Health insurance shoppers are heading into open enrollment with bad news: costs are climbing again across employer plans, marketplace plans, and Medicare. Here is what the latest data shows and how to prepare.
The 2027 numbers
KFF analyzed public rate filings from 276 insurers in every state and Washington, D.C., and found a median proposed premium increase of 15% for 2027. That follows a median increase of 20% that was finalized for 2026, which means marketplace premiums would rise by more than a third over two years if the 2027 requests hold. Requests vary widely by state. Washington insurers averaged roughly 22.4%, one major New York insurer asked for 52%, and Forbes, citing an analysis from healthinsurance.org, reported averages under 7% in Vermont, Iowa, and Utah and about 29% in Arizona. These are proposals; regulators can adjust them before rates are final.
What is driving them
Insurers point to higher costs for hospital stays, physician visits, and prescription drugs, including GLP-1 medications and other specialty drugs; KFF notes the underlying cost trend is about 10% for 2027, above the roughly 8% seen in recent years. A second factor is the end of the enhanced federal premium tax credits after 2025. Healthier, often younger, enrollees dropped coverage, leaving a smaller pool that needs more care on average, and insurers are pricing that in.
The subsidy math
Most marketplace enrollees still get help. Peterson-KFF found 87% received premium subsidies in 2026, and subsidies can shield many people from part of the increase. But with the enhanced credits gone, the amount enrollees actually paid after subsidies rose sharply in 2026, and coverage is again unsubsidized above 400% of the federal poverty level. The IRS's 2027 table expects enrollees to contribute between about 2.15% and 10.22% of income toward the benchmark silver plan.
Marketplace plans are not the only ones getting more expensive. Forbes reports that employer health benefit costs are projected to rise 8.2%, the fastest pace since 2003, with many employers shifting costs to workers through higher deductibles and premiums, and that Medicare Part B premiums will rise about 3%.
Key dates
- November 1, 2026: Open enrollment begins on HealthCare.gov.
- December 15, 2026: Last day to enroll or switch plans for coverage starting January 1.
- January 15, 2027: HealthCare.gov open enrollment ends; plans chosen after December 15 start February 1.
- State-run marketplaces can set different deadlines, so check yours. Medicare's separate open enrollment runs from October 15 to December 7.
Comparison checklist
- Do not auto-renew. Networks, drug lists, and prices change every year, and your current plan may no longer be the best value.
- Update your income estimate. Your subsidy depends on it, and an outdated figure can cost you money.
- Compare total cost, not just the premium. Add the deductible and the out-of-pocket maximum to see your worst-case year.
- Check your doctors and medications. Confirm they are in the network and on the plan's formulary.
- Consider silver if your income is lower. People with incomes between 100% and 250% of the poverty level can qualify for extra cost-sharing help, but only on silver plans.
Expect higher prices almost everywhere, so the biggest savings come from actively comparing plans instead of renewing by default. Start before December 15.
Health coverage is only one piece of your protection. Our life insurance calculator can help you check whether your family is covered if your income stops.