A fresh analysis from the Kaiser Family Foundation (KFF) projects that average premiums for Affordable Care Act marketplace plans will climb another 13% in 2027, marking the second consecutive year of double-digit increases. The forecast, released Friday, follows a 26% spike in rates between 2025 and 2026, intensifying political pressure on lawmakers as the midterm elections approach.
KFF based its calculations on new data from the Trump administration, which published 2027 pricing for the 30 states that rely on the federal exchange, HealthCare.gov. The release comes just days before the 2027 open enrollment period begins on Sunday, giving consumers their first look at next year's costs.
Roughly 19.2 million Americans are currently enrolled in Obamacare plans, according to federal estimates from earlier this year. However, a KFF analysis from May found that enrollment dipped in 2026, breaking a four-year streak of record growth. The decline coincides with the expiration of enhanced premium tax subsidies, which Republicans declined to extend over Democratic objections, and the administration's new enrollment barriers aimed at curbing what it calls widespread fraud.
The projected 2027 increases are not out of line with broader health insurance trends—federal and employer-sponsored plans are expected to rise about 10% over the same period—but they land at a politically sensitive moment. Healthcare costs have emerged as a central issue in the midterm races, with voters consistently ranking affordability among their top concerns. A KFF survey published earlier this month found that six in ten voters worry about their ability to pay for insurance and out-of-pocket medical bills, placing healthcare costs on par with gas prices as a leading affordability issue this cycle.
The Trump administration has tried to blunt the political fallout. The president announced one-time $500 payments to nearly one million Americans who were allegedly overcharged for Obamacare, and earlier this month, the administration began distributing $90 checks to more than 20 million Medicare Part B enrollees—a total outlay of about $2 billion. These moves echo the administration's broader effort to address cost-of-living pressures, as seen in its handling of rising energy costs.
Democrats, meanwhile, have pledged to make restoring the expired subsidies and expanding health care tax credits a top priority if they win back Congress. They point to the KFF data as evidence that Republican policies are driving up costs for working families. "This is a direct result of the GOP's decision to let premium relief lapse," said one Democratic strategist, speaking on condition of anonymity. "Voters will remember this at the ballot box."
The premium hikes also revive memories of the first Trump administration, when Obamacare rates surged by an average of 20% in 2017 and 34% in 2018, according to KFF. That history, combined with the current trajectory, has made healthcare a potent attack line for Democrats, even as the administration points to its rebate checks as evidence of its commitment to affordability.
For enrollees, the practical impact is stark: many will face significantly higher monthly payments unless they qualify for subsidies or switch plans. The administration's enrollment restrictions, which include stricter identity verification and shorter enrollment windows, could further reduce participation, especially among younger and healthier consumers who are vital to keeping risk pools stable.
As the midterm campaigns heat up, the premium data is likely to fuel debates over the future of the Affordable Care Act itself. With rural discontent and farm cost concerns already threatening GOP turnout, the healthcare issue could prove decisive in swing districts. "This is not just a policy problem—it's a political landmine," said KFF's vice president for health reform, Cynthia Cox. "The numbers are moving in the wrong direction for everyone."
