- Insurers propose a median 14% premium increase for ACA Marketplace plans in 2027, marking the second consecutive year of double-digit hikes.
- Key drivers of rising premiums include underlying healthcare cost growth (10% medical trend), general inflation, labor shortages, and increasing claims severity.
- The expiration of enhanced premium tax credits at the end of 2025 is leading to a sicker risk pool, adding about 4 percentage points to 2027 premium increases.
- Other factors influencing premiums are high-cost GLP-1 medications, provider consolidation, the No Surprises Act, and federal regulatory changes like the NBPP and H.R. 1.
- Premium changes vary widely among insurers, ranging from 1% to 52%, with most proposals between 10% and 20%.
- Subsidized enrollees may be partially shielded from premium hikes, but the expiration of enhanced credits has reduced assistance and increased out-of-pocket costs.