Most Americans will pay a lot more for their health insurance starting in 2027, regardless of whether it’s employer-provided insurance. Obamacareor Medicare. In some cases, premium increases could be the highest in decades and are driven by numerous economic pressures. But they will not be the same for everyone. Some will pay more in the form of higher copays or deductibles.
“Health care costs are rising faster than we have seen in years, and it is during the open enrollment period that the health care affordability crisis will really be felt,” said Larry Levitt, executive vice president of health policy at KFF, a nonpartisan research group. “This applies no matter what type of insurance you have.”
Prices have risen in all areas of daily life.
Rising health care costs are due, in part, to rising prices for hospital care and other services, as well as the increased use of high-cost prescription drugs — including those for weight loss — that are driving up costs for insurers and employers.
The pressures are specific for each type of coverage.
People who buy insurance through the Affordable Care Act (ACA) marketplace or Obamacare — about 19 million adults — will face another year of steep premium increases after special federal subsidies expired last year.
The White House on Thursday promised $500 refund checks to approximately one million ACA enrollees, alleging they had been mistakenly overcharged. It’s unclear where the money would come from or whether its distribution would require congressional approval, but experts said this is unlikely to provide significant relief.
The $500 check “pales in comparison to the increased premiums that marketplace enrollees face due to the expiration of special subsidies,” said Miranda Yaver, associate professor of health policy and management at the University of Pittsburgh.
Those with health insurance through their employer could be asked to shoulder a larger share of rising health costs. And some Medicare beneficiaries could see changes in their prescription drug premiums after the Trump administration ended a temporary program that helped keep those premiums in check.
We tell you what to expect from 2027.
who have Obamacare
People who buy health insurance through the ACA are headed for a second straight year of double-digit premium increases.
Insurers offering ACA plans are proposing a premium increase of about 15% by 2027, according to a KFF analysis of public filings by insurers in all 50 states and Washington, D.C. By 2026, they have raised rates by an average of 20%.
A person making $80,000 a year who doesn’t qualify for standard ACA subsidies could see the cost of their Bronze plan — the cheapest — increase by about $80 a month, which would add almost 1,000 to your annual expense.
One of the main reasons insurers are raising rates is that health care is becoming more expensive, Levitt said. Insurers have pointed to rising prices for hospitalizations, doctor visits and prescription drugs, among other costs.
In general, insurers “have felt pressure to include coverage of GLP-1 weight-loss drugs, but they are also seeing very, very large increases in the costs of them,” Levitt said.
The ACA market also continues to adjust to the expiration of enhanced federal subsidies at the end of 2025. Those subsidies — which were first implemented during the pandemic — reduced monthly premiums for millions of middle-class people. When they expired, they had to pay significantly more for coverage in 2026 or downgrade their plans.
The expiration of the subsidies also caused a roughly 3 million drop in Obamacare enrollment.
Young adults — who are generally in better health and more likely to drop insurance when it becomes too expensive — accounted for a large share of the decline in enrollment. That left insurers with a group of customers who, on average, need more medical care, Yaver said, which also factored into insurers’ rates for 2027.
Those who have health insurance through their employers
Most Americans, about 165 million people, have health insurance through their jobs. Many of them may also be feeling the price increases.
Employers expect the cost of providing health benefits to each worker to rise 8.2%, on average, in 2027 — the largest increase since 2003 — according to a survey of more than 1,800 employers by Marsh, a benefits consulting group.
That doesn’t necessarily mean workers’ premiums will increase by 8.2%, said Dr. Kevin Schulman, a professor of medicine at Stanford University School of Medicine who researches employer-based health insurance.
Employers typically subsidize a large portion of workers’ health coverage. But when health care costs rise too high, Schulman explained, they have several ways to pass along some of the increase to employees. They may charge you more for your monthly premiums, increase deductibles, or make other changes to your benefits.
Sometimes they hold back wage increases to offset the expense.
“Because costs are going up, employers are trying to slow the growth rate, and the easiest way to slow the growth rate of health care costs is to shift more of the costs to the employee,” Schulman said.
Many seem willing to do just that.
The Marsh survey found that about two-thirds of large employers — those with 500 or more employees — said they expected to increase employees’ contributions to their premiums in 2027.
Others can redistribute costs in other ways, such as waiving copays and deductibles for primary care visits while charging for other types of care, or keeping premiums unchanged while increasing the deductible.
For workers, that makes it important to look beyond the premium during the open enrollment period, Schulman said. A plan that costs less or about the same on each paycheck may have a higher deductible or require people to pay more when they seek medical care.
Those with Medicare
Monthly premiums are handled somewhat differently for the approximately 70 million people enrolled in Medicare.
People with Medicare generally have more than one premium to consider: usually one for Part B, which covers doctor visits and other outpatient care; and, for 9 out of 10 enrollees, a separate one for Part D, which covers prescription drugs.
Prescription drug costs are where enrollees may see the most significant changes, according to Yaver of the University of Pittsburgh.
The Centers for Medicare and Medicaid Services projected in July that the baseline monthly cost for Part D coverage will increase about 6% in 2027, from $38.99 to $41.33.
What enrollees end up paying actually varies, depending on their income and their specific plan.
The increase is due to the Trump Administration withdrawing its support for a temporary federal program that helped offset increases in premiums for Part D plans. The initiative began in 2025, when the Medicare prescription drug benefit underwent major changes under the Inflation Reduction Act. Without it, enrollees would have seen their monthly premiums nearly double, according to a Government Accountability Office report.
The change will affect seniors, Yaver said, noting that the program had reduced the average premium by 40% last year. People with Medicare are usually retired and live on a fixed income.
“Although seniors do not change their Part D plans frequently, this year could be an exception, which could lead them to opt for lower quality plans, leaving them less protected,” he said.
Members will continue to have an annual out-of-pocket limit for prescription drugs. In 2027 it will be $2,400.
