Insurers Want 15% More for 2027 ACA Plans: What You'll Pay

Open enrollment for 2027 Affordable Care Act coverage starts on November 1, 2026. It arrives after the most expensive year the Marketplace has had: the enhanced premium tax credits expired at the end of 2025, the average premium people actually paid rose 58%, from $113 to $178 a month, and the benchmark silver plan for a 40-year-old jumped 26%, to $625 a month before subsidies. Now insurers have filed their 2027 rates, and the Peterson-KFF Health System Tracker's review of 276 of them puts the median proposed increase at 15%.

That headline number tells you surprisingly little about your own bill. For most people who buy their own coverage, the subsidy — not the sticker price — decides what leaves the bank account each month, and the subsidy is set by income. This guide works through five households, from a single 30-year-old to a couple just over the subsidy cliff, and shows who absorbs the 15% and who pays all of it.

Who this is for: anyone who buys health insurance through HealthCare.gov or a state Marketplace — the self-employed, early retirees, part-time and gig workers, people between jobs. What it does not cover: Medicare (its open enrollment runs October 15 to December 7 and works differently), Medicaid, and employer plans, except for one rule at the end that decides whether an employer offer locks you out of Marketplace subsidies.

The numbersWhat has changed going into 2027

Three things drive the 2027 filings, in the insurers' own words: medical and drug costs rising about 10% (the median "medical trend" in the filings, up from roughly 8% in recent years, with GLP-1 drugs cited repeatedly), a sicker risk pool because healthier people dropped coverage when their subsidies shrank, and the federal rule changes that cut eligibility for some groups from 2027. The 15% is a proposal: last year the median proposed increase was 18% and the median finalized one was 20%, so final rates can land above the filings as well as below them.

How it worksWhy the sticker price matters less than you think

The premium tax credit is built so that your share is fixed by your income, and the government pays the rest of the benchmark plan's price. Three numbers set it:

The benchmark is the second-lowest-cost silver plan available to you. Whatever it costs, you pay the same expected amount and the credit covers the gap. So when the benchmark goes up 15%, a subsidized household's credit goes up by almost exactly the same dollars, and its own payment barely moves. The household that pays the full 15% is the one with no credit — anyone above 400% of the federal poverty line, where eligibility now ends abruptly.

For 2027 coverage the poverty line is the 2026 HHS guideline: $15,960 for one person, $21,640 for two, $33,000 for a family of four. So 400% is $63,840 for a single person, $86,560 for a couple and $132,000 for a family of four. The applicable percentages were also indexed up for 2027 by IRS Revenue Procedure 2026-26, from a range of 2.10%–9.96% in 2026 to 2.15%–10.22%.

Five householdsWhat each one pays in 2027

Here is the benchmark silver plan, priced at the national average and adjusted for age, for five households. Incomes are held at the same figure in every year so that only the rules and prices change.

Read it in two halves.

The first three households barely notice 2027. Their big increase happened in 2026, when the enhanced credits expired — the single 30-year-old went from $154 to $287 a month, the family from $284 to $560. In 2027 the benchmark for the family rises about $300 a month, from $1,998 to $2,298, and the credit rises with it, from $1,438 to $1,740. The family's own payment stays near 8.4% of income.

The last two pay the whole increase. The 60-year-old earning $64,000 and the couple earning $88,000 sit just above 400% of the poverty line, so they have no credit at all. Every dollar of the 15% is theirs: $2,389 more a year for the retiree, $3,926 more for the couple. Since 2025 their premiums have more than tripled — the retiree's from $453 to $1,526 a month, now 28.6% of income.

The cliffOne dollar of income, $11,792 a year

The steepest number in the whole system sits at exactly 400% of the poverty line. Below it, your benchmark premium is capped at 10.22% of income. One dollar above it, the cap disappears.

For a couple in their mid-fifties the same step is $21,253 a year at $86,560 of income. That is why 400%–500% earners were only 3% of 2025 sign-ups but accounted for 27% of the drop in 2026 sign-ups, according to KFF: for many of them, staying covered became the largest bill in the budget.

Because the line is based on modified adjusted gross income (MAGI) — adjusted gross income plus tax-exempt interest, non-taxable Social Security and excluded foreign income — the levers that lower AGI are worth far more than their tax saving near the cliff:

• Pre-tax retirement contributions. A traditional IRA, a SEP-IRA or a solo 401(k) for the self-employed, or a workplace plan for a working spouse, all reduce AGI. In the model, cutting the retiree's MAGI from $64,000 to $62,000 cuts the year's premium from $18,316 to $6,336.
• An HSA, if you choose an HSA-qualified plan (most are bronze). Contributions come off AGI.
• The timing of investment income. For early retirees, capital gains, Roth conversions and IRA withdrawals all count. Taking a gain in December 2027 rather than January 2028 can move a whole year's subsidy.
• The self-employed health insurance deduction, which lowers AGI by the premiums you pay. It interacts with the credit itself, so tax software calculates the two together.

The low endCost-sharing and Medicaid

Two income lines at the bottom matter as much as the cliff at the top.

• 250% of the poverty line ($39,900 for one person in 2027). Below it, a silver plan comes with cost-sharing reductions — lower deductibles and copays — at no extra premium. The 30-year-old in the table, at $40,000, is $100 over that line; a $100 pre-tax contribution would bring a cost-sharing silver plan within reach. KFF found that only 45% of eligible people in HealthCare.gov states picked a cost-sharing silver plan in 2026, down from 66%.
• 138% of the poverty line (about $22,000 for one person). In the 40 states and DC that expanded Medicaid, most adults below it qualify for Medicaid rather than Marketplace credits. In states that did not expand, people below 100% of the poverty line generally get no help from either.

The federal law passed in 2025 also narrows who can receive the credit: from 2027, many lawfully present immigrants who are not green-card holders lose eligibility, and insurers named that change in their filings. HealthCare.gov's eligibility screener is the place to check a specific case.

The other sideIf you have, or could have, employer coverage

Most Americans under 65 are not in this market at all. For employer plans, KFF's 2025 survey put the average premium at $26,993 for family coverage, of which workers paid $6,850 — far less of the bill than a family with no subsidy pays on the Marketplace.

The rule that links the two markets: if an employer offers you coverage that counts as affordable — for 2027, your share of the cheapest self-only plan is no more than 10.22% of household income — you cannot get a Marketplace tax credit, even if you would rather buy there. Family members are judged separately on the cost of family coverage, a fix that took effect in 2023. If you are leaving a job, losing employer coverage triggers a 60-day special enrollment window, and the Marketplace plan is often far cheaper than COBRA once the credit applies; how long your savings would last after a job loss shows why that premium belongs in the monthly number you plan around.

What to doBefore December 15

The premium is now one of the largest fixed bills for many self-employed households and early retirees. Give it its own line in a budget tracker and a due date in a bill tracker, and if your income swings, set aside for it from each paycheck — the same approach as splitting monthly bills across biweekly pay. For freelancers, the income figure that sets the credit is the same profit figure that sets quarterly estimated taxes, so one projection serves both.

MethodologyWhere these numbers come from

• 2027 rate filings: Peterson-KFF Health System Tracker, "How much and why ACA Marketplace premiums are going up in 2027" (August 3, 2026): 276 insurers in 50 states and DC, median proposed increase 15%, 25th–75th percentile 11%–22%, median medical trend 10%. KFF's July 8 first look at 77 insurers found a 14% median.
• Benchmark premiums: KFF State Health Facts, average benchmark (second-lowest-cost silver) premium for a 40-year-old: $497 in 2025, $625 in 2026. Premiums for other ages use the federal default age curve published by CMS (ages 0–14 0.765, 30 1.135, 40 1.278, 55 2.230, 60 2.714). Several states use their own curve, and New York and Vermont do not vary premiums by age at all.
• 2027 benchmark: the 2026 average × 1.15. This is an assumption: the 2026 benchmark rose 26% against an 18% median proposal, so final 2027 benchmarks may differ.
• Credit rules: applicable percentage tables from IRS Rev. Proc. 2025-25 (2026) and Rev. Proc. 2026-26 (2027), interpolated linearly within each band; 2025 uses the enhanced table that expired after 2025 (0% to 8.5%, no 400% limit). Poverty guidelines for the 48 contiguous states and DC: 2024 for 2025 coverage, 2025 for 2026, 2026 ($15,960 + $5,680 per person) for 2027. Alaska and Hawaii have higher guidelines.
• Enrollment and premiums paid: KFF, "What We Know So Far About 2026 ACA Marketplace Enrollment, Premiums, and Deductibles": average net premium $113 → $178, deductible $2,759 → $3,786, 400%–500% FPL share of the drop 27%.
• Dates: HealthCare.gov dates and deadlines (November 1, December 15, January 15). Employer premiums: KFF 2025 Employer Health Benefits Survey. Repayment cap: removed for tax years after 2025 by Public Law 119-21.
• What the model leaves out: local prices (a 40-year-old's 2026 benchmark ranged from $401 in New Hampshire to $1,299 in Vermont), state subsidies that top up the federal credit, tobacco surcharges, and income growth. Holding incomes flat while the poverty line rises slightly flatters subsidized households a little; with a typical raise, the 2026→2027 changes for the first three households would be a few dollars higher.
• Nothing here is tax or insurance advice; plan availability and your exact credit come from your Marketplace application.

FAQFrequently asked questions

How much are ACA premiums going up in 2027?
Insurers have proposed a median increase of 15% for 2027, according to a Peterson-KFF review of 276 insurers' filings; most requests fall between 11% and 22%. Final rates can differ, and prices for your area appear on HealthCare.gov shortly before open enrollment starts on November 1, 2026.

Will my subsidy cover the 2027 increase?
If your income is at or below 400% of the poverty line and you buy the benchmark silver plan, mostly yes: your payment is capped at 2.15%–10.22% of income and the credit rises with the benchmark. If your plan rises faster than the benchmark, or your income is above 400%, you pay the difference.

What is the 400% FPL cliff for 2027?
For 2027 coverage the limit is 400% of the 2026 poverty guidelines: $63,840 for one person, $86,560 for two and $132,000 for a family of four in the 48 contiguous states. Above it there is no premium tax credit at all.

When is open enrollment for 2027?
On HealthCare.gov it runs from November 1, 2026 to January 15, 2027. Enroll by December 15 for coverage starting January 1; enrollments from December 16 to January 15 start February 1. Some state Marketplaces have longer windows.

Do I have to pay back the tax credit if my income goes up?
Yes, in full. The cap on repaying excess advance credits was removed starting with tax year 2026, so any credit you received above what your final income allows is added to your tax bill. Updating your income on the Marketplace during the year avoids most of it.

Can I get a Marketplace subsidy if my job offers insurance?
Not if the employer's cheapest self-only plan costs you no more than 10.22% of household income in 2027. Family members are judged on the cost of family coverage, so they may qualify even when the employee does not.