2027 ACA Rates Are Out: What Your State’s Final Numbers Show
Every summer, health insurers file proposed premiums with state regulators, and every fall those numbers become real when open enrollment opens. The 2027 filings are now largely finalized, and they confirm a second straight year of steep increases, though a handful of states used their own regulatory authority to soften the impact considerably. This matters right now because open enrollment for 2027 coverage begins in a matter of weeks, and the size of your specific increase depends heavily on which state you live in, whether you still qualify for a subsidy, and a significant new federal enforcement action that just reshaped Marketplace enrollment nationwide.
How much are 2027 ACA premiums going up nationally?
According to the Peterson-KFF Health System Tracker’s analysis of 276 insurers across all 50 states and Washington, D.C., updated August 3, 2026, insurers proposed a median premium increase of 15% for 2027. That follows an even larger jump the year before, since last year’s median proposed rate change was 18%, and the median finalized rate change was 20%. Put together, that is the second-highest requested rate change since 2018, after several years of relatively flat pricing in this market.
The increases are not uniform. Among the 276 insurers reviewed, proposed premium changes for 2027 ranged from -1% to 54%, though most (63%) fell between 10% and 25%, with 51 insurers requesting increases above 25%. If the proposed changes hold, typical Marketplace premiums will have climbed by more than one-third across just two years. A separate tracker from Families USA puts the average requested increase slightly higher, at 15.6%, reflecting a different weighting methodology, but the two figures tell the same basic story.
Why are 2027 premiums rising so much?
Insurers point to a mix of factors in their rate filings. The rising cost of health services, driven by hospitalizations, physician visits, and prescription drugs including GLP-1 medications, is a major factor, and labor shortages and general inflation have pushed up provider wages and costs as well. The underlying trend shows in the numbers: the underlying cost of medical care and prescription drugs is projected to rise 10% for 2027, above the roughly 8% average growth of recent years.
The other major driver is the Marketplace’s own risk pool. The enhanced premium tax credits expired at the end of 2025, which led to a 58% average increase in out-of-pocket premiums in 2026 and about $1,000 more in deductibles per person. That change hit hardest for one group in particular: people with incomes at or above 400% of the federal poverty level lost subsidies entirely and now face the full increase. As some of those healthier, unsubsidized enrollees left the Marketplace, the people who remained were on average sicker and costlier to insure, and insurers estimate that shift alone drove up 2026 premiums by roughly four percentage points, with another four points expected for 2027.
To put a dollar figure on it: for someone earning $80,000 a year who no longer qualifies for a subsidy, a KFF analysis reported by NBC News found that the cheapest Bronze plan could rise by roughly $80 a month, or nearly $1,000 over the year. If your income sits above that subsidy cliff, the sticker shock in your renewal notice is the real number, not an exaggeration.
How much did rates change in specific states?
Colorado: state action softened the blow
Colorado’s final numbers show what state policy can do to a national trend. According to the Colorado Division of Insurance’s final announcement, Colorado’s individual market premiums increased by an average of 10% for 2027, compared to the 15% national median. Thanks to the state’s Colorado Premium Assistance program, financially assisted customers saw a net premium increase of just $20 a month, versus an estimated $69 a month without that support. The state’s Division of Insurance also reported that its rate review process saved Colorado consumers more than $42.1 million on their 2027 premiums, and a new carrier, Colorado Access, is entering the individual market for 2027.
New York: regulators cut proposed increases sharply
New York’s rate review process also trimmed insurer requests substantially. According to Becker’s Payer Issues, the New York State Department of Financial Services approved an overall increase of 6% for 2027 individual market plans on September 4, 2026, well below the 20.6% average increase insurers had originally requested. New York’s small group market saw a similar reduction, with the state cutting a requested 23.7% increase down to 8%. Roughly 860,000 New York residents are enrolled across individual and small group plans.
Delaware and New Mexico: final rates confirmed in September
Delaware finalized its 2027 rates on the same September 4 date as New York. Highmark Blue Cross Blue Shield requested a 20.2% increase and the state approved an average 17.2% increase, while AmeriHealth Caritas requested 13.9% and received approval for essentially that full amount at 13.94%. Notably, Centene’s Ambetter plan will exit Delaware’s ACA market entirely for 2027, reducing consumer choice in that state even as prices rise.
New Mexico’s Office of Superintendent of Insurance approved individual market rates on September 1 with an average increase of 24.4%, well above the national median and one of the steeper state-level increases confirmed so far this rate-filing season.
Missouri and Kansas: increases across the board
Not every state saw the same relief. In the Kansas City area, preliminary filings showed every insurance company selling individual plans wanted to raise prices for 2027, with average increase requests ranging from 10% to 35%. That pattern illustrates why it is worth checking your own state’s Department of Insurance filings rather than assuming the national median applies to you.
The pattern across state-run versus federal marketplaces
A broader trend is visible across the states that have finalized rates so far: states that run their own marketplace, including Colorado, New York, California, and Massachusetts, generally have more regulatory authority to push back on insurer requests and, in some cases, state-funded subsidy programs that cushion the impact further. States that rely on the federal HealthCare.gov platform generally have less leverage to negotiate rates downward, which is part of why the steepest increases have tended to show up in Southern and Mountain West states using the federal exchange.
A significant new development: CMS cancels 760,000 enrollments
Separately from the rate filings, a major federal enforcement action is reshaping Marketplace enrollment right as open enrollment approaches. On September 22, 2026, CMS announced it had canceled approximately 315,000 Marketplace enrollments affecting more than 760,000 individuals, citing unauthorized or unverifiable citizenship and immigration status documentation, according to Becker’s Hospital Review. CMS said it expects to recoup approximately $2.2 billion in advance premium tax credit payments tied to these canceled enrollments, and the agency is separately reviewing an additional 419,000 enrollments for legal status and income verification issues.
Alongside the cancellations, CMS issued an interim final rule imposing a temporary moratorium on new agent and broker registrations for the 2027 plan year, effective September 22, 2026 through February 1, 2027, for agents and brokers who did not have an active 2026 exchange agreement. According to CMS’s own rulemaking documents, applications handled by newly registered brokers were 2.6 times more likely to contain unresolved citizenship or immigration status issues and 2.7 times more likely to be missing Social Security numbers, compared to applications from brokers registered before 2026. The moratorium does not apply to fully state-based exchanges, web-brokers, or brokers who already held a 2026 agreement, and public comments on the rule are due November 21, 2026.
If you enrolled in Marketplace coverage with help from an agent or broker and are uncertain whether your enrollment was affected, contacting HealthCare.gov or your state’s Marketplace directly before open enrollment begins is the most reliable way to confirm your status. This action does not apply to fully state-based exchanges, so if you live in a state with its own Marketplace, such as California, New York, or Colorado, this specific cancellation action does not affect you directly.
When can I actually shop for 2027 coverage?
Open enrollment timing has been unusually contested this year, but the schedule is now confirmed. In most states that use HealthCare.gov, open enrollment for 2027 coverage runs from November 1, 2026 through January 15, 2027, the same window used in recent years, after a federal rule that would have shortened it was vacated in court. A few states run on different calendars: Idaho’s window opens October 15, and Connecticut and Massachusetts open October 23, while several state-run Marketplaces, including New York, New Jersey, California, and Washington, D.C., keep enrollment open into late January. Regardless of your state’s exact closing date, enrolling by December 15, 2026 is generally what you need to do to have coverage take effect on January 1, 2027.
What if 2027 premiums are unaffordable for you?
If your renewal notice shows a number you cannot fit into your budget, the Marketplace is still the right starting point. Before assuming there is no affordable option, it is worth taking a few minutes to compare your coverage options by state and income, since subsidy amounts and available plans vary block by block.
For people who are priced out of subsidized coverage entirely, a few realistic alternatives exist. A Health Share, more precisely called a Modern Health Sharing arrangement, is a cost-sharing community where members contribute a monthly amount and the group helps pay eligible medical bills among its members. It is not insurance and does not guarantee payment of any specific bill, but no payment method offers an absolute guarantee: traditional insurance can also deny claims, require prior authorization, or exclude certain services. For many healthy households, the appeal is a materially lower monthly contribution paired with meaningful protection against a major medical event, and pairing that with a Direct Primary Care membership for routine and preventive visits is a common combination. Small business owners and some individuals may also want to look into an ICHRA, an employer-funded arrangement that reimburses workers for individual market premiums, as a way to access Marketplace coverage through a different funding structure.
Frequently Asked Questions
Is the 15% median increase what I will personally pay? Not necessarily. The 15% figure is a median across insurers and plan types, and it reflects the sticker price before subsidies. Most Marketplace enrollees still receive some premium subsidy and will see a smaller net increase, while people who no longer qualify for any subsidy will feel closer to the full increase.
Why did some states see smaller increases than the national median? States like Colorado and New York used their rate review authority and, in Colorado’s case, additional state funding, to bring approved increases in below what insurers originally requested. Other states without similar programs, including Delaware and New Mexico, saw insurer requests approved close to what was originally filed.
Does the CMS enrollment cancellation affect my coverage? It depends on your state and how you enrolled. The September 22, 2026 cancellations apply to the federally facilitated Marketplace and state-based Marketplaces that use the HealthCare.gov platform, and specifically target enrollments with unresolved citizenship or immigration status verification issues. Fully state-based exchanges, such as California, New York, and Colorado, were not affected by this specific action. If you are uncertain about your enrollment status, contact HealthCare.gov or your state Marketplace directly.
When do I need to enroll to avoid a coverage gap? In most states using HealthCare.gov, enrolling by December 15, 2026 ensures your coverage starts January 1, 2027. Some state-run Marketplaces have later deadlines, so check your specific exchange’s calendar.
What happens if I do nothing and let my plan auto-renew? Auto-renewal will keep you covered, but it will not necessarily give you the best price or the same subsidy amount, since both premiums and subsidy eligibility can change year to year. Reviewing your options during open enrollment is the only way to confirm you are getting the current best fit.
Are Health Shares a substitute for Marketplace insurance if premiums are too high? A Health Share can lower monthly costs for people who are priced out of subsidized coverage, but it is a cost-sharing arrangement, not insurance, and typically involves waiting periods for pre-existing conditions. It is worth weighing against Marketplace plans, Direct Primary Care, and other options before deciding.
This article is for general informational purposes only and is not insurance, legal, or financial advice. Premium and rate filing data cited here comes from the Peterson-KFF Health System Tracker’s August 2026 analysis, the Families USA ACA Marketplace Premium Rate Tracker, the Colorado Division of Insurance’s final 2027 rate announcement, reporting on New York and Delaware’s approved rates via Becker’s Payer Issues, New Mexico’s Office of Superintendent of Insurance rate approval, coverage of Missouri and Kansas filings, CMS’s September 22, 2026 enrollment cancellation and broker moratorium announcement as reported by Becker’s Hospital Review and PSM Brokerage, and CMS’s confirmed 2026 to 2027 open enrollment schedule. Always confirm your specific plan options, subsidy eligibility, enrollment status, and enrollment deadline at HealthCare.gov or your state’s Marketplace before making a coverage decision.
By the Modern Healthcare Works team