Affordable Care Act premiums are increasing again, and these plans have new rules Affordable Care Act premiums are going up again, and that may force more Americans to go without health insurance. The median increase in the cost of mid-tier health-insurance premiums sold on Healthcare.gov or through state marketplaces is 13% in 2027, according to KFF. That’s lower than the 26% median increase for 2026, but still far higher than the single-digit percentage increases in the years immediately before that.
Much of the focus last year had to do with the expiration of enhanced premium tax credits, which were given to middle-class Americans to lower the cost of their premiums. There are different issues to deal with this year. Along with new rules about who can enroll in ACA plans in 2027, Americans are also grappling with the rising cost of living.
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By June of this year, about 3 million Americans had opted out of their ACA plans. And as costs continue to climb, even more people in the U.S. are expected to drop their ACA coverage in 2027. Along with those who have dropped coverage, some people have picked plans with lower premiums, hoping to balance the monthly cost with their desire to continue coverage.
About 19% of Americans with ACA plans said they downgraded their coverage to a plan with lower premiums and higher out-of-pocket costs in 2026, according to a Commonwealth Fund survey conducted earlier this year. But having a plan with a higher deductible puts patients at risk of big medical bills. The same survey found that 30% of adults between the ages of 19 and 64 are paying off medical debt.
Most of the participants said they are underinsured, meaning they have a plan with high cost-sharing or have experienced a gap in coverage. The open enrollment period for ACA plans is under way — it began Nov. 1 and ends Dec. 15, with coverage to start on Jan. 1. Here are three things for Americans to understand about the ACA in 2027.
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