2027 Health Insurance Premium Increases by State: What ACA Shoppers Need to Know

Health insurance premiums are rising again in 2027.

Across the ACA individual health insurance market, insurers proposed a median premium increase of about 15% for 2027. That follows a finalized median increase of roughly 20% for 2026, making this the second consecutive year of unusually large premium increases.

But a 15% national increase does not mean every person will pay 15% more. Your actual 2027 health insurance premium can change much more—or much less—depending on:

• •your state
• •your county and ZIP code
• •your age
• •your insurance company
• •the specific plan you choose
• •whether you qualify for an ACA subsidy
• •how the benchmark Silver plan changes in your area
• •and whether you actively shop or simply auto-renew

For some households, 2027 may mean only a modest change in what they actually pay after subsidies. For others—especially people who earn too much to qualify for premium tax credits—the increase can hit almost dollar-for-dollar.

How Much Are Health Insurance Premiums Increasing in 2027?

KFF reviewed proposed filings from 276 ACA Marketplace insurers across all 50 states and Washington, D.C. and found a median proposed rate increase of approximately 15%. KFF notes that 2027 would represent the second-highest median requested increase since 2018.

The important word is: proposed. Insurance companies submit requested rates to state and federal regulators before Open Enrollment. Some regulators approve those rates largely as filed. Others reduce them substantially.

For example, New York insurers initially requested much larger increases for 2027, but regulators ultimately approved an overall average increase of roughly 6%. By contrast, New Mexico’s approved increases remained close to insurers’ original requests.

2027 Health Insurance Premium Increases by State

The following figures represent approximate statewide average increases in the individual health insurance market based on proposed filings or finalized rates where already available. They do not represent the exact premium increase every consumer will receive.

These statewide averages are drawn from carrier filings and regulatory decisions compiled from state insurance departments and national ACA rate analyses. Some states have finalized 2027 rates, while others were still using proposed figures at the time of the latest reporting.

Which States Are Seeing the Largest 2027 Health Insurance Increases?

Among the states with the highest reported statewide average increases are:

• •Arizona — approximately 29%
• •Alabama — approximately 25%
• •New Mexico — approximately 24.4%
• •Kansas — approximately 24.2%
• •Alaska — approximately 22.9%
• •Montana — approximately 22.6%
• •Washington — approximately 22.2%
• •Mississippi — approximately 21.8%
• •Oregon — approximately 21.6%
• •Wisconsin — approximately 21.1%

Those figures can look alarming, but they are still averages. One carrier may increase rates by 8% while another carrier in the same state increases them by 25%. Even within the same carrier, different plan designs and counties can experience different changes.

States With More Moderate 2027 Increases

A handful of states are seeing significantly smaller average increases. Examples include:

• •Vermont: approximately 3%
• •New York: approximately 6%
• •Iowa: approximately 6.7%
• •Utah: approximately 6.7%
• •Arkansas: approximately 7.6%

Florida Health Insurance Rates Are Rising About 16%

Florida’s average individual-market increase is currently around 15.9% based on available filings. For a Floridian paying $700 per month, a 15.9% increase would equal roughly $811 per month before accounting for any subsidy change. That would be an additional $1,332 per year if the entire increase were passed through.

Florida has a very large ACA Marketplace population, so subsidy changes can substantially alter what many consumers actually pay. People receiving no subsidy, however, are much more exposed to the full premium increase.

Texas Health Insurance Rates Are Rising About 13%

Texas’ approximate statewide increase is 13.1%. A $600 monthly premium increased by 13.1% would rise to about $679 per month, or roughly $948 more per year. Texas has millions of Marketplace enrollees, making it one of the country’s largest individual health insurance markets. Consumers should compare carriers rather than assuming their current plan remains competitive.

Georgia Health Insurance Rates Are Rising More Than 20%

Georgia stands out. The statewide average proposed increase is approximately 20.7%. A $700 monthly premium rising 20.7% becomes approximately $845 per month. That’s roughly $1,740 more per year. For unsubsidized households, an increase of that size can make comparing alternatives particularly important.

North Carolina Health Insurance Rates Are Rising About 15%

North Carolina’s statewide average is approximately 14.9%. However, statewide averages hide substantial differences between insurers. Some North Carolina insurers have proposed increases in the single digits while others have requested increases well above 20%. That is a major reason consumers should compare the actual plans available in their ZIP code rather than relying only on statewide averages.

Ohio Health Insurance Rates Are Rising About 11%

Ohio’s approximate statewide increase is 10.7%, making it somewhat lower than the national median. That still represents a substantial increase when compounded with the large increases many consumers experienced going into 2026.

Michigan Health Insurance Rates Are Rising About 14%

Michigan’s statewide average is approximately 14.2%. Michigan residents should compare carriers such as Blue Cross Blue Shield of Michigan, Priority Health, HAP, and other available options because individual carrier increases can differ substantially.

Illinois Health Insurance Rates Are Rising About 14%

Illinois’ statewide average proposed increase is approximately 14.1%. Illinois also has carrier changes affecting the individual market for 2027, making active shopping particularly important for some consumers.

Why Are Health Insurance Premiums Increasing So Much?

There isn’t one reason. Insurance companies are pointing to several overlapping forces.

1. Hospitals and doctors are getting more expensive

The underlying price of healthcare continues to rise. Insurers cite higher costs for hospital admissions, outpatient care, physician services, medical procedures, labor, and medical supplies as major drivers of 2027 premiums. Healthcare prices remain the primary driver of rate increases.

2. Prescription drug costs are rising

Drug spending is another major factor. Specialty medications can cost thousands or tens of thousands of dollars per patient. Insurers specifically cited increasing spending on specialty prescriptions, biologics, high-cost cancer treatments, and GLP-1 medications as contributors to 2027 premiums.

3. GLP-1 Drugs Are Affecting Insurance Costs

The explosion in demand for GLP-1 medications has become significant enough to appear directly in insurer rate filings. These include drugs such as:

• •Ozempic
• •Wegovy
• •Mounjaro
• •Zepbound
• •other semaglutide and tirzepatide products

Some can cost around four figures per month before discounts or insurance. When millions of people potentially qualify for expensive ongoing drug therapy, insurers have to account for that spending when pricing premiums.

4. Healthcare utilization is increasing

Insurance companies are not only paying more per service. People are also using more healthcare. That can include:

• •physician visits
• •surgeries
• •imaging
• •prescriptions
• •hospital care
• •behavioral health
• •and specialty treatments

Higher utilization combined with higher unit prices puts pressure on premiums from both directions.

5. The Enhanced ACA Subsidies Expired

Another major change happened at the end of 2025. The enhanced ACA premium tax credits that had temporarily increased Marketplace assistance expired. KFF estimates that average out-of-pocket Marketplace premium payments increased by approximately 58% in 2026 after those enhancements ended.

Why the Loss of Subsidies Can Also Push Future Premiums Higher

There is another less obvious effect. When insurance becomes expensive, healthier people are often more likely to drop coverage. People with cancer, chronic illnesses, expensive medications, upcoming surgery, or high medical utilization have much stronger reasons to keep insurance.

If healthier people leave while higher-cost members remain, the insured population becomes more expensive on average. Insurers then need to charge more to cover that risk. Insurers are specifically citing deterioration in the individual-market risk pool following the expiration of enhanced subsidies as another factor behind 2027 pricing.

Does a 15% Premium Increase Mean You Will Pay 15% More?

No. This is one of the most important things to understand.

There are two different numbers: full-price premium and what you actually pay after a subsidy. Suppose a health plan costs $700/month in 2026 and rises 15% to $805/month in 2027. If you receive no subsidy, you may have to absorb nearly that full $105 monthly increase. But if you qualify for a Marketplace premium tax credit, your subsidy may also increase.

Why ACA Subsidies Can Increase When Premiums Increase

ACA subsidies are tied to the cost of the benchmark Silver plan in your area. The benchmark plan is generally the second-lowest-cost Silver plan available to your household. The government calculates how much you’re expected to contribute toward that benchmark based on income. The premium tax credit generally covers the difference between the benchmark premium and your required contribution.

Subsidies Will Not Protect Everyone

The protection is not universal. The enhanced premium tax credits expired after 2025, meaning the traditional ACA 400% Federal Poverty Level subsidy cutoff returned. For 2027, households above roughly 400% FPL generally cannot receive a federal Marketplace premium subsidy.

Based on 2026 federal poverty guidelines used for 2027 subsidy calculations, that works out to approximately:

• •Single adult: $63,840
• •Family of four: $132,000
• •for the continental United States. Alaska and Hawaii use higher poverty thresholds.

The 400% ACA Subsidy Cliff Matters Again

Consider two households.

2027 Required ACA Contribution Levels

For people who remain subsidy eligible, the amount they’re expected to contribute toward the benchmark plan is indexed based on income. For 2027, that contribution can range from approximately 2.15% to 10.22% of household income, depending on income level. That represents a relatively modest adjustment from 2026’s percentage schedule rather than the major subsidy reset that consumers experienced when enhanced credits expired.

Who Is Most Exposed to the 2027 Rate Increases?

Several groups are especially vulnerable.

• •People who receive no ACA subsidy — they experience the full premium price
• •Higher-income households — especially those just above the 400% FPL subsidy cutoff
• •Self-employed households — business owners and 1099 workers often purchase their own coverage and may not receive employer contributions
• •Adults ages 50–64 — ACA premiums generally increase substantially with age
• •Families paying for several unsubsidized members — a percentage increase applied across several people can create a large annual increase
• •People buying coverage outside the Marketplace — off-Marketplace ACA consumers do not receive federal Marketplace premium tax credits

Example: What a 15% Increase Actually Costs

For a family already paying $1,500–$2,000 per month for health insurance, another double-digit increase can become a major household expense.

Should You Automatically Renew Your 2026 Health Insurance?

Probably not without comparing first. Automatic renewal is convenient, but several things can change from year to year:

• •premiums
• •subsidy amounts
• •provider networks
• •deductibles
• •copays
• •drug formularies
• •insurance companies
• •and benchmark plans

Your current plan may still be the best option. But you will not know without comparing it against the 2027 alternatives.

Your Subsidy Can Change Even If Your Income Does Not

This surprises many consumers. Your subsidy depends partly on the benchmark Silver premium in your area. That means your tax credit can change even if your income stays exactly the same, your household doesn’t change, and you stay in the same home—because the benchmark plan itself may become more or less expensive.

Your Current Plan and the Benchmark Plan Can Move Differently

This can create strange results. Suppose:

Your plan increases 10%, but the benchmark plan increases 20%. Your subsidy might increase substantially enough that your actual premium barely changes—or could potentially decline. Now reverse it: your plan increases 20% while the benchmark increases only 5%. Your subsidy may not rise enough to offset your plan’s increase.

Should You Switch Health Insurance Companies for 2027?

Maybe. A large premium increase is a good reason to compare, but price is not the only factor. Before switching, check:

• •doctors
• •specialists
• •hospitals
• •prescription drugs
• •deductible
• •copays
• •coinsurance
• •out-of-pocket maximum
• •mental-health coverage
• •maternity benefits
• •and out-of-network benefits

What About Private Health Insurance and PPO Options?

ACA Marketplace insurance is not the only coverage market for every consumer. Depending on your state, health history, and eligibility, you may also encounter:

• •off-Marketplace ACA coverage
• •private medically underwritten plans
• •PPO-style coverage
• •employer plans
• •HSA-compatible plans
• •and short-term coverage where permitted

Private medically underwritten options may be particularly worth comparing for someone who:

• •is generally healthy
• •earns too much for meaningful ACA assistance
• •pays a high unsubsidized premium
• •wants broader PPO access
• •is self-employed
• •or owns a small business

However, private plans can have different rules for pre-existing conditions, maternity, prescriptions, mental health, and benefit limits. They should not automatically be considered equivalent to ACA comprehensive major medical coverage.

ACA vs. Private PPO in 2027

For a consumer receiving a large ACA subsidy, Marketplace coverage may remain very difficult to beat. For someone paying full price, the situation may look very different. Consider this simplified example:

• •ACA plan: $900/month
• •Private alternative: $550/month
• •Difference: $350/month, or $4,200 per year

That does not mean the private option is automatically better. You still have to compare deductible, hospital coverage, prescriptions, pre-existing-condition rules, network, and maximum exposure. But once ACA premiums rise into the high hundreds or thousands per month, comparing both markets can become worthwhile.

What About Self-Employed People?

Self-employed consumers can be particularly exposed to individual-market premium increases because there is no employer paying part of the premium. They should compare:

• •ACA Marketplace coverage
• •ACA subsidy eligibility
• •private individual options
• •PPO networks
• •HSA-compatible plans
• •and spouse employer coverage

Qualifying self-employed individuals may also be able to take a self-employed health insurance deduction for eligible premiums, subject to IRS rules.

Can HSA Contributions Help With ACA Subsidy Eligibility?

Potentially. Marketplace subsidy calculations use an ACA-specific version of Modified Adjusted Gross Income. Certain pre-tax contributions, including qualifying retirement contributions and HSA contributions, can reduce MAGI. For households near the subsidy cutoff, legitimate tax planning can therefore affect Marketplace eligibility. This should be coordinated with a tax professional rather than manipulated solely for insurance purposes.

What Should You Do Before 2027 Open Enrollment?

Do not wait until the final day. Gather:

• •your current premium
• •2027 renewal notice
• •projected 2027 household income
• •doctors
• •hospitals
• •prescription medications
• •expected procedures
• •deductible usage
• •and employer coverage alternatives

Then compare the entire market. For HealthCare.gov states, Open Enrollment begins November 1, 2026. To generally obtain coverage starting January 1, enroll by December 15, 2026. Federal Open Enrollment generally ends January 15, 2027.

Frequently Asked Questions About 2027 Health Insurance Rate Increases

Bottom Line: 2027 Is a Year to Shop, Not Auto-Renew

Health insurance was already becoming more expensive. Now ACA insurers are proposing another median increase of roughly 15% for 2027, after finalized median increases of approximately 20% for 2026. Some states are seeing relatively modest average increases. Others are approaching or exceeding 20%.

The people most exposed are generally those who:

• •buy their own health insurance
• •receive little or no subsidy
• •are self-employed
• •are approaching Medicare age
• •cover multiple family members
• •or purchase coverage outside the Marketplace

But the statewide increase is only the beginning of the analysis. Your real cost depends on your income + subsidy + age + ZIP code + plan + carrier + benchmark premium + health needs.

For some consumers, ACA coverage will remain the best option. For others—particularly healthy households paying full price—2027 may be a good time to compare available private PPO-style alternatives.