Approved 2027 ACA premium increases are landing state by state. Here is how to find an insurance agent and lower your bill before November 1 open enrollment.
2027 ACA Rate Increases Are Not Uniform
State regulators are finalizing individual-market Affordable Care Act rates for 2027. The approved averages are substantial, but the state average does not identify the premium for a specific person.
The Maryland Insurance Administration reported an average 14.6% increase for unsubsidized individual ACA plans. The agency attributed the increase to the expiration of enhanced federal premium tax credits, changes to Exchange eligibility under H.R. 1, and higher hospital and prescription drug costs.
Washington approved an even higher average increase. Washington’s Office of the Insurance Commissioner reported that 2027 Exchange rates will rise by an average of 22.2%. Insurers had requested an average increase of 22.4%.
The Washington filing identified four primary drivers:
- Higher charges for health care services and prescription drugs.
- Increased use of health care services and higher-cost services.
- Healthier members leaving the individual market.
- The expiration of enhanced premium tax credits, which reduced affordability and encouraged some healthier members to leave.
Washington’s Exchange enrollment fell to approximately 250,000 in 2026, a 13% year-over-year decline. The lapsed credits had reduced enrollee costs by approximately $1,330 per year on average.
The national filing pattern is also elevated. KFF found a median proposed increase of about 14% among Marketplace insurers reviewed in 16 states and the District of Columbia. Most requests were between 10% and 20%. More than 20 insurers requested increases above 20%.
The State Average Is Not the Personal Rate
An approved average rate is a market statistic. It is not a personal renewal quote.
A consumer’s actual premium can change based on:
- The selected carrier.
- The specific plan and network.
- Age.
- Geographic rating area.
- Metal tier.
- Household size.
- Projected income.
- Eligibility for federal or state assistance.
Maryland’s approved rate table demonstrates the difference. For a 40-year-old in the Baltimore metropolitan area purchasing the lowest-cost unsubsidized silver plan, approved monthly changes ranged from $9 to $89.
| Carrier | Network | 2026 Monthly Premium | Rate Change | 2027 Monthly Premium | Monthly Change |
|---|---|---|---|---|---|
| CareFirst BlueChoice | HMO | $371 | 16.1% | $431 | $60 |
| CareFirst GHMSI/CFMI | PPO | $585 | 15.2% | $674 | $89 |
| Kaiser | HMO | $344 | 7.8% | $371 | $27 |
| Optimum Choice | HMO | $342 | 2.6% | $350 | $9 |
| Wellpoint Maryland | HMO | $437 | 19.2% | $521 | $84 |
The table compares unsubsidized prices. It does not show what an eligible consumer will pay after financial assistance.
The example also shows why selecting the first renewal option can be costly. The lowest increase is not necessarily the lowest premium, and the lowest premium is not necessarily the best option for a specific doctor, hospital, prescription, or expected level of care.
Premium Tax Credits Change the Calculation
The approved rate generally applies to the unsubsidized premium. The amount paid by a consumer depends on the financial assistance calculation and the plan selected.
Consumers with household income below 400% of the federal poverty level may qualify for a premium tax credit, subject to Marketplace eligibility rules. In most states, the credit is tied to the cost of the second-lowest-cost silver plan in the consumer’s rating area. The credit does not simply follow the plan selected.
This creates an important shopping issue. A consumer may receive the same general tax credit while paying different amounts for different plans. A lower-priced plan may reduce the monthly premium. A different silver plan may provide a more suitable network. A gold plan may have a higher monthly premium but lower cost sharing for a person who expects frequent care.
Consumers above the subsidy cliff generally pay the full premium. For those households, comparing carriers and plan designs may be the primary available method for limiting the increase.
Several states have added assistance to replace part of the lost federal support. KFF identified Maryland, California, Colorado, Washington, and New Mexico as states with their own subsidy programs or backfill assistance. Residents should check the applicable state exchange before assuming that the full approved rate applies.
Maryland residents can review available agent records through the VerifiedAgent Maryland directory. Consumers seeking Marketplace assistance for income-based coverage or chronic-condition needs may also review the ACA assistance information at GetACA.
Open Enrollment Timeline
The following timeline applies from September 30, 2026, forward.
September 30 Through October 2026: Review the Renewal Record
A renewal notice or Annual Notice of Change should be reviewed when received. The record may identify:
- The 2027 premium before and after assistance.
- Changes to the plan’s deductible and out-of-pocket maximum.
- Changes to the provider network.
- Changes to the prescription formulary.
- Whether the current plan will continue in 2027.
The renewal amount should not be treated as the only available option. A current plan may continue automatically at a different price unless the consumer changes plans.
Before Applying: Update the Income Estimate
The premium tax credit is based on projected household income for the coverage year. Income from self-employment, contract work, seasonal employment, investments, or other sources should be included in the estimate.
The estimate should be reviewed immediately before the 2027 application is completed. An inaccurate estimate can affect the advance credit and may create a repayment obligation when federal taxes are filed.
November 1 Through December 15: Select Coverage for January 1
HealthCare.gov lists November 1, 2026, as the start of Open Enrollment. December 15, 2026, is the last day to enroll in or change a plan for coverage starting January 1, 2027.
This is the primary comparison period for consumers who want uninterrupted January coverage.
December 16 Through January 15: Fallback Enrollment Period
Open Enrollment ends January 15, 2027. Plans selected from December 16 through January 15 generally begin February 1, provided the first premium is paid.
After January 15, enrollment or plan changes generally require a Special Enrollment Period. Medicaid and CHIP applications remain available throughout the year for eligible households.
Three Coverage Decisions for 2027
| Option | Primary Benefit | Trade-Off |
|---|---|---|
| Stay on the current plan | Requires the fewest changes and may preserve existing providers | Usually provides the least opportunity to avoid a new premium or benefit change |
| Switch metal tiers within the Marketplace | May reduce the monthly premium or improve cost-sharing balance | A lower premium can come with a higher deductible, copayments, or coinsurance |
| Move off-exchange to a private-market plan | May provide a different network or product structure | No Marketplace subsidy is available, and eligibility, benefits, and underwriting rules may differ by product |
Remaining on the current plan is the simplest move. It is not automatically the lowest-cost move.
Changing from silver to bronze may reduce the monthly premium but increase the deductible and cost exposure. Changing to gold may increase the premium while reducing cost sharing for a consumer who expects regular services.
Off-exchange coverage requires additional caution. A private-market plan may offer a broader network or a different eligibility path, but it does not receive Marketplace premium tax credits. Some non-ACA products may not provide the same benefits, protections, or coverage requirements as an ACA-compliant plan.
Questions to Ask a Licensed Insurance Agent
Before an agent-assisted enrollment, the following questions should be answered for the specific 2027 plan:
- What is the actual monthly premium after the premium tax credit, not before the credit?
- Are the consumer’s doctors and hospitals in network for this specific plan ID?
- Are the consumer’s prescriptions on the formulary, and at which cost-sharing tier?
- What are the deductible and out-of-pocket maximum for 2027 compared with 2026?
- Does the household qualify for a state subsidy in addition to the federal premium tax credit?
- What happens if income is under-reported and part of the advance credit must be repaid?
- Is the agent licensed for health insurance in the consumer’s state, and what is the agent’s NPN?
- What is the last date to change plans for coverage beginning January 1?
The NPN, or National Producer Number, is the standard identifier used for an insurance producer. Licensing and appointment authority vary by state. An agent licensed in one state may not be authorized to sell or enroll consumers in another state.
Verify the Agent Before Enrollment
A premium increase is also a point to confirm the status of the person providing assistance. VerifiedAgent directory records can be searched by state, and available profile information can be reviewed for licensing details, product categories, reviews, and NPN information.
The VerifiedAgent select-state directory provides access to state-specific searches. Washington consumers can review available records through the Washington agent directory search.
License status should be confirmed for the health line in the applicable state. A directory record does not replace confirmation with the state insurance department, and current licensing or appointment status may differ from older records.
Any agent-assisted Marketplace enrollment should include documented authorization. The consumer should retain copies of the authorization, application details, selected plan ID, confirmation number, and effective date. The completed enrollment should also be visible in the consumer’s own Marketplace account.
2027 Requires Plan Comparison
The 2027 market does not have one premium increase. It is a re-pricing of individual coverage across carriers, regions, plan tiers, and income categories.
Maryland’s $9-to-$89 monthly range and Washington’s 22.2% average increase show why state averages cannot substitute for a personal comparison. The rate applies to the unsubsidized price. The final bill depends on the available tax credit, the benchmark plan, the selected carrier, and the consumer’s household information.
Consumers who do not compare may remain enrolled in the same plan at a new price through auto-reenrollment. Consumers who compare can evaluate the current plan, other Marketplace metal tiers, state assistance, and off-exchange alternatives.
The reported shortage of newly federally Exchange-registered agents also makes the selection of a licensed, verifiable agent more consequential during this cycle. License status, NPN, appointment authority, written authorization, and Marketplace confirmation should be treated as standard enrollment records.
