Pennie Shoppers Face Nearly 16% Premium Increase for 2027 Coverage

source: WHP

Pennsylvania residents who buy their own health coverage will see premiums climb by an average of 15.97% in 2027, according to the Pennsylvania Insurance Department.

Small businesses buying group plans face an average increase of 10.28%.

The department finalized the rates on Sept. 18.

Insurance Commissioner Michael Humphreys said in the release that federal health care cuts continue to drive up costs for Pennsylvania families, and that regulators fought insurers for every savings they could reasonably assert.

Regulators denied $94.7 million in what they called unjustified premium increases during their review.

The approved individual-market rate is lower than the 17.14% insurers originally requested, and the small-group figure fell from an initial 11.49% request.

Why Costs Are Climbing

Congress has not reauthorized enhanced pandemic-era premium tax credits for 2026 and beyond, prompting people to drop coverage and shifting uncompensated care costs onto hospitals and remaining policyholders.

A federal budget law passed in July 2025, known as H.R. 1, added Medicaid work requirements and new enrollment paperwork that the department expects will leave more Pennsylvanians uninsured next year.

Medical and prescription drug claims also rose sharply. Insurers in the individual and small-group markets paid $845 million more on 2025 claims than in 2024, a 13% jump, the department said.

Coverage Losses Statewide

More than 200,000 people have dropped coverage through Pennie since last year's open enrollment period, WHYY reported. Many cited unaffordable premiums after the enhanced tax credits expired.

That drop followed an earlier one. WHYY has reported that 120,000 Pennsylvanians had already left ACA coverage this year as the loss of the federal subsidies took hold.

How Rates Vary by Insurer

Ambetter Health of Pennsylvania received the largest approved hike among individual plans, 35.1%, down from a requested 40.9%.

Oscar Health Plan of PA saw the smallest increase, just 1.4%, cut from a requested 15.4%.

Two insurers had their rates raised above what they requested.

Health Partners Plans' approved increase rose to 18.3% from a requested 15.9% after federal risk-adjustment data showed its membership was less healthy than projected.

Keystone Health Plan East's approved rate climbed to 16% from 14.7% because of worsening medical and drug cost trends, the department said.

Shopping for 2027 Coverage

Open enrollment for 2027 plans on Pennie runs from Nov. 1 through Jan. 15, WHYY reported.

Most shoppers will still qualify for standard premium tax credits or other financial assistance to offset monthly costs.

Every Pennie plan carries the same baseline protections regardless of price, Local 21 News reported.

Those include coverage for pre-existing conditions, essential benefits like preventive care and hospital visits, and annual limits on out-of-pocket costs.

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