If you buy your own health insurance through the ACA Marketplace, 2027 could bring another noticeable increase in premiums.
The latest ACA premium increases 2027 data point to a second consecutive year of double-digit proposed rate hikes. KFF's updated analysis of publicly available filings from 276 ACA Marketplace insurers across all 50 states and Washington, D.C. shows a 15% median proposed premium increase for 2027. That is below the 18% median proposed increase for 2026, but still represents the second-highest requested increase since 2018.
For self-employed workers, freelancers, consultants and other people who purchase their own coverage, the headline number matters but it is only part of the story. Your actual 2027 premium will depend on your state, insurer, plan, age, household income, subsidy eligibility and the final rate approved by regulators.
Quick Overview
Preliminary ACA filings show a 15% median proposed premium increase for 2027. Rising healthcare, prescription drug and operating costs are driving much of the increase. Rates vary significantly by state, insurer and plan, so the national figure is not a personal quote. Final rates may change, making early plan and subsidy reviews important for self-employed shoppers.
The 2027 Premium Picture Is Getting Clearer
Early July filings initially showed a 14% median proposed increase among 77 insurers in 16 states and Washington, D.C. Once filings from all states became available, the broader analysis put the median at 15% across 276 insurers.
That distinction matters because preliminary rate filings arrive at different times and not every insurer's filing becomes publicly available simultaneously.
The latest numbers provide a much stronger national snapshot of health insurance rates 2027. They also show that the increase is not uniform.
Among the 276 insurers analyzed by KFF, proposed changes range from -1% to 54%. Most proposed increases fall between 10% and 25%, while 51 insurers are asking for increases above 25%. One insurer has proposed a premium decrease.
In other words, there is no single "2027 Marketplace premium." Your local market could look considerably different from the national median.
Why Are Health Insurance Premiums Rising?
So, why are health insurance premiums rising again? The preliminary filings point to several overlapping pressures.
1. Medical Care Is Becoming More Expensive
The biggest underlying factor is the rising cost of healthcare services.
Insurers cite higher spending on hospital care, physician services, prescription drugs and other medical treatment. Inflation and labor shortages are also pushing up the cost of delivering healthcare.
When insurers expect claims to cost more, they generally build those higher expected expenses into their premiums.
2. Prescription Drug Costs Are Adding Pressure
Prescription drugs are another important part of the equation.
Insurers have pointed to increasing costs for specialty medications, including newer high-cost therapies. KFF's analysis of detailed filings found that prescription drug and medical costs are among the factors contributing to higher underlying healthcare spending for 2027.
For consumers, that means a premium increase can reflect more than the number of doctor visits or hospital claims. Drug spending can influence the overall cost of covering a Marketplace population.
3. The Enhanced ACA Tax Credits Expired
This is one of the most important factors for Marketplace shoppers.
The enhanced premium tax credits that had reduced many consumers' out-of-pocket premiums expired at the end of 2025. KFF reports that average premium payments after subsidies increased by 58% in 2026. People with incomes at or above 400% of the federal poverty level lost eligibility for the enhanced assistance entirely.
That change does not simply affect what an individual pays each month. It can also change who remains enrolled.
4. A Smaller Risk Pool Can Push Rates Higher
When healthier people leave the Marketplace because coverage becomes less affordable, the remaining population can be more expensive to insure.
Insurers reported that this shift toward a somewhat sicker risk pool contributed roughly four percentage points to 2026 rates. They are expecting a similar additional effect for 2027.
This creates a difficult cycle:
Higher premiums → fewer healthy enrollees → higher average medical costs → greater pressure on premiums.
That dynamic is particularly important for the individual market because people who purchase their own coverage are directly exposed to changes in Marketplace pricing.
ACA Rate Filings by State: Why Your Location Matters
National averages are useful for understanding the direction of the market, but they should not be treated as a personal quote.
The ACA rate filings by state can differ substantially because each state has its own insurance market, insurer mix, regulatory environment and healthcare costs.
Two self-employed shoppers with similar ages and incomes could see very different premium changes simply because they live in different states or select different insurers.
Proposed Rates Are Not Final Rates
This is one of the most important details to remember when reading 2027 headlines. A rate filing is an insurer's request, not necessarily the price consumers will pay.
State insurance regulators review proposed rates and supporting actuarial information before final premiums are established. Regulators can approve the request, reject it, modify it or require additional justification.
KFF notes that the 2027 filings remain preliminary and that rates are expected to be finalized in late summer. So, the 15% figure should be viewed as an early market indicator rather than a guaranteed increase for every Marketplace customer.
What This Means for Self-Employed Marketplace Shoppers
For someone who works independently, health insurance is often one of the largest recurring personal business expenses.
Unlike an employee with an employer contribution, a freelancer or self-employed professional may be responsible for the full premium before any applicable financial assistance.
That makes the 2027 shopping process especially important.
Don't Automatically Renew
Automatic renewal may be convenient, but it does not guarantee that your current plan will remain your best value. A competing insurer could offer a lower premium, different deductible structure or a more suitable provider network.
Look Beyond the Monthly Premium
The cheapest monthly premium is not always the cheapest plan overall.
Check:
1. Deductible
2. Out-of-pocket maximum
3. Copays
4. Coinsurance
5. Prescription coverage
6. Provider network
7. Specialist access
8. Expected healthcare usage
9. Premium tax credit eligibility
A plan that costs $50 less each month could become more expensive if its deductible and cost-sharing are substantially higher.
Recheck Your Income Estimate
For self-employed shoppers, income can fluctuate from year to year. Your projected Marketplace income can affect eligibility for premium assistance, so review your expected annual income carefully during enrollment and update it when circumstances change.
This is especially important in 2027 because the expiration of enhanced tax credits has already changed the subsidy landscape.
Will Everyone Pay 15% More in 2027?
No. The 15% figure is a national median proposed increase across insurers. It is not a universal increase applied to every consumer.
Your actual premium could rise by more than 15%, rise by less, remain relatively stable or potentially fall depending on your state, insurer and plan. The latest filings demonstrate that range clearly: proposed insurer changes span from -1% to 54%.
Your personal financial assistance can also make a major difference. A consumer who qualifies for premium tax credits may not experience the same increase in net monthly cost as someone paying the full unsubsidized premium.
What About 2026?
The 2027 story becomes easier to understand when viewed alongside 2026.
KFF reports that insurers' median proposed rate increase for 2026 was 18%, while the median finalized increase was 20%. The proposed 15% median for 2027 is therefore lower than the 2026 finalized increase, but it still represents another year of substantial premium pressure.
If the 2027 proposed increases ultimately hold, typical Marketplace premiums would have increased by more than one-third between 2025 and 2027.
For people buying coverage without employer assistance, that two-year trend is arguably more important than any single annual percentage.
What Should You Do Before 2027 Open Enrollment?
You do not need to wait for final rates to start preparing.
1. Review your current plan.
Know what you pay now and what you actually use: doctors, prescriptions, specialists and healthcare services.
2. Estimate your 2027 income.
Self-employed income can change and your estimate may affect premium assistance.
3. Watch your state's rate filings.
Local filings can tell you more about your market than the national average.
4. Check competing plans.
Do not assume your current insurer will remain the best-value option.
5. Calculate total annual costs.
Consider premiums, deductibles, copays, coinsurance and the out-of-pocket maximum.
6. Recheck subsidy eligibility.
Changes in income and federal policy can affect your final monthly cost.
If you are looking for broader coverage options, you can also review available health insurance options or explore short-term health insurance quotes where appropriate. Dental coverage can also be evaluated separately through dental insurance quotes.
The Bottom Line
The latest ACA premium increases 2027 filings send a clear message: Marketplace premiums are likely heading higher for a second consecutive year.
The current median proposed increase is 15%, with substantial variation among insurers and states. Rising medical costs, prescription spending, inflation, labor costs, the changed risk pool and the expiration of enhanced premium tax credits are all contributing to the pressure.
But these numbers are not final. Regulators still have to review the filings and your personal premium will depend on your state, plan, age, income and available financial assistance.
For self-employed Marketplace shoppers, the smartest move is simple: watch the final rates, reassess your subsidy eligibility and shop the full cost of coverage rather than relying on automatic renewal.
Frequently Asked Questions
1. Will ACA premiums increase in 2027?
Based on current filings, ACA Marketplace insurers are proposing a 15% median premium increase for 2027. The rate is preliminary and can change before final approval.
2. What is the average ACA premium increase for 2027?
The latest KFF analysis finds a 15% median proposed increase across 276 insurers with publicly available filings covering all 50 states and Washington, D.C.
3. Why are health insurance premiums rising in 2027?
Insurers cite higher healthcare and prescription drug costs, inflation, labor expenses and changes in the ACA Marketplace risk pool. The expiration of enhanced premium tax credits has also contributed to market changes.
4. Are the 2027 ACA rate increases final?
No. The current figures are proposed rates. State regulators review insurer filings before rates are finalized, so final premiums may differ.
5. What should self-employed people do about rising ACA premiums?
Self-employed shoppers should review their expected income, check financial-assistance eligibility, compare plans during enrollment and evaluate total annual costs instead of looking only at the monthly premium.
6. When will 2027 ACA rates be final?
The preliminary filings are expected to move through state review during summer 2026, with final 2027 rates expected in late summer.
