South Philly Pennie Shoppers Face Nearly 16% Premium Hike for 2027 Coverage

South Philadelphia residents who buy their own health coverage through Pennie, Pennsylvania's Affordable Care Act marketplace, will pay noticeably more starting next year.

According to WHYY, individual plans will rise by an average of nearly 16%, while small-business plans will climb about 10%.

The Pennsylvania Insurance Department finalized the new rates on Sept. 18, northeasttimes.com reported, setting the individual-market average at 15.97% and the small-group average at 10.28%.

Both figures came in below what insurers originally requested.

Why the Increases Are Happening

Insurance Commissioner Michael Humphreys said the increases will be difficult for families and businesses, and that his agency pushed insurers to trim their proposed hikes wherever it could, according to a department statement carried by WHYY and pennwatch.org.

Regulators pointed to three drivers, per northeasttimes.com: the loss of pandemic-era enhanced federal premium tax credits, cuts to federal safety-net health programs, and a jump in medical and prescription drug use.

Insurers paid $845 million more on 2025 claims than the year before, a 13% increase, the department said.

A federal budget measure passed in July 2025, known as H.R. 1, also added Medicaid work requirements and new paperwork that the department expects will push more Pennsylvanians into uninsured status next year.

How the Rate Review Played Out

Regulators denied $94.7 million in premium increases they deemed unjustified.

The individual-market average fell from a requested 17.14% to the approved 15.97%, while the small-group figure dropped from 11.49% to 10.28%.

Increases still vary widely by carrier.

Ambetter Health of Pennsylvania received the largest approved individual-market hike at 35.1%, down from a requested 40.9%, while Oscar Health Plan of PA saw the smallest increase at just 1.4%, cut from 15.4%.

Two insurers actually saw their rates pushed higher than requested.

Health Partners Plans' approved increase rose to 18.3% from 15.9% after federal data showed its enrollees were less healthy than projected, and Keystone Health Plan East's rate climbed to 16% from 14.7% because of worsening cost trends.

Coverage Already Dropping

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

That followed an earlier decline of 120,000 enrollees reported by WHYY earlier this year.

Before the 2027 rates were finalized, Spotlight PA reporting in the Morning Call found the Shapiro administration saying it has limited legal authority to cap the increases and is calling for federal action instead.

Matt Yarnell, president of SEIU Healthcare Pennsylvania, said in a statement that insurance corporations are demanding double-digit hikes while posting billions in profits and paying executives large salaries.

What Shoppers Can Expect

Open enrollment for 2027 Pennie coverage runs Nov. 1 through Jan. 15.

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

Every Pennie plan still carries the same baseline protections regardless of price, according to Local 21 News reporting cited by northeasttimes.com, including coverage for pre-existing conditions, preventive care, hospital visits and annual limits on out-of-pocket costs.

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