Obamacare premiums are set to jump by a median of 14 percent in 2027, according to preliminary filings analyzed by KFF, adding hundreds of dollars in monthly costs for many Americans and intensifying Democratic attacks on Republicans over affordability just ahead of the midterm elections.
The projected increase follows a 20 percent median rise in 2026, which itself was a sharp spike after years of relative stability under the Affordable Care Act. If approved, the 2027 hike would be the second-largest since 2018, underscoring the volatility that has returned to the health exchanges under the Trump administration.
Driving the increases are rising medical costs—including hospital care and prescription drugs—along with surging demand for expensive specialty medications and GLP-1 weight-loss drugs. Some insurers have stopped covering GLP-1s for weight loss due to high costs and utilization. Inflation is also straining supply chains, pushing healthcare expenses higher across the board.
Policy changes have compounded the problem. Congressional Republicans let enhanced ACA premium subsidies expire at the end of last year, a move Democrats tried and failed to block. A 45-day government shutdown in late 2025 ended without an extension, and a subsequent standalone vote on the subsidies also failed.
Democrats are now making the subsidy expiration a central campaign issue. Sen. Jon Ossoff (D-Ga.) recently said at a rally, “Donald Trump and his puppet [Rep.] Mike Collins, they doubled health insurance premiums for more than a million Georgians and threw 300,000 Georgians off their insurance altogether. I never want to hear these two pretend they give a damn about working people again.”
The DNC is also leaning in. “Healthcare is unaffordable for millions of Americans because Donald Trump and Republicans sold them out to give billionaires even bigger tax cuts,” said Kendall Witmer, DNC Rapid Response Director. The party is targeting key House and Senate seats, hoping to flip red districts where healthcare costs resonate most.
The loss of subsidies has already driven down enrollment. As of February, ACA enrollment had dropped by about 3 million people compared to the same period last year. Experts say the exodus of younger, healthier enrollees is worsening the risk pool, forcing insurers to raise premiums further. Stacey Pogue, a senior research fellow at Georgetown University’s Center on Health Insurance Reforms, noted that “the fact that fewer people can afford insurance, and more people are dropping insurance, and people who are more likely to drop it are healthy has ongoing ramifications well past January 1.”
Insurers expect the sicker risk pool to add about 4 percentage points to premiums in 2026 and a similar amount in 2027. Matthew McGough, a policy analyst at KFF, said, “There’s this air of uncertainty that insurers are contending with when they are calculating their rates for the upcoming year, and when there is this uncertainty, specifically at the federal level with federal policy, the end result is that consumers are the ones that are fronting the cost of that.”
While most enrollees still qualify for subsidies that cap their payments, middle-class Americans who earn too much to qualify are bearing the brunt. Leslie Dach, chair of the Democratic-aligned group Protect Our Care, said, “This was a deliberate choice by Republicans who took away affordable coverage from millions of people to help fund tax breaks for billionaires and big corporations. The damage is already being felt at kitchen tables across America, and these new premium hikes show the worst is still ahead.”
Republicans defend the expiration, arguing the enhanced subsidies were a taxpayer handout to insurers. They also point out that most consumers still get some help and claim the enrollment drop is largely due to fraud—though the administration has not provided evidence to back that up. Experts say they don’t foresee a full-blown “death spiral” like in 2017, when political uncertainty and plan exits raised fears of insurance deserts, but the market remains fragile.
A recent poll showing that 95% of Americans believe the nation is in an affordability crisis underscores the political stakes. Democrats are betting that tying GOP policies to rising healthcare costs will resonate with voters, especially in swing states where the issue hits close to home.
