New Jersey finalizes 19.8% average ACA premium increase for 2027

New Jersey finalizes 19.8% increase

Rates in New Jersey's individual market, which includes Get Covered New Jersey, will increase by an average of 19.8% for 2027, according to final rates published by the New Jersey Department of Banking and Insurance on Thursday. That figure is a final state average; KFF's 15% national median is based on proposed insurer filings, so the two are not directly comparable. The small employer market will rise 18.8%, and carrier increases range from Horizon at 15.3% to UnitedHealthcare at 35.7%, NJBIA reported. Under New Jersey statutes, the department does not approve rates or have authority to reject filings based on rates. "These health insurance rate increases will place extraordinary pressure on household budgets, and drive more New Jerseyans to make the heartbreaking choice to drop coverage altogether," acting Commissioner Susan Ochs said.

National median is 15%

KFF's August analysis of 276 insurers with public filings in all 50 states and DC put the median proposed 2027 increase at 15%. That follows a median proposed change of 18% and a finalized change of 20% for 2026. If the 2027 proposals hold, typical marketplace premiums will have climbed by more than one-third in two years. The 15% would be the second-highest requested change since 2018, KFF said. Proposed changes run from -1% to 54%, with 63% of insurers filing between 10% and 25% and 51 asking for more than 25%.

KFF measures an insurer's increase as the enrollment-weighted average across its bronze, silver, gold and platinum plans in a state. That is not the benchmark silver premium that sets subsidies, which rose 26% on average in 2026 once finalized. The median is an insurer-level measure, not a household bill.

Why insurers say costs are climbing

Insurers point to hospital and doctor bills and to prescription drug spending, including GLP-1 obesity drugs and specialty cancer drugs. Medical and prescription drug spending rose 10%, USA Today reported, citing KFF. Filings from 16 states and DC also cite general economic inflation and labor shortages. Insurers also list a smaller, sicker pool of enrollees as a reason for 2027 rates. KFF said the expiration of enhanced premium tax credits at the end of 2025 drove that shift, as healthier enrollees dropped coverage and left behind people who are sicker and costlier to insure. About 19.2 million people were enrolled in an ACA plan as of February, down from 23.1 million who signed up by January, HHS figures show. In 2026, 87% of marketplace enrollees received a subsidy.

"This is a triple hit," Cynthia Cox, senior vice president and director of the program on the ACA at KFF, said of the consecutive years of higher rates and the absence of enhanced subsidies. "That's a really big hit for people who won't get a subsidy."

Pennsylvania still reviewing

Pennsylvania insurers requested average increases of 10.5% to 41% for 2027, with an average of 17.1% in the individual market, WHYY reported. The state Insurance Department reviews the requests before approving final rates this fall. "These rates are higher than we'd hoped and reflect continued rising costs across the health care environment," Pennsylvania Insurance Commissioner Michael Humphreys said.

What happens next

Open enrollment on the federal marketplace ends on 15 December for coverage starting 1 January 2027, The Phoenix reported. New Jersey's state-run window runs from 1 November 2026 through 31 January 2027. New Jersey's rates are final; Pennsylvania's are still under review.