By Qamar S, 15 years in US medical billing · Last reviewed October 11, 2026
Marketplace (Obamacare) premiums are going up again for 2027. Insurers proposed a median increase of about 15%, after a 20% median increase for 2026. The biggest jumps hit people who don’t get a premium tax credit, especially those earning just over 400% of the federal poverty level, who lost help when the extra pandemic-era tax credits ended after 2025.
Don’t let your plan auto-renew without checking. Open Enrollment on HealthCare.gov runs November 1, 2026 to January 15, 2027. Pick a plan by December 15 for coverage that starts January 1. Update your income first, then compare total yearly cost, not just the monthly premium.
How much are premiums going up?
| What insurers asked for | |
|---|---|
| Median proposed increase for 2027 | About 15% (276 insurers, all states and DC) |
| Range | From a 1% cut to a 54% increase |
| 2026 increase (final median) | 20% |
These are proposed rates. Final rates vary by state and plan, and you’ll see your own numbers when window shopping opens on HealthCare.gov or your state’s marketplace.
Why premiums are rising
- Higher medical and drug costs. Insurers expect costs to grow about 10%, above the usual 8%, driven by hospital and doctor prices and more use of care.
- A sicker group of enrollees. When the enhanced tax credits ended, many healthier people dropped coverage in 2026. Insurers estimate that adds about 4 percentage points to 2027 premiums.
- GLP-1 drugs. Some insurers are dropping weight-loss coverage; others expect more use to push costs up.
- New federal rules. Changes to Marketplace rules added uncertainty, which insurers priced in.
Who pays more, and who’s protected
- If you get a premium tax credit: your credit is tied to the benchmark silver plan, so it rises when premiums rise. Your share may stay similar if you keep a similar plan, but switching or auto-renewal can change it.
- If your income is just over 400% of the poverty level: you no longer get a tax credit, so you pay the full increase. One example from KFF: a 40-year-old earning $65,000 paid $316 a month in 2025, $477 in 2026 and could pay about $546 in 2027.
- If your insurer is leaving your area: you’ll get a notice and be moved to another plan unless you choose one. Always compare.
7 ways to pay less in 2027
- Update your income estimate. Your tax credit is based on what you expect to earn in 2027. A lower, accurate estimate can mean a bigger credit.
- Compare bronze and silver carefully. Bronze has lower premiums but higher deductibles. If your income is under 250% of the poverty level, silver plans come with cost-sharing reductions that lower your deductible. See bronze vs silver vs gold.
- Look at total yearly cost. Add 12 months of premiums plus what you expect to pay in deductibles and copays. Our health plan cost comparison tool does the math.
- Check employer coverage. If a spouse’s job offers coverage, compare it. See employer insurance vs Marketplace.
- Check Medicaid and CHIP. If your income dropped, you or your children may qualify.
- Use an HSA-eligible plan if you’re healthy. Some bronze plans let you save pre-tax money in an HSA. See HSA vs FSA.
- Get free help. Marketplace navigators help at no cost, and they don’t sell plans. Find one at HealthCare.gov’s local help page.
From 15 years in billing: the most expensive surprise I see isn’t the premium. It’s people who switch plans to save $40 a month and find out in January that their doctor or prescription isn’t covered. Before you switch, check your doctors and your drug list in the new plan’s directory.
Frequently asked questions
How much will ACA premiums go up in 2027?
Insurers proposed a median increase of about 15% for 2027, after a 20% median increase for 2026. Your actual change depends on your state, plan and whether you get a premium tax credit.
Did the enhanced premium tax credits end?
Yes. The enhanced credits expired at the end of 2025. Regular premium tax credits still exist, but people earning over 400% of the federal poverty level generally no longer qualify.
When is Open Enrollment for 2027 health insurance?
On HealthCare.gov, November 1, 2026 to January 15, 2027. Enroll by December 15 for coverage starting January 1. Some state marketplaces have different dates.
Is it worth switching from silver to bronze to save money?
Only if you can afford the higher deductible. If your income is under 250% of the poverty level, a silver plan with cost-sharing reductions is often the better value even with a higher premium.
Sources: Peterson-KFF: How much and why ACA premiums are going up in 2027 · KFF: Preliminary 2027 rate filings · HealthCare.gov: Dates and deadlines
This guide is educational and is not legal, financial or insurance advice. MedBillGuide is not connected to Medicare, CMS or any government agency, and we do not sell insurance. See our Disclaimer.