Americans who get health insurance through an employer, the Affordable Care Act marketplace, or Medicare are widely expected to see higher monthly bills in 2027, according to NBC News. Some of those premium jumps may be among the biggest in decades and are tied to a mix of economic pressures. The added expense will not land the same way on every household. Some people may instead pay more through larger copays or deductibles.
“Healthcare costs are going up faster than they have in years, and open enrollment is when the healthcare affordability crisis is really going to hit home for people,” Larry Levitt, executive vice president for health policy at KFF, said. “That’s true for whatever kind of insurance you have.”
Part of the climb comes from steeper prices for hospital care and other medical services, plus heavier use of high-cost prescription drugs. That list includes GLP-1 medicines used for weight loss, which insurers and employers say are pushing their spending higher.
Marketplace plans face another year of double-digit proposed rate increases
Roughly 19 million adults who buy coverage on the Affordable Care Act marketplace appear headed for a second year of double-digit premium hikes. Insurers that sell those plans are proposing an average increase of about 15 percent for 2027, according to a KFF review of public rate filings from all 50 states and Washington, D.C. The same insurers raised rates by an average of 20 percent for 2026.
Someone earning $80,000 a year who does not qualify for the standard ACA subsidies could see the cost of the cheapest bronze plan rise by about $80 a month. That would add nearly $1,000 to the annual cost.
Levitt said insurers are raising prices in large part because medical care itself is growing more expensive. Carriers have cited higher charges for hospital stays, office visits, and medicines. Insurers generally “have felt pressure to add coverage of GLP-1 drugs for weight loss, but they’re also seeing big, big increases in costs for those drugs,” Levitt said.
The marketplace is still absorbing the end of enhanced federal subsidies, which expired at the close of 2025. Those extra subsidies had cut monthly premiums for millions of middle-income buyers.
Once they lapsed, many people either paid far more in 2026 or moved to leaner plans. Enrollment dropped by about 3 million. Young adults, who are typically healthier and more likely to skip coverage when prices climb, accounted for a large share of that decline. The remaining pool, on average, needs more care, Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh, said.
The White House on Thursday pledged $500 rebate checks to an estimated 1 million ACA enrollees, saying they had been overcharged.
It remains unclear how the payments would be funded or whether Congress would have to sign off. Yaver said the $500 check “pales in comparison to the increased premiums that marketplace enrollees are facing due to the expiration of the enhanced subsidies.”
About 165 million people get insurance through work. Employers expect the cost of covering each worker to rise 8.2 percent on average in 2027, the steepest jump since 2003, according to a Marsh survey of more than 1,800 employers.
That 8.2 percent figure does not mean workers will automatically see the same increase in their own premiums, Dr. Kevin Schulman, a professor of medicine at the Stanford University School of Medicine, said.
Companies typically pick up a large share of the tab. When costs spike, they can shift more of the burden by raising employee premiums, lifting deductibles, changing benefits, or holding back on wage growth.
This dynamic plays out differently across the globe, as a viral video shows an American woman’s hospital visit in China costing just $12, sparking debate over costs and wait times. “Because the costs are going up, the employers are trying to reduce the rate of growth, and the easiest way to reduce the rate of growth of healthcare costs is to push more of the costs onto the employee,” Schulman said.
The Marsh survey found that about two-thirds of large employers with 500 or more workers expected to increase what employees contribute toward premiums in 2027. Other firms may leave premiums unchanged while raising deductibles, or drop copays for primary care while charging more for other services.
Schulman said workers should look beyond the monthly premium at open enrollment, since a cheaper paycheck deduction can come with a higher deductible.
Medicare covers about 70 million people. Most enrollees pay a Part B premium for doctor visits and outpatient care, and nine in 10 also pay a separate Part D premium for prescription drugs. Drug costs are where people may notice the largest shifts, Yaver said.
The Centers for Medicare & Medicaid Services said in July that the baseline monthly Part D premium is projected to rise about 6 percent in 2027, from $38.99 to $41.33. Actual amounts vary by income and plan.
The increase follows the Trump administration’s decision to drop support for a temporary federal program that had limited Part D premium growth. That program began in 2025 as the Inflation Reduction Act overhauled the drug benefit. Without it, monthly premiums would have nearly doubled, a Government Accountability Office report said.
Yaver said seniors will feel the impact, noting the program had reduced the average premium by 40 percent last year. Many people on Medicare are retired and live on fixed incomes. “Though seniors don’t change their Part D plans often, this year may be an exception, potentially resulting in seniors opting into lower-quality plans, leaving them less protected,” she said. An annual out-of-pocket cap on prescription drugs will still apply, set at $2,400 in 2027.
Published: Sep 15, 2026 12:30 pm