ACA premiums expected to jump 13% as open enrollment starts

The open enrollment period for Affordable Care Act marketplace plans begins Sunday in most states and runs through Jan. 15. People in Bernalillo County looking to buy health insurance should expect average premiums to rise by 13% in 2027, according to a analysis of new Centers for Medicare and Medicaid Services data by the healthcare research nonprofit KFF.

KFF vice president and director of the ACA program Cynthia Cox said the price hike stems from rising healthcare costs and hospital market concentration. She also cited the No Surprises Act, which took effect in 2022, and the increased availability of GLP-1 drugs as factors driving the increase. Cox noted that the people most affected by these changes are those who do not qualify for a subsidy.

Cox said many of these unsubsidized shoppers 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. She added that a lot of these enrollees have already shifted to the lowest tier to manage costs.

A fact sheet from CMS distributed Friday stated that Americans using HealthCare.gov will have robust access to low-cost plans. However, financial assistance such as premium tax credits and cost-sharing reductions is now restricted for many groups who were previously eligible. The changes follow the expiration of enhanced subsidies that Republicans opposed extending after they helped offset costs during the administration of President Joe Biden.

The expiration of those subsidies has already reduced enrollment. KFF data indicates 1.2 million fewer people signed up for coverage in the exchanges during the previous cycle. 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. That number had grown during the pandemic when the American Rescue Plan Act and Inflation Reduction Act made enhanced subsidies available.

New regulations starting in 2027 will limit tax credits for certain lawfully present immigrants. Experts estimate this change could result in an additional 1 million uninsured individuals over time. The administration has also been removing enrollees from the program as part of an effort to reduce 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. The administration alleged these individuals were fraudulently enrolled or did not exist. Vance said the discovery and canceled subsidy payments for hundreds of thousands of people would result in $2.2 billion in cost savings.

Cox said it is unclear how many more people will drop off of ACA coverage in 2027. She noted that with higher premiums, immigration eligibility changes, and anti-fraud efforts, fewer people will be enrolled in this market. “I think there’s going to be fewer people enrolled in this market, but it’s going to be harder to understand why,” Cox said.