ACA premiums jump 13% as enrollment window opens

The open enrollment period for Affordable Care Act health plans begins Sunday in most states.

The sign-up window runs through January 15, 2027, marking the start of a coverage year defined by higher prices and fewer options. According to analysis by the healthcare research nonprofit KFF, the average cost of marketplace insurance is projected to rise by 13 percent. This increase follows the expiration of financial assistance that had previously lowered premiums for many households.

Cynthia Cox, a vice president and director of the ACA program at KFF, attributes the price surge to rising healthcare costs and increased hospital market concentration. She also cites the No Surprises Act and the growing availability of GLP-1 drugs as contributing factors. The financial burden falls hardest on individuals who do not qualify for subsidies. Cox noted that many of these consumers have already shifted to bronze plans, the lowest tier of coverage available.

“They may or may not be able to afford to continue to keep their coverage into next year,” Cox said. “A lot of them have already moved into bronze plans, which are the cheapest plans.”

A fact sheet distributed by the Centers for Medicare & Medicaid Services on Friday states that Americans using HealthCare.gov will have strong access to low-cost plans. This government messaging contrasts with the experience of many consumers who saw prices climb during the current administration. Republicans opposed extending the pandemic-era subsidies that had offset insurance costs for most enrollees during the prior administration. That policy shift resulted in 1.2 million fewer people signing up for coverage in the exchanges.

As of February, roughly 19.2 million people were actively enrolled in ACA marketplace plans, according to the Department of Health and Human Services. New regulations effective in 2027 will limit tax credits for certain lawfully present immigrants. These changes could lead to an additional 1 million uninsured individuals over time. The administration has also pursued an aggressive campaign to remove enrollees it characterizes as fraudulent or non-existent.

In September, Vice President JD Vance announced plans to remove 760,000 ACA enrollees from public healthcare exchanges. Vance stated that the cancellation of subsidy payments for these individuals would result in $2.2 billion in cost savings. Cox said it is unclear how many more people will drop off coverage in 2027. She noted that with higher premiums and stricter enforcement, the total number of enrolled individuals will likely decrease, making the specific reasons for that drop harder to determine.