ACA marketplace premiums are heading for a second straight year of double-digit increases, and the reasons behind the jump reach well beyond the usual story about subsidy expiration.
The Peterson-KFF Health System Tracker’s analysis of preliminary 2027 rate filings from 77 insurers across 16 states and Washington, D.C. found a median proposed premium increase of 14 percent, with most insurers requesting between 10 and 20 percent and 20 insurers requesting more than 20 percent. That follows an 18 percent median increase proposed for 2026 that finalized at 20 percent, meaning marketplace premiums are on track to rise more than a third between 2025 and 2027. A 40-year-old in Indianapolis, for example, would see a monthly premium climb from $316 in 2025 to $477 in 2026 to $546 in 2027, a 41 percent jump in two years. Insurers point to underlying medical cost growth of 10 percent, above the recent 8 percent average, alongside labor shortages, higher-acuity claims coding, and GLP-1 drug costs that tripled per member in two years. A sicker risk pool left behind after enhanced tax credits expired in December 2025 is adding roughly four more percentage points to the increase.
For HR and benefits teams, the exposure is not limited to employees enrolled directly through the marketplace. Any organization using an individual coverage health reimbursement arrangement, or fielding questions from part-time staff, retirees, or gig workers who buy marketplace coverage instead of group insurance, is about to field sticker shock during open enrollment planning. The original angle to watch: as marketplace plans get measurably less affordable relative to employer coverage, the multi-year push toward ICHRA as a cost-control strategy loses some of its appeal, and teams that adopted it may need to revisit whether group coverage now compares more favorably than when they made the switch, a recalculation that belongs on the same list as the other federal policy shifts forcing HR compliance programs to rewrite their assumptions this year.
