Health Insurance Is Getting 8% to 15% More Expensive in 2027. How to Pick a Plan Before Open Enrollment
Last updated 10/09/2026 by
SuperMoney Team
Edited by
Andrew Latham
Summary:
Employer health costs are projected to climb 8% to 11% in 2027, and ACA marketplace insurers want a median 15% increase. Open enrollment is where you can fight back. Compare total yearly cost, not just the monthly premium, and use an HSA if your plan qualifies. The 2027 limit is $4,500 for individuals and $9,000 for families.
If your paycheck feels thinner every fall, it isn’t your imagination. Health insurance keeps getting more expensive, and 2027 looks like another rough year.
The good news is that open enrollment is the one time each year you get to change course. Most people click “renew” and move on. That habit can cost you well over $1,000 a year.
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What’s coming in 2027
Start with employer plans. Consulting firms project that employer health costs per worker will rise 8% to 11% next year. Marsh puts it at 8.2%, Aon at 9.5%, and WTW at 11.1%. Marsh says its figure would be the biggest single-year jump since 2003. Nearly six in ten employers plan cost-cutting changes, and raising deductibles is the most common one.
Now the marketplace. KFF analyzed filings from 276 insurers and found a median proposed premium increase of about 15% for 2027. That’s lower than last year’s proposed 18%, but last year’s final increase landed at 20%. These are proposals, so final numbers may differ.
Insurers point to rising healthcare prices, general inflation, and labor shortages. They also cite the expiration of the enhanced premium tax credits at the end of 2025, which shifted the mix of people who stayed covered.
What that looks like in dollars
Say you pay $250 a month for employer coverage and your share rises 8%. That’s $270 a month, or $240 more per year. Not catastrophic, but it adds up when deductibles rise too.
Now say you buy on the marketplace and pay $500 a month. A 15% increase takes you to $575. That’s $900 more over the year.
The bigger shock is deductibles. KFF found the average marketplace deductible rose 37% in 2026, to $3,786 per person. That’s more than $1,000 higher than in 2025, and KFF calls it the steepest increase on record. If you don’t have that cash sitting around, a surprise ER visit becomes a debt problem fast.
One more group to watch. If your income is above 400% of the federal poverty level (about $64,000 for a single person or $132,000 for a family of four), you get no premium tax credit at all now, because the 400% cap came back when the enhanced credits expired. About 1.6 million marketplace enrollees were in that bracket last year.
How to choose a plan without getting burned
Add up the full-year cost
Compare two plans. Plan A costs $200 a month with a $500 deductible. Plan B costs $120 a month with a $3,500 deductible. Plan B saves you $960 a year in premiums. But if you have a year with real medical needs, you could pay up to $3,000 more in deductible. So the break-even question is simple. Will you spend more than roughly $960 of that extra deductible? If you take regular prescriptions, see specialists, or are planning a surgery, Plan A probably wins. If you’re healthy and rarely see a doctor, Plan B can come out ahead.
Check the doctors and drugs, not just the price
Confirm your doctors and your preferred hospital are in-network. If you take a GLP-1 weight-loss drug, check coverage in writing. Marsh estimates these drugs add about a percentage point to employer cost growth in 2027, which means more plans may restrict them.
Update your income if you’re on the marketplace
Subsidies depend on your projected income. Guess too low, and you may owe money back at tax time. Guess honestly.
The HSA is the best tax deal in the code
If you choose a qualifying high-deductible health plan, an HSA (health savings account) lets you put pre-tax money aside for medical costs. The 2027 IRS limits, per Revenue Procedure 2026-24, are $4,500 for self-only coverage and $9,000 for family coverage. That’s up from $4,400 and $8,750 in 2026.
To qualify, a 2027 plan needs a minimum deductible of $1,750 for individuals or $3,500 for families. Out-of-pocket costs for those plans are capped at $8,700 for individuals and $17,400 for families.
Here’s what the tax break is worth. Contribute the full $4,500 through payroll while in the 22% federal bracket. That’s about $990 in federal income tax saved, plus roughly $344 in payroll taxes (7.65%) if your employer runs it through a cafeteria plan. Together, about $1,334. Not bad for money you were going to spend on healthcare anyway.
The catch is the deductible. If you can’t cover a $3,500 bill, an HDHP is risky unless you’ve built up some HSA cash first. Don’t pick the plan just because the premium is lowest.
Build a cushion before the bills come
Whatever plan you pick, set aside money for the deductible. A good target is your plan’s full deductible, or at least half of it. If your deductible is $3,500, saving about $300 a month gets you there in under a year.
The SuperMoney app can help here. It tracks your spending and shows where your monthly cash goes, so you can see how much room you have to fund an HSA or a medical savings goal. It also helps you keep an eye on debts and credit, which matters if a medical bill ever lands on a card.
Your open enrollment checklist
- Know your dates. ACA marketplace open enrollment runs November 1 to January 15 on HealthCare.gov, and you need to enroll by December 15 for coverage that starts January 1. State-run exchanges can set different dates. Employer windows vary, so check your HR portal now.
- Pull last year’s medical spending and estimate next year’s.
- Compare total cost (premiums plus likely out-of-pocket) for every plan.
- Verify doctors, hospitals, and prescriptions are covered.
- If you’re eligible, decide how much to put in an HSA and set the payroll election.
Key takeaways
- Employer health costs per worker are projected to rise 8% to 11% in 2027.
- ACA marketplace insurers are proposing a median 15% premium increase, after a final 20% jump last year.
- The average marketplace deductible jumped 37% in 2026, to $3,786.
- The 2027 HSA limits are $4,500 (self-only) and $9,000 (family).
- A full $4,500 HSA contribution can save about $1,334 in federal income and payroll taxes for someone in the 22% bracket.
- Marketplace open enrollment runs November 1 to January 15 (December 15 for a January 1 start). Compare yearly cost, not just the premium.
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