Health Insurance Costs Set to Jump as Open Enrollment Begins
The marketplace sign-up window opens Sunday, bringing higher premiums and fewer options to nearly 20 million current enrollees.
By Beatriz Soto ·
The open enrollment period for Affordable Care Act marketplace plans begins Sunday in most states and continues through January 15.
Health insurance prices are expected to rise by 13% in 2027, according to analysis of new Centers for Medicare and Medicaid Services data by the healthcare research nonprofit KFF. This projected increase comes as financial assistance for many groups expires and coverage options narrow. The sign-up process also faces stricter enrollment checks and new restrictions affecting certain immigrants.
The cost hikes follow the expiration of pandemic-era subsidies that had lowered premiums for most enrollees during the administration of former President Joe Biden. Republicans opposed extending those temporary cost offsets, leading to a drop in marketplace enrollment. The number of people signing up for coverage through the exchanges fell by 1.2 million as a result. As of February, roughly 19.2 million people in the United States were actively enrolled in ACA marketplace health plans, according to the Department of Health and Human Services.
Cynthia Cox, a vice president and director of the ACA program at KFF, stated that the price increase is primarily driven by rising healthcare costs and hospital market concentration. She also cited the No Surprises Act, which took effect in 2022 and bans surprise billing, and the rising availability of GLP-1 drugs as contributing factors. Those who do not qualify for a subsidy will feel the impact most. Cox noted that many of these individuals have already moved into bronze plans, which are the cheapest options available.
"They may or may not be able to afford to continue to keep their coverage into next year," Cox said. "A lot of them have already moved into bronze plans, which are the cheapest plans."
New regulations starting in 2027 will limit tax credits for certain lawfully present immigrants. This change could result in an additional 1 million uninsured individuals over time. The Trump administration has also been removing ACA enrollees from the program as part of a campaign against what it characterizes as waste, fraud, and abuse. In September, Vice President JD Vance and other officials announced plans to remove 760,000 ACA enrollees from public healthcare exchanges. Vance said the discovery and canceled subsidy payments for hundreds of thousands of people would result in $2.2 billion in cost savings.
A CMS fact sheet distributed Friday states that Americans using HealthCare.gov will have robust access to low-cost plans. Cox said it is unclear how many more people will drop off of ACA coverage in 2027. With higher premiums, immigration eligibility changes, and anti-fraud efforts, she expects fewer people to be enrolled in the market.
