State insurance regulators finalized 2027 Affordable Care Act marketplace rates this month, and the increases vary sharply by state: Washington approved an average 22.2% rise, Pennsylvania approved 15.97%, and New York held its increase to 6%. Each state’s insurance department reviewed and trimmed what insurers originally requested before signing off on a final number. The gap between the three states shows how much a state regulator’s review can change what an ACA shopper actually pays in 2027.
What these state reviews don’t touch: Washington, Pennsylvania and New York each set their own 2027 marketplace rate, and Medicare costs follow that same state-by-state pattern, one The Medicare Cost & Coverage Protection Kit maps with its state cost-help packs. Open the Medicare cost-help pack for these three states →
Washington’s 22.2% Increase
Washington’s Office of the Insurance Commissioner approved an average 22.2% increase in 2027 individual marketplace premiums, according to the agency’s own announcement, trimmed slightly from the 22.4% insurers requested. The approval covers roughly 281,055 people enrolled in Washington’s individual exchange plans through 12 participating insurers. Washington’s exchange enrollment already dropped about 13% during 2026, a decline the state’s insurance regulators noted alongside the new rate approval.
Pennsylvania’s 15.97% Increase
Pennsylvania’s Insurance Department approved a 15.97% average increase in 2027 individual marketplace premiums, down from the 17.14% average insurers had requested, according to the department’s own announcement. Insurance Commissioner Michael Humphreys said the department’s rate review “requires insurers to justify every dollar that they propose to charge with data to support the rate.” Pennsylvania’s open enrollment period for the resulting plans runs from November 1 through December 15, 2026, for coverage that starts January 1, 2027.
New York’s 6% Increase, Far Below What Insurers Wanted
New York’s Department of Financial Services cut insurers’ requested 2027 individual marketplace increase from an average 20.6% down to 6%, according to the department’s September 4, 2026 announcement. The department estimated the reduction saves New York’s roughly 860,000 individual-market enrollees about $1.6 billion collectively compared with what insurers had proposed. New York also approved an 8% average increase for its small-group market, down from a requested 23.7%.
What Drives a State Rate Review
Insurers file their proposed 2027 rates with each state months before a decision is announced, laying out expected medical costs, prescription drug spending and administrative expenses for the coming year. A state’s insurance department then examines those assumptions against the insurer’s actual claims history, comparing projected costs with what similar plans paid out in prior years. Washington, Pennsylvania and New York each run this review independently under their own state law, which is why one state’s regulators can demand more support for an insurer’s numbers than another state does for a similar filing. The process typically plays out over the summer, with final rates published in the weeks before open enrollment begins each November.
Why the Three States’ Reviews Produced Different Numbers
Every state with its own ACA marketplace runs an independent rate review, weighing an insurer’s claims history, projected medical costs and administrative expenses before approving a final number, which is why Washington, Pennsylvania and New York arrived at three different results from three different starting requests. New York’s regulators cut the insurers’ request by more than two-thirds, while Washington’s regulators trimmed their state’s request only slightly. The size of that gap reflects how aggressively each state’s insurance department pushes back during the review, not a difference in the underlying medical-cost trend driving rates up nationally across the country.
How These Three Approvals Compare Nationally
Many states are approving 2027 marketplace increases in the double digits this year, and Washington’s 22.2% and Pennsylvania’s 15.97% both sit within that broader pattern, while New York’s 6% stands out for how far its regulators cut the original request. The size of an approved increase does not by itself say whether a state’s review was thorough: Washington’s smaller cut from its original request still produced a larger final number, while New York’s steep cut still left enrollees facing a real increase, just a much smaller one than insurers wanted.
What a Premium Increase Changes on a Monthly Bill
An average increase does not apply evenly to every plan or enrollee; someone in a lower-cost bronze plan in Pennsylvania will see a smaller dollar increase than someone in a comprehensive gold plan, even though both fall under the same 15.97% statewide average. Federal premium tax credits, where they still apply, can offset part of any increase for lower-income households, though the size of that offset depends on income and the benchmark plan available in a given county. Shoppers in all three states will see the new 2027 numbers reflected once open enrollment begins later this year, typically in November, when marketplace listings update to show the approved 2027 pricing for every available plan. New York’s Department of Financial Services framed its 6% figure in dollar terms as well, estimating close to $1.6 billion in combined savings for the state’s individual-market enrollees compared with the 20.6% insurers had originally requested, a scale that shows how much a single regulatory decision can move statewide premium spending.
Medicare Costs Follow the Same Pattern as ACA Rates
Washington, Pennsylvania and New York each ran an independent review before settling on a 2027 marketplace rate, and no single federal notice lists what any of the three states’ residents pay once they later move onto Medicare. That state-by-state patchwork is exactly what a household aging into Medicare eventually has to navigate on its own, one program and one deadline at a time.
The Medicare Cost & Coverage Protection Kit organizes 51 state Medicare cost-help packs alongside the prior-authorization appeal steps, so the search does not start from nothing.
Look up the prior-authorization appeal steps in The Medicare Cost & Coverage Protection Kit.
This article was produced with AI assistance and reviewed by a human editor. The percentages and totals above are sourced directly from the agencies linked in the text.
