In 2025, a 40-year-old earning $65,000 a year in Indianapolis paid $316 a month for an Anthem silver plan after a federal tax credit brought the price down. This year, with that credit gone, the same plan costs $477 a month. Insurers have now filed rates for 2027 that would push it to $546 — a $158 jump, or 41 percent, in two years, for someone whose job, income and health never changed.
The Anthem Plan Behind the Indianapolis Numbers
The figures come from a specific, named policy: Anthem Heart Healthy Silver Essential 4500, sold on the ACA Marketplace in Indianapolis and underwritten by Anthem Insurance Companies. Researchers at the Peterson-KFF Health System Tracker used this plan to illustrate what happens to a household that earns too much for the biggest subsidies once the extra help disappears. Their example: a 40-year-old enrollee earning $65,000, whose unsubsidized premium on that plan would have been $388 a month in 2025. With enhanced premium tax credits still in place that year, the buyer’s actual bill was $316.
Those enhanced credits, first created under the American Rescue Plan and extended through the Inflation Reduction Act, expired at the end of 2025. Once they were gone, the same Anthem plan billed $477 a month in 2026. Insurers have now filed preliminary rates for 2027, and if regulators approve them as submitted, the same coverage reaches $546 a month next year.
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Why the Subsidy Cliff Is Driving the Increase
This isn’t a one-plan quirk. Across 276 insurers filing 2027 rates in all 50 states and Washington, D.C., the median proposed premium increase is 15 percent — the second straight year of double-digit hikes, after a median finalized increase of 20 percent for 2026. Insurers point to two forces stacking on top of each other. The first is ordinary medical inflation: hospital, physician and prescription costs rose enough in 2027 filings that the median underlying medical trend hit 10 percent, above the roughly 8 percent average of recent years. Anthem’s own Indiana filing cites broader economic inflation and potential tariff-related supply-chain costs as factors built into its pricing.
The second force is specific to people like the Indianapolis buyer in this example: households earning more than four times the federal poverty level, who lost eligibility for the enhanced credits entirely once they expired. Insurers say that as healthier enrollees drop coverage rather than pay full price, the remaining pool gets sicker and more expensive to cover — a dynamic insurers are now pricing into 2027 on top of the increases they already built into 2026. Some carriers also point to smaller, plan-specific factors: several filings cite rising use of GLP-1 medications, higher-severity billing for outpatient procedures, and continued hospital-contract increases tied to staffing shortages as add-ons to the base rate.
What the Extra $158 a Month Means for Your Budget
If you’re the one paying it, $158 more a month is $1,896 more a year — coming out of the same paycheck that also has to cover rent, groceries and gas. To put that in perspective, it’s close to a full mortgage or car payment for many households, added on top of a bill that was already $477. And it isn’t a one-time bump: it’s the second increase in as many years on the same policy, with no guarantee 2027 is the last one. If your income sits just above the subsidy cliff — roughly four times the federal poverty level, or about $62,600 for a single adult in 2026 — you’re the buyer these filings are built around, because you get little or no help absorbing the increase.
The honest math to do before you renew isn’t just “can I afford $546 a month.” It’s “can I afford it again if next year’s filing does the same thing.” A silver plan that rises 41 percent in two years on medical trend and subsidy loss alone can plausibly rise again if either driver doesn’t ease off, and nothing in the current filings suggests either one is cooling.
Why Indiana’s 2027 Rate Isn’t Final Yet
The $546 figure is a filed rate, not a locked-in one. Every year, insurers submit proposed premiums to state regulators, who review the assumptions behind them before anything takes effect. In Indiana, that review runs through the Department of Insurance, which posts each year’s marketplace filings publicly and accepts written comments on specific filings, identified by their SERFF tracking number, before final approval. Rates for 2027 can still move before open enrollment locks them in, which is exactly why KFF frames its own $546 estimate as conditional on approval rather than a done deal. That review process matters: a filing can come in higher than what regulators ultimately approve, or lower, depending on how state actuaries weigh an insurer’s assumptions about medical costs and enrollment.
How to Check Your Own Plan Before You Renew
You don’t have to wait for a renewal notice to find out where you stand. Marketplace open enrollment for 2027 coverage begins November 1, 2026, according to HealthCare.gov’s own dates-and-deadlines page, which lets you compare next year’s approved rates against what you’re paying now once they’re finalized. If your household income sits near the subsidy cliff, it’s worth running the numbers both with and without the enhanced credits, since Congress has not restored them and current law assumes they stay expired. Shopping around also matters here: a different insurer’s silver plan in the same county can carry a very different rate filing than Anthem’s, even after the same subsidy cliff hits both of them.
Indiana’s own filings, and the underlying analysis, are public record. The Department of Insurance publishes the year’s ACA rate filings and the process for reviewing them at in.gov/idoi, so any household on an Indiana marketplace plan can see exactly what an insurer proposed and how it compares with what’s actually approved 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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