Obamacare Premiums Are About to Jump 14%, and Everyone Blames Someone Else

Affordable Care Act insurers are proposing a median premium increase of 14% for 2027 in preliminary rate filings released this week, which would be the second-highest jump since 2018 if approved. Insurers say roughly 4 percentage points of the proposed increase stems directly from the lasting effects of last year’s expiration of enhanced federal premium subsidies, which has pushed younger, healthier enrollees out of the marketplace and left insurers covering an older, sicker and more expensive risk pool [1, 2]. ACA marketplace enrollment has already fallen by about 3 million people since February compared with the same period last year [1].

The Trump administration maintains that much of the enrollment growth recorded under the Biden administration was fraudulent rather than a reflection of genuine need, and it is preparing an ACA rule change that would push more consumers toward stripped-down catastrophic coverage plans as an alternative to rising premiums [3].

Why It Sucks:

ACA Enrollees and Patient Advocates

• A second straight year of double-digit hikes. Consumers already absorbed one round of premium increases in 2026 before the enhanced subsidies expired, and now face a second “triple whammy” of higher sticker prices, lost tax credits and shrinking coverage options [1, 2].
• Sicker, older, and paying more for it. As healthier enrollees drop out rather than pay more, the remaining pool skews older and costlier, which patient advocates say creates a downward spiral that punishes the people who most need coverage [1].
• Losing subsidies was a policy choice. Advocates argue the coverage crunch traces directly back to Washington allowing the enhanced tax credits to lapse, not to any inherent flaw in the ACA marketplace itself [2].

Trump Administration and Congressional Republicans

• Biden-era enrollment numbers were inflated. The administration argues much of the enrollment growth counted under the previous administration reflected fraud rather than genuine coverage need, meaning the “millions lost” narrative overstates the real impact [3].
• Catastrophic coverage as a cheaper alternative. Officials are preparing a rule change to steer more consumers toward stripped-down catastrophic plans, arguing that lower-cost options are a better fix than extending subsidies indefinitely [3].
• Subsidies masked the marketplace’s real costs. Republicans say enhanced tax credits artificially suppressed what consumers saw at checkout while doing nothing to control the underlying premium growth insurers are now passing through [2].

ACA Marketplace Insurers

• The risk pool got worse, not the insurers’ math. Insurers say roughly a quarter of their proposed rate hike is a direct, calculable consequence of healthier customers leaving the pool after subsidies expired, not padding on their part [1].
• Pricing has to follow who’s actually enrolled. Carriers argue that setting rates too low for an older, sicker population would just push more insurers out of the marketplace entirely, reducing choice further for everyone remaining [1].
• Second-highest hike since 2018 isn’t arbitrary. Insurers point to the scale of the historical comparison as evidence the increase reflects a genuine cost shock tied to enrollment changes, not a routine annual pricing adjustment [2].

Sources & Citations:

[1] U.S. News & World Report: Affordable Care Act Insurers Want More Premium Increases As Enrollment Sags
[2] The Hill: ObamaCare coverage costs expected to surge by 14% in 2026
[3] CNBC: As ACA enrollment falls by millions, Trump administration and policy gurus disagree on why