根据凯撒家庭基金会（KFF）的最新分析，美国《平价医疗法案》（ACA，即“奥巴马医改”）市场的中位数保费预计将在 2027 年再次出现两位数增长 [1]。该机构预测，到 2027 年，提交公开费率申报的 77 家保险公司的 ACA 市场保费增幅将达到 14%[1]。这将是连续第二年出现此类显著上涨：2026 年的中位数费率增幅为 20%，而今年（即分析所指的前一年）涨幅同样巨大 [1]。
保险公司将此次及未来的价格上涨归因于医疗成本的上升、联邦监管的变化以及疫情时期增强补贴的到期 [1]。与此同时，ACA 市场的参保人数在过去一年内减少了超过 250 万人 [1]。对于无补贴覆盖人群而言，收入达到贫困线 400% 的家庭（个人约为 6.3 万美元，四口之家约为 12.9 万美元）将直接面临这些价格调整的影响 [1]。针对保费上涨与参保人数下降的现象，KFF 分析师 Stacey Pogue 表示：“当健康人群离开时，价格上涨”[1]。
A new analysis by the Kaiser Family Foundation (KFF) projects that median premiums for health insurance plans under the Affordable Care Act (ACA), commonly known as "Obamacare," will rise another double-digit percentage in 2027 [1]. This forecast marks a second consecutive year of significant price increases, following a projected 20% surge in median rates for 2026 [1]. The analysis indicates that among the 77 insurance carriers submitting public rate filings to ACA markets this year, the median premium increase is estimated at 14% [1].
Insurance companies attribute these rising costs primarily to escalating medical expenses, changes in federal regulations, and the expiration of enhanced subsidies established during the pandemic era [1]. The financial pressure on consumers has already contributed to a decline in enrollment within ACA markets, which saw more than 2.5 million fewer enrollees over the past year [1].
The affordability crisis is particularly acute for individuals without premium tax credits or cost-sharing reductions; these plans are available only to households earning up to 400% of the federal poverty level, roughly $63,000 annually for an individual and approximately $129,000 for a family of four [1]. Stacey Pogue highlighted this dynamic by noting that "when healthy people leave, prices go up" [1].