ACA marketplace premiums climb again as subsidy expiration pushes costs higher

Millions of Americans who purchase health insurance through the Affordable Care Act marketplace are facing another steep increase, with benchmark premiums set to rise an average of 13% in 2027 after climbing 26% this year.

Those consecutive increases could weigh heavily on people who do not get insurance through an employer, including self-employed workers and employees of small businesses. In most states, open enrollment begins Nov. 1, giving shoppers a chance to compare next year’s plans and prices.

The 13% figure reflects finalized benchmark silver premiums. Insurers had proposed a median increase of 15% across marketplace plans, although the final amount varies by state, insurer and plan. Because benchmark premiums also help determine federal subsidies, they play a major role in how much many enrollees ultimately pay.

The higher prices come after enhanced federal tax credits that had reduced premiums expired at the end of 2025. People with incomes above 400% of the federal poverty level are no longer eligible for premium tax credits and must pay the full cost of coverage.

A Washington Post analysis offers one example of the impact: a 40-year-old in Arizona earning $65,000 could see a Blue Cross Blue Shield marketplace premium rise from $300 a month in 2025 to $555 in 2027. Actual costs differ depending on location and plan.

Enrollment has also slipped. Marketplace plan selections fell by 1.2 million during the 2026 sign-up period, and by February there were 2.6 million fewer people enrolled and paying premiums than a year earlier, according to KFF. Insurers say higher medical expenses and the loss of the enhanced tax credits are helping drive rates upward.

Some shoppers may face fewer choices as well. As of Oct. 29, 11 insurers had said they plan to exit at least one state marketplace for 2027, KFF reported. When an insurer leaves, customers may need to switch coverage, and their doctors or prescriptions could be affected.