Ohioans who buy health insurance through the Affordable Care Act (ACA) marketplace are facing another significant premium increase next year, on top of steep rises they already saw this year. This latest proposed jump in costs is set to further strain household budgets across West Central Ohio.
The 11 insurers still operating in Ohio’s marketplace are proposing an average premium increase of 14.7% for 2027, according to an analysis by the Center for American Progress. This comes after Ohio marketplace customers already experienced a substantial hike in their monthly payments this year.
The average monthly cost for an Ohio marketplace customer jumped by 85% this year, rising from $126 to $233 per person, as reported by the Health Policy Institute of Ohio. While the price insurers charged for marketplace plans rose by an average of 18%, a major factor in the overall increase was the expiration of enhanced federal subsidies at the end of 2025, which had previously helped individuals afford these premiums.
With the price of insurance itself now poised to rise again, an individual currently paying $233 a month could see their bill increase by $34, reaching $267 a month if the full 14.7% hike is applied. This means the average Ohio marketplace customer would be paying $1,692 more annually than they did just two years prior. Natasha Murphy, director of health policy at the Center for American Progress, noted that while such an increase would be challenging in normal times, it "becomes one additional budget pressure" when people are already facing higher costs for everything else.
Congressional Republicans chose not to extend the enhanced federal subsidies last year when they passed the One Big Beautiful Bill Act, which extended President Donald Trump’s 2017 tax cuts, valued at approximately $4 trillion. Republicans stated that these enhanced subsidies were a temporary pandemic-era benefit that had become too expensive and vulnerable to fraud. The Congressional Budget Office estimated that making these subsidies permanent would have cost the federal government about $350 billion over 10 years. They also argued that continuing to spend more federal money on insurance subsidies would not effectively address the underlying issue of rising healthcare costs.
Without this extra federal assistance, fewer people enrolled in coverage, resulting in a smaller and potentially sicker pool of customers for insurers. Ohio was among the states most severely affected by this change, experiencing the largest percentage drop in ACA marketplace enrollment nationwide last year. Enrollment fell by 32.4%, meaning more than 161,000 Ohioans discontinued their coverage. Murphy expressed hope that some of these individuals later found health insurance through an employer or qualified for Medicaid, but acknowledged "the unfortunate reality is that thousands are and will remain uninsured."
The implications extend beyond those who lose their health coverage. When uninsured patients require medical care but cannot afford it, hospitals and other providers frequently face unpaid bills, known as uncompensated care. There are already indications that this trend is developing. A survey conducted in May by the Community Hospital Corporation found that two-thirds of 25 health systems reported an increase in their uncompensated care. Murphy explained that hospitals must eventually recover these losses, which places upward pressure on prices for people who do have insurance, affecting everyone.
Another significant change impacting health coverage is slated for January. Approximately 700,000 Ohioans currently receiving Medicaid through the state’s expansion program will become subject to new work requirements. Most recipients will need to demonstrate that they are working, attending school, volunteering, or participating in another approved activity for at least 80 hours per month to maintain their coverage. Exemptions are available for individuals who are pregnant, medically frail, or caring for young children or people with disabilities.
Republicans have contended that these requirements will encourage more able-bodied adults to work and help reduce government spending on Medicaid. However, research into previous Medicaid work requirements has indicated that many of the people who ultimately lose coverage are either already working or qualify for exemptions but face difficulties providing sufficient proof.
While it is challenging to forecast precisely how many more Ohioans will drop coverage in 2027, Murphy anticipates the number will reach into the tens of thousands. She also does not expect the trend of double-digit premium increases to subside in the near future. Murphy stated that until policymakers in Washington "prioritize healthcare access," these costs will continue to escalate.