ACA agent conversations
Why Are ACA Premiums Going Up in 2027, and What Do I Tell My Clients?
ACA premiums are under pressure in 2027 because insurers expect higher healthcare costs and a more expensive mix of enrolled members. But a client’s actual monthly bill depends on both the insurance premium and any financial assistance they qualify for.
KFF’s analysis of publicly available insurer filings found a 15% median proposed increase for 2027. That is a proposed national measure—not a final increase for every carrier, Texas county, or client. Insurers cited rising healthcare prices and changes in who remains insured among the reasons for their requests. KFF
How should agents explain the difference between premiums and subsidies?
Separate the conversation into two numbers:
- Full premium: What the insurance company charges for the plan.
- Net premium: What the client pays after any applicable premium tax credit.
HealthCare.gov explains that tax credits can change because of household income, household size, and available plan premiums—even when the client’s income stays the same. It also confirms that the additional pandemic-era savings ended December 31, 2025. Don’t describe that expiration as a new event beginning in 2027. HealthCare.gov
What can I say to a worried client?
“I understand why that increase is frustrating. Let’s check what changed in the plan’s price and what financial help you qualify for. Then we’ll compare your available options, including your doctors, prescriptions, deductible, and monthly payment, before you decide.”
Avoid promising that another plan will restore last year’s price.
A practical review should:
- Update the client’s expected coverage-year income and household information.
- Review their eligibility results and renewal notices.
- Compare available plans using their actual healthcare needs.
- Explain the tradeoffs before they choose.
- Refer tax-specific questions to a tax professional.
The message for agents: Don’t give every client the same explanation for a higher bill. Identify what changed in that household’s coverage and help them compare realistic choices.