Maryland insurance officials have signed off on a 14.6% average premium rate increase for individual Affordable Care Act marketplace plans in 2027, a jump that stacks on top of last year's already steep hike and lands as some residents downgrade coverage or go without insurance altogether. The increase, approved September 25, is higher than the 13.7% average bump insurers initially requested back in May and June, after companies came back over the summer with amended proposals seeking even more.
Why Regulators Signed Off on a Bigger Hike
According to WTOP News, the approved average is still lower than what insurers ultimately asked for in their amended filings, even though it exceeds their original request. The state also approved a 10.2% average increase for small-group plans, driven by increased inpatient hospital care and rising prescription drug costs, and a 3% increase for dental plans — below the 6.5% bump insurers had sought there. Marylanders buy individual coverage through the Maryland Health Connection under the ACA, and the 2027 increase compounds on top of the 13.4% rate increase that took effect in 2026.
Matthew F. Celentano, executive director of the League of Life & Health Insurers of Maryland, said the released rates reflect the effects of expired premium tax credits. “The tax credits were critical for consumers and helped keep health care costs down,” he said, according to the same report. Enhanced federal premium tax credits expired in December 2025 after Congress failed to renew them, and insurers say the resulting rates are needed to remain solvent and cover rising medical and drug costs.
What It Could Mean for Your Monthly Bill
The premium impact will vary by insurance carrier, plan type, household size and income, per WTOP's report. A household of four enrolled in an Optimum Choice bronze plan could see its monthly premium rise from $975 to $1,009 — a 3.5% increase, or about $34 more per month. A household of four with a CareFirst bronze plan could see a steeper 17.2% increase, adding roughly $302 to monthly costs. The Maryland Insurance Administration's examples exclude subsidies that could lower premiums for households that qualify, and officials note those below 400% of the federal poverty level may be eligible for state assistance.
Insurance Commissioner Marie Grant cautioned that the 14.6% figure may not be the number any single Marylander actually sees, since rates vary by age, family structure and plan. She urged residents affected by the increases to explore their options on the ACA marketplace, and separately warned consumers to steer clear of unauthorized health insurance plans while shopping around. “People need to shop and understand your options,” she said.
Enrollment Already Sliding as Costs Climb
Maryland Health Connection enrollment dropped from 294,000 to 274,000, and state insurance regulators expect the decline to continue into the next plan year. Higher health care costs are already pushing some Marylanders to downgrade their coverage or go without insurance entirely, according to the WTOP report, which was republished from Maryland Matters.
Vincent DeMarco, president of the Maryland Health Care for All Coalition, warned that current state efforts aren't keeping pace with rising premiums and health care costs. He said Marylanders will pay higher premiums because of decisions made by the Trump administration and Congress, and argued that additional state revenue and action to control drug costs are needed.
A National Pattern Beyond Maryland
Maryland's situation mirrors a broader trend playing out across the country. Nationally, insurers are proposing a median 15% premium increase for 2027 based on filings from 276 insurers, according to KFF, marking the second-highest requested rate change since 2018 and the second consecutive year of double-digit hikes. ACA marketplace enrollment fell in 2026 in every state except New Mexico — the first nationwide enrollment decline in seven years, which KFF says coincides with the end of the enhanced federal subsidies.
Maryland's own carriers had requested an overall average individual-market rate change of 13.7% for 2027, with individual carrier requests ranging from 12% to 14.6%, according to Tri-State Alert. Small-group carriers separately cited increased use of medical and prescription-drug services in seeking their own increase. Last year's pattern looked similar in shape but sharper in scale nationally — the median nationwide proposed rate change was 18%, finalized at 20%, per KFF's data — while Maryland itself had settled on a 13.4% average increase for 2026 after insurers initially proposed 17%, according to a separate report from Yahoo News.
