ACA Marketplace Faces 13% Premium Hike and Enrollment Slide for 2027
Updated
Updated · KFF · Oct 30
ACA Marketplace Faces 13% Premium Hike and Enrollment Slide for 2027
3 articles · Updated · KFF · Oct 30
Summary
Benchmark silver premiums for 2027 are rising 13% on average—11% in HealthCare.gov states and 16% in state-run exchanges—extending a second straight year of double-digit increases.
Insurers tie the jump to higher medical costs and a weaker risk pool after enhanced premium tax credits expired; KFF found risk-pool deterioration added about 4 percentage points to premiums in 2026 and is expected to do so again.
Enrollment is already shrinking: effectuated Marketplace coverage fell 12% to 19.2 million by February 2026, and CBO projects ACA enrollment dropping from 22.4 million in 2025 to 13.1 million in 2027.
Carrier pullbacks are adding pressure, with 11 insurers planning exits from at least one state for 2027 versus seven entrants; Cigna is leaving all 11 states where it now sells individual-market plans.
State subsidies in places such as New Mexico and California may soften the blow for some residents, but new federal eligibility limits, broker restrictions and ongoing litigation will leave 2027 access and affordability uneven.