Quick answer: ACA Marketplace premiums are going up again in 2027. Among the 32 HealthCare.gov states below, average increases range from 6% in Arkansas to 29% in Arizona, and nationally the median proposed increase is about 15% before subsidies (HealthInsurance.org). Most people who get a tax credit will see some or all of the increase offset. People who pay full price feel it most. Open Enrollment runs November 1, 2026 to January 15, 2027, and you need to enroll by December 15 for coverage starting January 1.
Who this is for
- Anyone with an ACA Marketplace plan in a HealthCare.gov state
- Self-employed people, 1099 contractors and freelancers who buy their own coverage
- Early retirees under 65 waiting for Medicare
- Families and individuals who earn too much for a tax credit and pay full price
- Anyone whose insurer is leaving the Marketplace for 2027
How much is health insurance going up in 2027?
This is the second year in a row of double-digit increases. Nationally, the median proposed increase for 2027 is about 15% before subsidies (HealthInsurance.org). In some states it’s much higher.
Arizona leads the country, with insurers proposing an average increase of about 29%. Montana, Oklahoma, Mississippi and Wisconsin are all above 21%. At the low end, Utah and Arkansas are under 8%.
These are average increases across all insurers in a state. Your own renewal could be higher or lower depending on your insurer, your plan, your age and your county.
2027 health insurance rate increases by state
| State | 2027 avg. increase | Status |
|---|---|---|
| Arizona | 29.0% | Proposed |
| Montana | 23.3% | Approved |
| Oklahoma | 21.6% | Proposed |
| Mississippi | 21.1% | Proposed |
| Wisconsin | 21.1% | Proposed |
| Alabama | 20.7% | Approved |
| Georgia | 20.7% | Approved |
| Kansas | 19.5% | Proposed |
| Kentucky | 18.7% | Proposed |
| Louisiana | 18.1% | Approved |
| West Virginia | 17.3% | Proposed |
| Nevada | 17.2% | Approved |
| South Carolina | 17.2% | Proposed |
| Indiana | 17.1% | Approved |
| Virginia | 16.9% | Approved |
| Delaware | 16.4% | Approved |
| Tennessee | 15.6% | Approved |
| Florida | 15.3% | Proposed |
| North Carolina | 14.9% | Proposed |
| Maryland | 14.6% | Approved |
| Michigan | 14.5% | Approved |
| Texas | 14.1% | Proposed |
| Illinois | 14.0% | Proposed |
| Nebraska | 13.6% | Proposed |
| Ohio | 13.0% | Proposed |
| Missouri | 12.4% | Proposed |
| Wyoming | 11.3% | Proposed |
| Iowa | 10.7% | Approved |
| South Dakota | 10.1% | Approved |
| Colorado | 10.0% | Approved |
| Utah | 7.4% | Approved |
| Arkansas | 6.0% | Proposed |
Average rate changes before subsidies, based on insurer filings posted at ratereview.healthcare.gov. “Proposed” rates can still change before Open Enrollment, and different trackers calculate state averages differently, so figures may vary slightly by source.
What “proposed” vs. “approved” means
Insurers file their requested rates with the state each spring. Regulators review them and approve, lower or, in some states, simply comment on them. Approved rates are final for 2027. Proposed rates are what insurers asked for and could still change.
Don’t count on proposed rates coming down much. In some states, regulators can review rates for reasonableness but have limited power to reject them.
Why are health insurance premiums going up in 2027?
According to HealthInsurance.org, insurers point to four main drivers:
- Rising medical costs. Hospital prices, prescription drugs (including GLP-1 weight-loss and diabetes drugs), labor costs and higher use of care.
- General inflation across the economy.
- A sicker risk pool. The enhanced subsidies that ran from 2021 through 2025 expired. Insurers expect healthier people to drop coverage, which raises the average cost per member.
- Federal rule changes that insurers expect to reduce enrollment, though courts have blocked some of those provisions.
On top of that, several insurers are leaving the Marketplace for 2027, including Cigna in several states. Fewer insurers usually means less competition. If your insurer is leaving, read what Cigna members need to do for 2027.
Will your premium actually go up? It depends on your subsidy
The headline percentages are before subsidies. What you actually pay depends mostly on whether you get a premium tax credit.
If you get a tax credit: Most Marketplace enrollees received a subsidy in 2026 (87%), and because tax credits are tied to the cost of your area’s benchmark Silver plan, they generally grow when premiums grow. For most subsidized enrollees, that will offset some or all of the 2027 increase (HealthInsurance.org). For 2027, the share of income you’re expected to pay for the benchmark plan ranges from 2.15% to 10.22%.
If you pay full price: You’ll feel the full increase. This includes people above the subsidy cliff (400% of the federal poverty level) and anyone buying coverage off-exchange.
Watch out for the benchmark trap. Even with a subsidy, your net premium can jump if you stay on a plan whose price rose faster than the benchmark plan in your area. That’s why auto-renewing is risky this year.
Subsidized vs. full-price buyers: who’s affected most
| Get a tax credit | Pay full price | |
|---|---|---|
| Who | Income up to 400% of the federal poverty level | Income above 400% FPL, or buying off-exchange |
| Effect of 2027 increase | Often partly or fully offset by a larger tax credit | You pay the full increase |
| Biggest risk | Staying on a plan that rose faster than the benchmark | Paying much more for the same coverage |
| Best move | Compare plans; re-check your 2027 income estimate | Compare Marketplace plans and private plans |
What to do before you renew for 2027
- Open your renewal notice. It shows your 2027 premium if you do nothing. Compare it with what you pay now.
- Don’t auto-renew without looking. Prices, networks and drug lists change every year.
- Update your 2027 income estimate. Your tax credit is based on it, and since 2026 there’s no cap on paying back excess tax credits at tax time (HealthInsurance.org).
- Compare every insurer in your county. The cheapest plan in 2026 may not be the cheapest in 2027.
- Check your doctors and prescriptions in each plan’s 2027 directory and drug list.
- Consider a different metal level. Healthy people may save by moving from Silver to Bronze. Bronze plans can be HSA-eligible, but they come with a higher deductible.
- Enroll by December 15 for coverage starting January 1. You can enroll through January 15, but coverage then starts February 1 (HealthCare.gov).
When a private plan may make more sense in 2027
If you’re healthy and earn too much for a tax credit, these rate increases hit you directly, and there’s no subsidy to cushion them. That’s when a private medically underwritten plan is worth comparing.
Why some full-price buyers look at private plans:
- Priced on your health. Healthy applicants may find private plans compare well with full-price Marketplace premiums.
- PPO networks. Some private plans offer PPO networks with out-of-network coverage, which helps if you travel or see specialists across state lines.
- Year-round enrollment. You aren’t limited to Open Enrollment.
- No tax credit reconciliation. Private plans don’t use tax credits, so there’s no repayment surprise if your income changes.
The trade-offs:
- Private plans use health questions and can decline coverage or exclude pre-existing conditions.
- They aren’t HSA-eligible.
- They don’t qualify for tax credits.
- They don’t have to cover all ACA essential health benefits, so read the exclusions.
Stay with the Marketplace if you qualify for a tax credit, have a pre-existing condition, are pregnant or planning to be, or are in active treatment. For most people with a subsidy, a Marketplace plan is still the better value.
Your 2027 options at a glance
| Option | When it fits | Keep in mind |
|---|---|---|
| Switch Marketplace plans | Your current plan rose more than others nearby | Check doctors and drugs before switching |
| Lower metal level (e.g., Silver to Bronze) | Healthy and trying to offset the increase | Higher deductible; Bronze plans can be HSA-eligible |
| Stay on Silver for cost-sharing reductions | Lower income that qualifies for extra savings | Only Silver plans carry cost-sharing reductions |
| Private medically underwritten plan | Healthy and over the subsidy cliff | Not HSA-eligible; may exclude pre-existing conditions |
| Employer or spouse’s plan | You now have access at work | Can make you ineligible for tax credits |
Real-world scenarios
These are illustrative examples.
The subsidized family (Marketplace). A Texas family qualifies for a tax credit. Their renewal notice shows a higher premium, but when they compare plans they find their tax credit grew too. They switch to a Silver plan from a different insurer that keeps their pediatrician and pays less than renewing would have.
The full-price self-employed earner (private vs. Marketplace). A Phoenix consultant earns above the subsidy cliff and is healthy. With Arizona rates rising about 29%, his Marketplace renewal jumps sharply. He compares full-price Marketplace plans with private PPO plans he qualifies for, confirms he’s comfortable without an HSA, and chooses based on total cost and network.
The early retiree near the cliff (Marketplace). A Florida retiree, 61, lives on retirement income just under 400% FPL. She updates her 2027 income estimate, confirms she still qualifies for a tax credit, and picks a Silver plan. Her tax credit absorbs most of the increase.
The person in active treatment (Marketplace). A Georgia man in ongoing cancer care sees his premium rise. A private plan isn’t an option for him because of his health history, so he compares Marketplace plans by his oncologist and medications first, then by price.
Frequently asked questions
How much are health insurance premiums going up in 2027? Nationally, the median proposed increase is about 15% before subsidies. In the 32 HealthCare.gov states, average increases range from about 6% in Arkansas to 29% in Arizona.
Which state has the biggest health insurance increase for 2027? Arizona, where insurers have proposed an average increase of about 29%. Montana, Oklahoma, Mississippi and Wisconsin are also above 21%.
Why is health insurance going up so much in 2027? Insurers cite rising hospital and drug costs, inflation, a sicker risk pool after enhanced subsidies expired at the end of 2025, and federal rule changes expected to reduce enrollment.
Will my subsidy cover the 2027 increase? For many people, partly or fully. Tax credits are tied to your area’s benchmark Silver plan, so they usually rise when premiums rise. If you pay full price, you’ll pay the full increase.
Can proposed rates still change? Yes. Proposed rates can be lowered during state review, but in some states regulators have limited power to reject increases.
When is Open Enrollment for 2027? November 1, 2026 to January 15, 2027 in HealthCare.gov states. Enroll by December 15 for coverage that starts January 1.
Is a private health plan cheaper than a Marketplace plan in 2027? It can be for healthy people who pay full price. Private plans can be bought year-round and may offer PPO networks, but they aren’t HSA-eligible and can exclude pre-existing conditions. If you get a tax credit, a Marketplace plan is usually the better value.
Should I just auto-renew my plan for 2027? No. Prices, networks and drug lists change every year, and your plan’s increase may be bigger than others in your area. Compare before December 15.
Don’t renew blind in 2027. Let’s compare first
I’ll compare every 2027 Marketplace plan in your area, plus private options if you qualify, against your doctors, prescriptions and budget. Free, no obligation, and I’m licensed in multiple states.
Derek Greenlee, Greenlee Health Insurance 8687 East Vía de Ventura #210, Scottsdale, AZ 85258 Phone: 480-375-1652 Email: derek@greenleehealthinsurance.com Website: greenleehealthinsurance.com
Related reading
- Why the ACA Subsidy Cliff Hits High-Income Households Hardest in 2026
- High Income Earner? Why You’re Probably Overpaying for Health Insurance!