the full impact of any rate increase. And if you are enrolled in a plan that rises faster than the benchmark plan, you could still see a higher bill even with a subsidy.
Steps You Can Take Before Open Enrollment
Open enrollment for 2027 coverage will likely open in November 2026. You do not need to wait until then to start preparing. Here are a few practical steps:
- Check your current plan: Log into your marketplace account and review your current coverage, premium, and deductible.
- Update your income estimate: Your subsidy is based on your projected income. If your income has changed, updating it now ensures you get the right credit.
- Compare plans during open enrollment: Do not automatically re-enroll in your current plan. Premiums and benefits change each year, and a different plan may offer better value.
- Look for cost-sharing reductions: If your income falls below 250 percent of the federal poverty level, you may qualify for plans with lower deductibles and copays.
The Bottom Line
Premium increases can feel stressful, but the ACA marketplace is designed with tools to help absorb those changes for most enrollees. The key is staying informed and actively comparing your options each year rather than letting your coverage auto-renew without review.
Practical takeaway: Mark open enrollment on your calendar now, gather your income documents early, and plan to spend time comparing plans rather than sticking with what you had last year. A small amount of research can save you hundreds of dollars over the course of the year.