LIVE TRACKER — Last updated June 13, 2026. 2027 ACA rate filings are submitted to state insurance commissioners and CMS between May and August 2026. This article updates as each state's preliminary and final rates are released. Final approved rates publish by November 2026 for January 2027 plan year coverage.
The 2026 open enrollment season brought a 21% average ACA premium increase nationwide. Most employers absorbed it through higher contributions, cost-shifted to employees, or did nothing and renewed at the new rate.
2027 is shaping up to be worse.
Insurers are already submitting their 2027 rate requests, and the early numbers signal that employers who do not act before open enrollment will face the largest consecutive two-year premium increase since the ACA's first years. This article is the first comprehensive tracker of 2027 state-by-state rate filings, published in June 2026 so employers have the full lead time to respond.
What Do the First 2027 Rate Filings Show?
The first states to release 2027 ACA marketplace rate filings show a wide range, with Washington state at the high end and Vermont at the low end.
Washington state insurers filed a weighted average premium increase of 22.4% for 2027, according to preliminary filings tracked by ACA Signups (acasignups.net, June 2026). Thirteen insurers filed rate requests in Washington. Washington's 2026 Silver plan average was already $761 per month, up 40% from 2025. A 22.4% increase on top of that pushes the 2027 Washington benchmark toward $932 per month for a 40-year-old.
Vermont filed its 2027 preliminary rates in May 2026, with insurers requesting an average increase of 6.5% (ACA Signups, May 2026). Vermont is consistently among the highest-premium states in the country. Its 2026 average was $1,224 per month. A 6.5% increase would push Vermont's 2027 benchmark toward $1,303 per month.
Nationally, early filings and insurer commentary reported by DistilINFO (June 10, 2026) indicate that ACA premium rates are rising for 2027, with some carriers requesting increases up to 30% based on medical cost trends and the regulatory environment created by the One Big Beautiful Bill Act (OBBBA), signed July 4, 2025.
Why Are 2027 Health Insurance Premiums Rising So Steeply?
2027 premiums are rising for four compounding reasons, each of which operates independently. Together they are pushing carriers to price more aggressively than at any point in the ACA's history.
The OBBBA Medicaid cuts. The One Big Beautiful Bill Act, signed July 4, 2025, makes the largest changes to Medicaid since the program's founding. Per-capita spending caps and new eligibility verification requirements are expected to push millions of previously Medicaid-enrolled individuals off public coverage (Congressional Budget Office, 2025 preliminary score). Many of those individuals will enter the individual ACA marketplace. Carriers pricing 2027 rates are factoring in a sicker, older risk pool than 2026 as Medicaid enrollment declines.
Enhanced subsidy expiration uncertainty. The enhanced ACA premium tax credits introduced under the American Rescue Plan Act and extended through 2025 reduced net premiums for millions of marketplace enrollees. The OBBBA did not fully extend them. Carriers pricing 2027 are uncertain about how many subsidy-eligible enrollees will remain in the pool versus exit coverage. Fewer subsidized healthy enrollees produces a worse risk pool and higher per-member costs.
Medical cost inflation. GLP-1 medications for diabetes and obesity management (Ozempic, Wegovy, Mounjaro) have become the single largest drug cost driver for commercial carriers. Average per-member GLP-1 costs have more than doubled since 2023. Combined with rising specialty drug costs, procedure cost inflation, and behavioral health utilization increases, carriers are pricing 2027 medical cost trends at 8% to 12% before administrative loads.
Insurer market exits. Several carriers reduced marketplace footprints after 2026's rate environment proved unprofitable in certain states. Fewer competing carriers in a market historically correlates with higher average approved rates. States where carrier count dropped from five to three between 2025 and 2026 are among those with the highest 2027 preliminary rate requests.
2027 State-by-State Rate Tracker (Updated as Filed)
This table shows 2027 preliminary rate filings where available, with 2026 approved rates as the baseline. States without a 2027 figure have not yet submitted or publicly released rate filings. This page updates as each state reports.
| State | 2026 Avg Monthly Premium | 2026 YoY Change | 2027 Preliminary Request | Source |
|---|---|---|---|---|
| Washington | $761 | +40% | +22.4% | ACA Signups, June 2026 |
| Vermont | $1,224 | +6% | +6.5% | ACA Signups, May 2026 |
| All other states | See 2026 table below | — | Filing pending | — |
2027 filings are submitted May through August 2026. Final approved rates publish by November 2026. This tracker updates as each state's preliminary filing becomes public.
2026 Baseline: Full 50-State Table
The 2026 premiums below are approved Silver plan rates for a 40-year-old, sourced from state insurance commissioner filings and CMS rate review data. These are the baseline every employer should understand before 2027 renewal conversations begin. States with the highest 2026 premiums and the steepest 2026 increases are the ones most likely to see continued pressure in 2027.
| Rank | State | 2026 Avg Monthly Premium | 2026 YoY Change |
|---|---|---|---|
| 1 | Vermont | $1,224 | +6% |
| 2 | Wyoming | $1,119 | +25% |
| 3 | West Virginia | $1,093 | +14% |
| 4 | New York | $1,090 | +5% |
| 5 | Alaska | $1,037 | -5% |
| 6 | Nebraska | $960 | +29% |
| 7 | Illinois | $888 | +30% |
| 8 | Florida | $859 | +33% |
| 9 | Connecticut | $859 | +21% |
| 10 | Louisiana | $827 | +26% |
| 11 | Texas | $826 | +35% |
| 12 | Arkansas | $823 | +67% |
| 13 | Utah | $821 | +22% |
| 14 | New Mexico | $800 | +26% |
| 15 | North Carolina | $800 | +21% |
| 16 | Nevada | $792 | +34% |
| 17 | Kansas | $787 | +23% |
| 18 | Tennessee | $775 | +39% |
| 19 | Maine | $771 | +24% |
| 20 | Montana | $763 | +20% |
| 21 | Washington | $761 | +40% |
| 22 | Delaware | $759 | +31% |
| 23 | Mississippi | $756 | +42% |
| 24 | Pennsylvania | $750 | +23% |
| 25 | Missouri | $742 | +20% |
| 26 | Oklahoma | $739 | +23% |
| 27 | South Dakota | $734 | +6% |
| 28 | Georgia | $729 | +32% |
| 29 | California | $728 | +11% |
| 30 | Massachusetts | $725 | +10% |
| 31 | Wisconsin | $722 | +19% |
| 32 | Michigan | $718 | +18% |
| 33 | Alabama | $714 | +28% |
| 34 | Idaho | $710 | +14% |
| 35 | Indiana | $707 | +16% |
| 36 | Iowa | $703 | +17% |
| 37 | Colorado | $698 | +15% |
| 38 | Kentucky | $695 | +22% |
| 39 | Arizona | $689 | +19% |
| 40 | South Carolina | $682 | +18% |
| 41 | Virginia | $675 | +14% |
| 42 | Ohio | $670 | +16% |
| 43 | Oregon | $663 | +12% |
| 44 | North Dakota | $658 | +10% |
| 45 | New Jersey | $640 | +13% |
| 46 | Hawaii | $626 | +8% |
| 47 | Minnesota | $608 | +9% |
| 48 | Rhode Island | $565 | +7% |
| 49 | New Hampshire | $527 | +11% |
| 50 | Maryland | $480 | +16% |
| — | U.S. Average | $752 | +21% |
Source: ACA marketplace Silver plan rates for a 40-year-old, state insurance commissioner filings and CMS rate review, as reported by Peterson-KFF Health System Tracker and Summit Health Benefits analysis.
What Does a 2027 Premium Increase Mean for Employers?
For employers offering group health coverage, 2027 ACA marketplace premium increases matter in two ways. First, group plan carriers benchmark their renewal rates against the individual market risk environment. When individual market medical cost trends run at 10% to 12%, group plan renewal increases of 8% to 15% follow. Second, ACA premium increases determine whether employees can afford individual marketplace coverage as an alternative to employer-sponsored plans, which affects workforce retention and benefit value perception.
A Texas employer whose group plan renews in January 2027 should expect to be presented with a renewal increase reflecting the same medical cost inflation that drove Texas's 2026 ACA Silver plan to $826 per month, up 35% from 2025. The Section 125 cafeteria plan is the one tool that directly reduces the cost of employer-sponsored coverage without changing the underlying plan design.
Under a Section 125 premium-only plan, employee health insurance premium contributions convert from after-tax to pre-tax deductions. The employer recaptures 7.65% of every pre-tax dollar in reduced FICA taxes. For a 50-person employer with each employee contributing $540 per month, the employer FICA recapture is $540 × 12 × 7.65% × 50 = $24,786 per year. That recapture partially or fully offsets the 2027 premium increase cost. See how FICA recapture math works across different wage levels.
Which States Should Employers Watch Most Closely for 2027 Increases?
The states most likely to see the steepest 2027 premium increases are those that already absorbed the largest 2026 increases AND have structural factors driving continued pressure.
High-risk states for 2027 continued increases: Arkansas (+67% in 2026), Tennessee (+39%), Washington (+40%), Mississippi (+42%), Texas (+35%), and Florida (+33%) all experienced outsized 2026 increases. These states have limited carrier competition, high medical cost baselines, or large Medicaid populations vulnerable to OBBBA eligibility changes. Washington's early 2027 filing at +22.4% confirms the pattern.
Moderate-risk states: States with 2026 increases in the 20% to 30% range — Nebraska (+29%), Illinois (+30%), Delaware (+31%), Georgia (+32%), Nevada (+34%) — are likely to see 2027 filings in the 10% to 20% range as carriers price above 2025 losses.
Lower-risk states: Vermont (+6%), Alaska (-5%), New York (+5%), South Dakota (+6%), and Hawaii (+8%) saw relatively modest 2026 increases. Vermont's 2027 filing at +6.5% continues that pattern. These states tend to have more stable carrier markets and stronger state-level rate review oversight.
For employers in high-risk states, the 2027 open enrollment window is a critical decision point. Employers evaluating ICHRA as an alternative to group coverage should model ICHRA alongside a Section 125 plan wrapper before the November 2026 deadline. Employers concerned about coverage gaps during a transition should understand COBRA implications before making plan design changes.
How Should Employers Respond to 2027 Premium Increases?
Employers have four levers to control group health costs in a rising premium environment. None of them require dropping coverage or reducing benefits.
Lever 1: Section 125 cafeteria plan. Converting employee premium contributions to pre-tax status does not change the premium. It reduces the employer's FICA tax by 7.65% on every pre-tax dollar. For employers without a Section 125 plan, this is the first and fastest lever. Summit Health Benefits charges $35 per enrolled employee per month. For most employers with average employee premium contributions above $457 per month, the FICA recapture exceeds the admin fee from the first enrolled employee.
Lever 2: Plan design review. Moving from a PPO to an HDHP with an HSA or a level-funded plan can reduce employer premium cost by 15% to 25% without eliminating coverage. The trade is higher employee cost-sharing. For workforces that are younger and healthier, the trade often works. For older or higher-utilization workforces, it may not.
Lever 3: Supplemental and zero-cost benefits. Zero-cost supplemental benefits — virtual primary care, generic prescription coverage, mental health access — reduce claims utilization on the primary carrier and can lower the next renewal increase by improving the group's claims experience.
Lever 4: Alternative coverage structures. For employers with fewer than 50 employees who are not ACA-mandate-obligated, small business health insurance alternatives including healthshare plans, level-funded coverage, and ICHRA structures may deliver equivalent or better benefits at lower per-employee cost than group ACA plans in high-premium states.
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Frequently Asked Questions
How much will health insurance premiums increase in 2027?
Which states have the highest health insurance premiums in 2027?
Why are health insurance premiums increasing so much in 2027?
How do 2027 ACA premium increases affect employer group health plans?
When will 2027 health insurance rate filings be complete for all states?
What can employers do to offset 2027 health insurance premium increases?
How does the OBBBA affect 2027 health insurance premiums?
Is the 2027 health insurance premium increase the same for employer group plans as for ACA marketplace plans?
Sources: ACA Signups (acasignups.net, May–June 2026, Washington and Vermont 2027 preliminary rate filings), DistilINFO Publications (June 4 and June 10, 2026, 2027 ACA premium rate filing coverage), Peterson-KFF Health System Tracker (2026 ACA premium increase analysis), Congressional Budget Office (OBBBA coverage impact preliminary score, 2025), KFF (ACA marketplace premium tax credit analysis), InsuranceNewsNet (2027 rate filing reporting, June 2026), CMS Rate Review (ratereview.healthcare.gov).