KFF data shows ACA premiums up 13% for 2027 as enrollment window opens

The Affordable Care Act open enrollment period begins Sunday in most states, marking the start of a coverage year characterized by higher costs and tighter eligibility rules.

The sign-up window for the health insurance marketplace will run through January 15. Consumers are facing a 13% average increase in premiums for 2027, according to an analysis of new Centers for Medicare & Medicaid Services data by the nonprofit KFF.

Cynthia Cox, a vice president and director of the ACA program at KFF, attributed the price hike to several factors. These include rising healthcare costs, increased hospital market concentration, and the impact of the No Surprises Act. The availability of GLP-1 drugs also contributes to the higher rates.

The financial burden falls hardest on individuals who do not qualify for subsidies. Cox noted that many of these consumers have already shifted to bronze plans, which are the most affordable tier available. She stated that some may struggle to afford continued coverage into next year.

A fact sheet distributed by CMS on Friday asserts that Americans using HealthCare.gov will have access to low-cost plans. However, the administration has moved to restrict financial assistance for groups that previously received premium tax credits and cost-sharing reductions.

The shift in pricing follows the expiration of subsidies implemented during the Biden administration. Republicans opposed extending those pandemic-era benefits, which had helped offset costs for most enrollees. This change resulted in 1.2 million fewer people signing up for coverage in the exchanges.

As of February, roughly 19.2 million people were actively enrolled in ACA marketplace health plans, according to the Department of Health and Human Services. Enrollment grew during the pandemic due to enhanced subsidies from the American Rescue Plan Act and the Inflation Reduction Act.

New regulations taking effect in 2027 will limit tax credits for certain lawfully present immigrants. Policy experts estimate this change could lead to an additional 1 million uninsured individuals over time. The administration has also intensified efforts to remove enrollees from the program to combat waste, fraud, and abuse.

In September, Vice President JD Vance and other officials announced plans to remove 760,000 ACA enrollees from public exchanges. The administration alleged that these individuals were fraudulently enrolled or did not exist. Vance said the canceled subsidy payments would result in $2.2 billion in cost savings.

Cox said it remains unclear how many more people will drop off of ACA coverage in 2027. With higher premiums, immigration eligibility changes, and anti-fraud efforts, she predicted fewer people will be enrolled in the market, though the reasons for the decline will be difficult to isolate.