Texans who buy their own health insurance are on track for a second consecutive year of steep premium increases, as insurers across the country file 2027 rates that would push the cost of Affordable Care Act coverage up by more than a third over two years.
ACA Marketplace insurers are proposing a median premium increase of 14% for 2027, according to a new analysis of preliminary rate filings released July 8 by KFF and the Peterson-KFF Health System Tracker. Across the 77 insurers in 16 states and Washington, D.C., that had filed so far, most requested increases between 10% and 20%, and 20 insurers asked for more than 20%. If the increases hold, KFF said, typical premiums for participating insurers “would jump by more than one-third between 2025 and 2027.”
The filings matter for Texas because the state runs the largest ACA Marketplace in the country. Roughly 4.2 million Texans enrolled for 2026, and nearly 92% received advance premium tax credits, according to federal enrollment data. Texas insurers already raised 2026 premiums by about 35%, as reported by The Texas Tribune, and the new national filings signal that the pressure has not eased.
The July 15 federal deadline for insurers to submit 2027 rates means Texas-specific numbers will firm up within days; the Texas Department of Insurance reviews and posts filings before rates are finalized in late summer.
KFF identified three drivers. First, the underlying cost of medical care and prescription drugs is rising about 10% for 2027, faster than the 8% average of recent years, pushed by hospitalizations, physician visits and specialty medications including GLP-1 weight-loss and diabetes drugs. Second, federal regulatory changes — the latest Notice of Benefit and Payment Parameters and the Marketplace Integrity and Affordability Rule — are adding upward pressure. Third, and most consequential for household budgets, the ACA’s enhanced premium tax credits expired at the end of 2025.
That expiration is the pivot point for affordability. KFF found the loss of the enhanced credits drove a 58% average increase in out-of-pocket premiums in 2026 and deductibles roughly $1,000 higher per person. Most enrollees still qualify for some ACA subsidy and are partly shielded, but people earning 400% or more of the federal poverty level — about $62,600 for a single person in 2026 — lost subsidies entirely and now absorb the full premium. Many healthier enrollees responded by dropping coverage, leaving a smaller, sicker and costlier risk pool that KFF estimates added about four percentage points to 2026 premiums and will add roughly four more in 2027.
For Texas, where the marketplace is the primary coverage route for hundreds of thousands of middle-income families in a state that has not expanded Medicaid, the compounding math is the core problem. A benchmark plan climbing double digits two years running, stacked on the loss of enhanced credits, prices out precisely the self-employed workers, small-business owners and near-retirees who have no employer plan to fall back on. Whether Congress revisits the enhanced credits before November open enrollment remains the single largest variable for what Texans will actually pay.
The near-term checkpoints are concrete. Insurers must submit final 2027 rates by July 15, TDI will post Texas filings for review, and regulators will finalize rates in late summer ahead of an open-enrollment window that will show how many Texans stay covered when the bill arrives. “These preliminary filings provide insight into the factors insurers expect to drive health costs for the coming year,” KFF wrote — a preview, for Texas families, of a second straight year of paying more.