If you buy your own health insurance through the Affordable Care Act marketplace, the letter that lands in your mailbox this fall is likely to carry a bigger number than last year’s. Insurers covering every state and Washington, D.C. have filed paperwork asking regulators to approve a median premium increase of 15 percent for 2027. That figure comes from 276 separate insurer filings, and it marks the second year in a row of double-digit requested hikes.
A 15 Percent Median, From Maine To Hawaii
The number comes from the Peterson-KFF Health System Tracker, a nonpartisan research project that pulled every publicly filed 2027 rate request it could find and updated its count in early August to cover all 50 states plus D.C. Across those 276 insurers, the requested changes range from a 1 percent cut to a 54 percent increase. Most filings cluster in the middle: 63 percent of insurers asked for somewhere between 10 and 25 percent, while 51 insurers filed for more than 25 percent — meaning nearly one in five insurers is asking regulators to sign off on an increase that would add well over a quarter to what you already pay.
Put in context, this is the second-highest median request since 2018, behind only last year’s 2026 filing season, when insurers asked for a median 18 percent and eventually had roughly 20 percent approved after state review. If 2027 follows that pattern, your actual bill could land higher than the 15 percent headline, not lower. The size and spread of the filings also matter: a national median can mask a lot of variation, so a household in a state where several insurers filed near the 54 percent ceiling could see a very different renewal notice than a household in a state clustered near the low end of that 10-to-25 percent band.
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Why “Asking” And “Paying” Are Different Numbers
A rate filing is not a bill. Under federal rules enforced through HealthCare.gov’s Rate Review program, any insurer proposing to raise a plan’s price by 15 percent or more has to publicly justify the increase, and either your state’s insurance department or, where a state lacks the authority, the federal government reviews the math before anything takes effect. States can approve a filing as submitted, negotiate it down, or reject it outright — New York’s financial regulator, for example, has a track record of trimming billions of dollars off health insurer requests in a single review cycle, and starting this year Illinois’ state insurance department gained the same approve-or-deny authority over individual and small-group filings.
That review process is exactly why this article sticks to what insurers asked for, not what regulators eventually approve. Approved 2027 rates will roll out state by state over the coming months as reviews finish, and the final, approved numbers are their own separate story worth tracking on their own once states start publishing decisions. Anyone who wants to check a specific insurer’s filing status today, rather than wait for the fall renewal notice, can look it up directly at ratereview.healthcare.gov, which lists each company’s requested increase, the justification it filed, and, once available, the reviewed outcome by state.
The Subsidy Cliff Behind The Number
Insurers did not pull 15 percent out of thin air. In their filings, they point to the same driver they cited last year: rising medical costs, with a median assumed medical trend of 10 percent baked into the 2027 numbers, along with growing demand for expensive specialty drugs and GLP-1 weight-loss medications. But there is a second factor unique to this year’s filings. The enhanced premium tax credits that made marketplace coverage sharply cheaper for millions of households expired at the end of 2025, and KFF’s companion analysis of that expiration found subsidized enrollees’ out-of-pocket premium payments were already on track to more than double this year as a direct result.
Insurers expect that same expiration to push healthier, price-sensitive customers out of the marketplace altogether once their true out-of-pocket cost jumps, leaving a smaller pool of sicker, costlier enrollees behind. In insurance terms, that is a shift in the risk pool’s morbidity, and insurers are pricing 2027 premiums to the risk pool they expect to have — a thinner, sicker one — rather than the one they have today. That is one reason the requested increase does not simply track medical inflation; it is also a bet about who stays enrolled once the extra subsidy money is gone.
Who Actually Pays The Full 15 Percent
If you receive a premium tax credit that scales with your income, a rate increase does not automatically mean your monthly bill jumps by the same percentage — your subsidy can absorb part of it, at least up to whatever the now-less-generous, pre-2021 tax credit formula still covers. The households that feel the full weight of a filed increase are the ones paying retail: self-employed workers, small-business owners, early retirees bridging the years between leaving a job and turning 65 for Medicare, and anyone whose income sits above the subsidy threshold and always paid full price. For that group, a 15 percent median increase on an already-expensive plan can mean an extra $100 to $300 or more a month, depending on your state and plan tier, once your insurer’s specific filing works through review. Households who lost their enhanced subsidy entirely at the start of this year are effectively facing two increases stacked on top of each other: the subsidy cut that already hit their monthly bill, and now a second, separate rate increase on top of the underlying premium for 2027.
What To Watch For This Fall
Open enrollment for 2027 marketplace coverage typically opens November 1, and your specific renewal notice should arrive before then with your plan’s actual approved rate, not the preliminary number insurers filed in the spring and summer. When that notice lands, it is worth shopping the marketplace again rather than letting your current plan auto-renew — insurers price aggressively for renewals, and a different plan at the same metal tier can sometimes cost meaningfully less. If you want to see whether your own insurer’s request was trimmed, increased, or approved as filed, HealthCare.gov’s rate review database publishes that outcome by state and company once the review closes.
This article was produced with AI assistance and reviewed by a human editor. Figures are linked to their primary sources; where a claim could not be verified from the public record, we say so.
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