If you purchase your own health insurance on the individual market, you should brace for yet another substantial price jump. Affordable Care Act premiums for 2027 are climbing once again, marking the second consecutive year of steep, double-digit rate increases for millions of Americans who shop for coverage through HealthCare.gov and state-run insurance marketplaces.

Benchmark silver premiums are rising by an average of 13% nationwide for 2027, following a massive 26% surge in 2026, as reported by The Wall Street Journal. Here’s what’s driving the increases, who will feel them most and how to find the most affordable coverage during open enrollment.

Why are Affordable Care Act insurance premiums rising again in 2027?

First, it helps to understand the benchmark plan. It is the second-lowest-cost silver plan in each area. It matters because it sets the size of federal premium tax credits.

For a 40-year-old, the average monthly benchmark premium is $704 in 2027, up from $625 in 2026 and $497 in 2025, according to KFF. In other words, the sticker price has climbed more than 40% in two years.

Prices also vary widely by state. For example, Vermont’s average benchmark premium for 2027 is $1,313 a month, while New Hampshire’s is $486, KFF data shows.

Importantly, these are prices before subsidies. Many enrollees who qualify for premium tax credits will pay far less, since the credits rise along with the benchmark.

What is driving the rising cost of health insurance under the ACA?

Several forces are pushing ACA premiums higher in 2027. As in most years, the biggest driver is the rising cost of care itself. Insurers point to higher prices for hospital stays, doctor visits and prescription drugs, according to KFF.

In fact, the underlying cost of medical care and prescription drugs is expected to rise about 10% for 2027, higher than the 8% average of recent years, KFF found.

Several pressures are adding up:

• General inflation across the economy.
• Healthcare workforce shortages that push wages higher.
• Expensive specialty drugs for cancer, autoimmune disease and other conditions.
• Growing use of GLP-1 medications like Ozempic and Wegovy.
• Hospital and provider consolidation that weakens price competition.

Insurance agents see the same forces at work. “Insurers are pricing in higher medical and drug costs from the past two years, and many are also adjusting because the pandemic-era risk pool shifted as healthier people came and went from the marketplace,” Ryan Kennelly, senior benefits advisor at Smart Insurance Agents, an independent agency with no exclusive insurer affiliations, told Blavity Health.

How did the expiration of enhanced ACA subsidies affect health insurance premiums?

From 2021 through 2025, enhanced premium tax credits made marketplace coverage much cheaper. They lowered what most people paid and removed the income cap on eligibility. However, Congress did not extend them, and they expired at the end of 2025.

Since then, many enrollees have paid much more out of pocket. For example, a 40-year-old in Indianapolis earning $65,000 paid $316 a month for a benchmark silver plan in 2025, but would pay an estimated $546 in 2027 if insurers’ proposed rates held, according to KFF.

To be clear, the original ACA premium tax credits are still available. Eligible people with incomes between 100% and 400% of the federal poverty level can still get help. Only the expanded eligibility and extra financial assistance ended.

For lower-income families, the difference can be steep. “For example, a family with a household income of $40,000 paid $0-50 per month with the enhanced tax credit; now that the tax credits expired, that family may have to pay upwards of $200 per month,” Linda Goler Blount, MPH, president and CEO of the health advocacy group Community Catalyst, told Blavity Health.

Why are fewer people enrolling in ACA health insurance plans?

Because of higher out-of-pocket costs, some people have left the market. Marketplace plan selections fell by 1.2 million during the 2026 sign-up period, and by February, 2.6 million fewer people were enrolled and paying premiums than a year earlier, KFF reported.

Unfortunately, the people most likely to drop coverage tend to be younger and healthier. When they leave, the remaining pool is sicker and more expensive to cover on average. As a result, insurers raise premiums further, which can push even more people out. That cycle helps explain why ACA premiums are climbing again in 2027.

Insurers say this shift is real. According to KFF, insurers attribute roughly four percentage points of their requested 2027 increases to a sicker risk pool.

Which Americans will be most affected by the 2027 ACA premium increases?

In particular, the hardest hit are people who earn just too much to qualify for help. With enhanced subsidies gone, the 400% federal poverty level cap is back.

For 2027 coverage, that cap is $63,840 for a single person and $132,000 for a family of four, based on the 2026 federal poverty guidelines. Above those limits, people pay the full price of their plans.

Middle-income households in high-cost states, along with older adults who face higher age-based premiums, may feel the biggest shock. Similarly, the increases could hit people who do not get coverage through an employer, including:

• Self-employed workers and freelancers
• Gig workers and contractors
• Small-business owners and employees
• Early retirees who are not yet eligible for Medicare

The stakes are high for Black families as well. Black Americans are more likely than white Americans to be uninsured, according to KFF, and rising costs could widen that gap.

How are health insurance companies responding to changes in the ACA marketplace?

Meanwhile, some insurers are pulling back. As of late October, 11 insurers had announced plans to leave at least one state marketplace for 2027, according to KFF.

Most notably, Cigna is exiting the ACA individual market entirely in 2027. The move affects about 369,000 members across 11 states, STAT reported. Cigna’s chief operating officer, Brian Evanko, said the company did not see a way to meaningfully grow the business.

Insurer exits can cause real disruption. When an insurer leaves, its members must pick a new plan, which may mean new doctors, a different pharmacy network or different drug coverage. In addition, fewer insurers can mean less competition and fewer choices.

What happens if Americans can no longer afford ACA health insurance?

When coverage becomes unaffordable, some people go without it. Others switch to plans with lower premiums but much higher deductibles, which can leave them underinsured.

Either way, health can suffer. Uninsured adults are more likely to skip needed care and less likely to get preventive services, according to KFF. They also face greater risk of medical debt.

That can make it harder to:

• Get routine screenings and checkups.
• Fill prescriptions consistently.
• Manage chronic conditions like high blood pressure and type 2 diabetes.
• Treat problems early, before they become emergencies.

Doctors say cost can shape even emergency decisions. “A patient comes to me with chest pain, and I have to spend extra time convincing him to go to the ER, because he is doing the math on his copay and deductible instead of thinking about his heart,” Elissa B. Gartenberg, DO, a board-certified family physician and founder of Modern Family Medicine, a membership practice in Scottsdale, Arizona, told Blavity Health.

Patients with chronic illness face the most danger. “The people most at risk are the ones who need daily medication to stay stable: diabetes, hypertension, asthma, heart disease. They cannot safely take a break from their medicine,” Gartenberg said.

Children can lose out, too. “When families can’t afford healthcare, they often delay seeking care until a problem becomes more serious,” Christy Rivers, DO, a board-certified pediatrician and owner of New Way Pediatrics, a direct primary care practice in Corvallis, Oregon, told Blavity Health.

What can consumers do to find affordable ACA health insurance in 2027?

Even with ACA premiums rising in 2027, careful shopping can still save money. The most important step is simple, though: don’t auto-renew without shopping. Your current plan’s price, network or drug list may have changed, and a better deal may exist.

When you compare plans, look beyond the monthly premium. Check the full picture:

• Deductibles, copays and coinsurance.
• The out-of-pocket maximum.
• Whether your doctors and hospitals are in network.
• Whether your prescriptions are covered, and at what cost.

Check your eligibility for financial help

Next, check whether you qualify for financial help. Enter your expected 2027 income on HealthCare.gov or your state marketplace to see your premium tax credit. Also, some states offer their own subsidies. For instance, New Mexico was the only state to fully replace the expired enhanced credits with state funding, KFF found.

Look into cost-sharing reductions

In addition to premium tax credits, some enrollees can lower their deductibles and copays. If your income is up to 250% of the federal poverty level, you may qualify for cost-sharing reductions, but only if you choose a silver plan, according to HealthCare.gov.

As a result, a silver plan can be a better value than a cheaper bronze plan for many lower-income shoppers. Although the bronze premium may look smaller, its high deductible can leave you paying more when you actually need care.

Weigh your health needs

Similarly, think about how often you use care. If you take regular medications or see specialists, a plan with a higher premium but lower out-of-pocket costs may save money over the year. On the other hand, if you rarely see a doctor, a lower-premium plan may make sense, as long as you could afford the deductible in an emergency.

Find low-cost care if you go without coverage

If you can’t afford a plan, you still have options. “Community health centers charge patients based on a sliding scale, where those who earn less pay less. They can also provide access to medicines at a low cost,” Aleksey Aronov, AGPCNP-BC, a board-certified adult-gerontology primary care nurse practitioner, told Blavity Health.

Also, check coverage for your kids separately. “Many families don’t realize their children may qualify for public insurance even when the parents don’t,” Rivers said.

Bottom line

ACA premiums for 2027 are rising an average of 13% for benchmark plans, on top of a 26% jump in 2026, as healthcare costs climb and enhanced subsidies disappear. People earning just above 400% of the poverty level face the steepest costs. Shopping carefully, checking for tax credits and comparing total costs can help you find coverage you can afford.

Frequently Asked Questions

Will my ACA health insurance premium automatically increase by 13% in 2027?

Not necessarily, because 13% is a national average for benchmark plans, and your actual cost depends on your state, plan, age, income and tax credit, according to KFF.

Are ACA premium tax credits still available in 2027?

Yes, the original premium tax credits remain available to eligible people with incomes between 100% and 400% of the federal poverty level, though the enhanced credits expired at the end of 2025, according to KFF.

Citations

HealthCare.gov. Dates and Deadlines for 2027 Health Insurance. Centers for Medicare & Medicaid Services. Accessed November 9, 2026. https://www.healthcare.gov/quick-guide/dates-and-deadlines/

HealthCare.gov. Save on Out-of-Pocket Costs. Centers for Medicare & Medicaid Services. Accessed November 9, 2026. https://www.healthcare.gov/lower-costs/save-on-out-of-pocket-costs/

HealthCare.gov. Find Local Help. Centers for Medicare & Medicaid Services. Accessed November 9, 2026. https://localhelp.healthcare.gov/

KFF. In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase for 2027, Following a Steep Climb This Year. KFF. Published July 2026. https://www.kff.org/affordable-care-act/press-release/in-preliminary-rate-filings-aca-marketplace-insurers-largely-propose-double-digit-premium-increase-for-2027-following-a-steep-climb-this-year/

KFF. Health Coverage by Race and Ethnicity. KFF. Accessed November 9, 2026. https://www.kff.org/racial-equity-and-health-policy/issue-brief/health-coverage-by-race-and-ethnicity/

KFF. Affordable Care Act. KFF. Accessed November 9, 2026. https://www.kff.org/topic/affordable-care-act/

KFF. Key Facts About the Uninsured Population. KFF. Accessed November 9, 2026. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/

KFF. Marketplace Average Benchmark Premiums. KFF State Health Facts. Accessed November 9, 2026. https://www.kff.org/affordable-care-act/state-indicator/marketplace-average-benchmark-premiums/

McGough M, Ortaliza J, Ferguson A, Telesford I, Rakshit S, Cotter L, Cox C. How Much and Why ACA Marketplace Premiums Are Going Up in 2027. KFF. Published August 3, 2026. https://www.kff.org/affordable-care-act/how-much-and-why-aca-marketplace-premiums-are-going-up-in-2027/

Office of the Assistant Secretary for Planning and Evaluation. Poverty Guidelines. U.S. Department of Health and Human Services. Accessed November 9, 2026. https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines

STAT. Cigna exits ACA market in 2027, 369,000 people affected. STAT. Published April 30, 2026. https://www.statnews.com/2026/04/30/cigna-exits-aca-market-2027-369-thousand-people-affected/

The Wall Street Journal. Affordable Care Act Rates to Rise Steeply Again. The Wall Street Journal. Published November 2026. https://www.wsj.com/health/healthcare/affordable-care-act-rates-to-rise-steeplyagain-986da40c

WJLA. ACA premiums jump for second straight year as subsidy loss squeezes shoppers. WJLA. Published November 2026. https://wjla.com/news/nation-world/aca-premiums-jump-for-second-straight-year-as-subsidy-loss-squeezes-shoppers