ACA premium increases in double digits for second year

Tennessee residents will see at least a 12% increase in monthly premiums for the average benchmark 2027 plan through the Affordable Care Act Marketplace, according to experts.

The rising costs mark the second year of double-digit premium increases since the expiration of enhanced premium tax credits last December-although it's a sharp decline from the 38% increase from 2025 to 2026.

Premium costs across the nation will increase by 13% on average, according to nonpartisan health research group KFF. Health insurer filings additionally point to overall rising healthcare costs, general economic inflation and labor shortages as reasons for higher prices, according to a KFF analysis. Many employer plans have also increased their rates for similar reasons.

According to the Centers for Medicare & Medicaid Services, a majority of Americans who buy coverage through the marketplace will still qualify for premiums and pay "at or below" $50 monthly with tax credits, the same price the agency cited last year.

TENNESSEE ACA ENROLLMENT DECLINES

Congress implemented the enhanced premium tax credits, or subsidies that help cover the costs of health insurance, under the American Rescue Plan Act of 2021. After much debate, the governing body let them expire in December 2025.

Although most Ten-nesseans receive coverage through their workplaces, ACA insurance became more prominent while enhanced credits were available; 443,000 more Ten-nesseans enrolled in 2025 than in 2020, according to the public policy research center The Sycamore Institute. Most of those enrollees had lower incomes equal to at least 100% of the federal poverty level.

Since the credit expiration, the number of state enrollees who paid their premiums fell by about 93,000. At the same time, 2024 data indicates that the number of Tennesseans without insurance-9.7%, up from 9.2% in 2023-is increasing.

The issue is widespread. A recent report from The Commonwealth Fund found that almost half (46%) of U.S. adults under 65 had inadequate health insurance in 2026. About 11% were uninsured.

LOCAL RESIDENTS CAN QUALIFY FOR HELP A two-adult, two-child household that makes the median Sullivan County household income of $64,545 and cannot get insurance through a provider is likely eligible for financial help through the marketplace, according to a KFF calculator tool.

At an income equal to about 200% of the federal poverty level, this family would pay $353 per month in premiums for the second-lowest cost silver plan, which is commonly used as the "benchmark" plan. Tax credits would likely cover about 85% of the plan's monthly costs.

In contrast, a single adult who makes the same income and cannot get insurance through work would not qualify for financial help at more than 400% of the federal poverty level. They would likely pay more than $700 per month in premiums, similar to the average full-price premium cost last year.

Across the state line in Scott County, Virginia, a similar four-person household making the county median income of $46,349 would equal about 140% of the federal poverty level. They would likely qualify for subsidies.

This family would likely pay $143 a month for a silver plan, with tax credits covering more than 90% of the costs.

A one-person Scott County household making the median income would also likely qualify for financial help. They would likely pay about $383 a month. Subsidies would cover a little less than a third of the costs.

The open enrollment period began Nov. 1. Dec. 15 is the last day to enroll for plans that start Jan. 1. The final day of the enrollment period is Jan. 15. Only major life events allow enrollment outside of this time period, including losing health coverage, moving, getting married, having a baby or adopting a child. More information can be found at Health-Care.gov.

The open enrollment period began Nov. 1. Dec. 15 is the last day to enroll for plans that start Jan. 1. The final day of the enrollment period is Jan. 15. Only major life events allow enrollment outside of this time period, including losing health coverage, moving, getting married, having a baby or adopting a child. More information can be found at Health-Care.gov.

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