ACA premiums jump 13% as enrollment opens

The open enrollment period for the Affordable Care Act marketplace starts Sunday in most states and continues through January 15. Individuals preparing to buy insurance for 2027 face a market defined by higher prices and tighter eligibility rules. The average cost of a plan purchased through these exchanges is projected to increase by 13% next year, according to analysis of new Centers for Medicare and Medicaid Services data by the healthcare research nonprofit KFF.

This price hike follows a period of rapid cost increases during the second Trump administration. Republicans voted against extending the enhanced subsidies that helped offset premiums for most enrollees under President Joe Biden. That decision resulted in 1.2 million fewer people signing up for coverage on the exchanges. As of February, approximately 19.2 million people remained actively enrolled in ACA marketplace health plans, per the Department of Health and Human Services.

Cynthia Cox, a vice president and director of the ACA program at KFF, identified rising healthcare costs, hospital market concentration, and the impact of the No Surprises Act as primary drivers of the 13% increase. She also pointed to the rising availability of GLP-1 drugs as a contributing factor. The financial burden falls most heavily on individuals who do not qualify for subsidies. Many of these consumers have already shifted to bronze plans, the lowest-cost tier, but may still struggle to afford continued coverage into the new year.

A fact sheet distributed by CMS on Friday stated that Americans using HealthCare.gov will have robust access to low-cost plans. However, new regulations taking effect in 2027 limit tax credits for certain lawfully present immigrants. Experts estimate this change could leave an additional 1 million individuals uninsured over time. The administration has also implemented stricter enrollment checks and introduced potential delays for those working with brokers.

The Trump administration is simultaneously removing participants from the program as part of a campaign against waste, fraud, and abuse. In September, Vice President JD Vance and other officials announced plans to drop 760,000 enrollees from the exchanges. The administration alleged these individuals were fraudulently enrolled or did not exist. Vance said the discovery and cancellation of subsidy payments for these hundreds of thousands of people would result in $2.2 billion in cost savings.

It is unclear how many more people will lose ACA coverage in 2027. Cox noted that while higher premiums, immigration eligibility changes, and anti-fraud efforts will likely reduce the total number of enrolled individuals, it will be difficult to determine the specific cause of the decline. The sign-up window will remain open for approximately ten weeks, allowing consumers to compare plans and select coverage for the upcoming year.