Obamacare insurers seek steepest premium jump in years for 2027 plans

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Obamacare premium hike 2027

Highlights

Insurers filing for 2027 Obamacare plans in 16 states and Washington, D.C. seek a median 14% premium increase from 2026 levels, the second-highest since 2018.
Premium hikes are driven by a sicker risk pool, projected to add 4% to costs, along with broad inflation, higher drug costs, and provider consolidation.
Obamacare enrollment drops 13% to 19.2 million in 2026 after pandemic-era subsidies expire, with insurers like Aetna exiting due to rising costs and premium surges totaling over 33% from 2025 to 2027.

Proposed 2027 rates and cost drivers

As reported by Reuters, citing KFF, insurers offering Obamacare plans for 2027 are seeking payment rates that reflect a 14% median increase from 2026 levels, based on filings from 77 insurers in 16 states and Washington, D.C. Proposals must be submitted to regulators by July 15, laying out expected costs and planned price changes before the new plan year.

KFF says the proposed increase is the second-highest since 2018. Insurers say a growing share of sicker patients, combined with healthier members continuing to leave coverage in 2027, is expected to add 4% to premiums next year.

The research group also points to broader economic inflation, higher drug costs and greater consolidation among medical providers as factors lifting requested rates. Last year, when insurers sought a median 18% increase, they similarly cited a risk pool shifting toward patients with greater medical needs.

Enrollment pressure and industry impact

Obamacare enrollment declines 13% in 2026 from 22.1 million people in 2025 after extra subsidies introduced during the COVID-19 pandemic expire. The Department of Health and Human Services now estimates that 19.2 million Americans are enrolled in plans created under President Barack Obama's Affordable Care Act.

Without those subsidies, premiums rise 58% in 2026 and deductibles increase by about $1,000 per person, according to KFF data. Based on the latest proposed rates, premiums are on track to climb by more than 33% between 2025 and 2027, although most marketplace enrollees earning less than 400% of the federal poverty level still qualify for subsidies.

The pricing pressure is also showing up in company results and strategy. Insurers including Centene and UnitedHealth flag elevated medical costs in their Obamacare businesses this year, while CVS Health says last year that its Aetna unit would stop offering Obamacare plans in 2026 because of anticipated higher costs in that segment.

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