ACA marketplace

A new analysis by KFF reveals that Affordable Care Act (Obamacare) insurers are proposing a 14% median premium increase for 2027, following a 20% rise in 2026. Insurers attribute the hikes to rising healthcare costs, expired federal subsidies, and a sicker, smaller enrollee pool, disproportionately affecting middle-class individuals.

A new analysis by KFF reveals that Affordable Care Act insurers are proposing a 14% median premium increase for 2027, driven by rising healthcare costs, regulatory changes, and expired pandemic-era subsidies. The ACA marketplace has shrunk by over 2.5 million enrollees since the subsidies ended, contributing to higher costs for middle-class enrollees without subsidies.

Rural residents in states using the ACA Marketplace are losing health insurance coverage at higher rates than urban and suburban counterparts, with a 12% drop in nonmetropolitan county enrollments. The expiration of enhanced subsidies under the American Rescue Plan and Inflation Reduction Acts, not renewed in a GOP budget bill, has led to increased premiums and coverage losses, particularly in rural areas.

Federal data shows a significant decline in Affordable Care Act (ACA) enrollments across many states, with Ohio and Oklahoma each losing over 32% of enrollees since January 2023, attributed to the expiration of enhanced subsidies and rising premiums. The data reveals 2.6 million fewer Americans with ACA plans in February 2023 compared to the same period the previous year.

Roughly 5 million people may lose coverage from the Affordable Care Act Marketplace after enhanced premium tax credits expired in 2025. The ACA Marketplace had four consecutive years of record growth in enrollment prior to this. This change is expected to impact enrollment significantly.