Pennsylvania’s Health Insurance Rate Hikes for 2027

Those purchasing health insurance in Pennsylvania through the Affordable Care Act marketplace, known as Pennie, should prepare for significant rate increases next year.

The Pennsylvania Insurance Department has confirmed an average hike of 16% for individual and family health plans sold via Pennie. Meanwhile, premiums for small business plans are set to rise by an average of 10%.

“We know that these increases are difficult for many families and businesses in Pennsylvania, and we put in considerable effort to negotiate with insurers for potential savings,” said Pennsylvania Insurance Commissioner Michael Humphreys in a recent statement.

Insurers had originally requested an even steeper average increase of 17% for individual plans and 11% for small-business plans.

According to Humphreys, these rate hikes are mainly due to escalating healthcare and prescription drug costs. He noted that cuts to federal Medicaid, along with the loss of a critical financial incentive program for ACA plans, are likely to keep driving the uninsured rate higher, which will, in turn, raise costs throughout the healthcare system and lead to higher insurance premiums.

By law, insurers must use at least 80% of the premiums they collect on healthcare costs for their members.

As for New Jersey, the Department of Banking and Insurance has yet to disclose the 2027 rates for its ACA marketplace, known as Get Covered New Jersey.

Pennie’s Cost Pressures

The 2027 rate increases come on the heels of considerable price spikes in ACA marketplaces this year, which followed Congress’s failure to extend a vital financial incentive program. Many saw their Pennie health plan costs more than double in 2026, resulting in at least 177,000 individuals dropping their coverage.

Prior to their elimination, enhanced premium tax credits made sure that nobody had to pay more than 8.5% of their income for an ACA premium. These credits had been renewed yearly since their introduction in 2021 but expired at the start of last year when Republicans did not approve their continuation for another term.

Advocates for patients have expressed worry that another price increase will further jeopardize insurance affordability for more individuals. Representatives from Affordable Healthcare for PA, a coalition of patients and community advocates, indicated they will focus on issues related to insurance costs and the expired tax credit program as they head into the upcoming midterm elections.

“This situation is dire,” remarked Alisha Hoffman-Mirilovich, a coalition member and executive director of Action Together NEPA, a nonprofit supporting progressive healthcare initiatives.

“It’s evident that as health insurance costs soar while wages stay flat, people will experience real hardships,” she continued.

Devon Trolley, the executive director of Pennie, encouraged current enrollees to review their coverage during the fall open enrollment period. Pricing varies by age, income, and geographic location.

Tax credits based on income are still available under the ACA for individuals earning up to about $62,600 or $128,600 for a family of four, which is 400% of the federal poverty level.

Pennie’s open enrollment window runs from November 1 to January 15, with December 15 being the deadline for those seeking coverage effective January 1. Meanwhile, Get Covered New Jersey will remain open for enrollment through the end of January.