Health-insurance renewal feels like software that auto-renews at a higher tier—except the features are deductibles and networks. The big policy shock was simpler: enhanced ACA premium tax credits expired at the end of 2025.
The numbers
KFF reports average enrollee premium payments rose about 58%, from $113 to $178 per month in 2026. Many people bought down to bronze plans; others above the subsidy cliff left the market. That adverse selection feeds next year’s rates.
For 2027, insurer filings pointed to a median increase around 14–15%, after a roughly 20% median finalized jump in the prior cycle. Insurers cite subsidy expiration alongside medical inflation and drug costs.
Sources: KFF 2026 analysis; Peterson-KFF outlook.
Systems view
Enhanced credits smoothed a cliff. When they expired, people above 400% of poverty lost eligibility and faced full freight. Cliffs produce drop-offs and a sicker remaining pool. Legacy claims systems and ransomware defenses matter, but they are not the master key to this shock.
What to do
Shop open enrollment. Model total cost—deductible, out-of-pocket maximum, formulary, and network. Recheck income projections if taking advance credits.
Premiums rise because care is expensive and Congress let a temporary affordability patch expire. Steve Miller — Mason, Ohio.