Iowans brace for another year of rising health insurance premiums, with the Affordable Care Act (ACA) subsidies set to expire and medical costs soaring. The proposed rate increases for 2027, filed with the Iowa Insurance Division, reveal a concerning trend. While some Iowans will face double-digit hikes, the average increase of 4.98% to 16.84% across multiple insurers is a stark reminder of the financial burden on individuals and families. This follows on the heels of a 12.5% to 25% increase in 2026, with a significant drop-off in ACA enrollments, particularly among lower-income enrollees who are healthier and younger. The expiration of expanded ACA premium tax credits and rising medical service costs are cited as key factors. As the ACA subsidies phase out, the financial burden shifts to individuals, leaving many with no choice but to drop coverage. This exodus of younger, healthier enrollees could exacerbate the situation, as insurers are left with a sicker, more expensive pool of people to insure. The situation is further complicated by the fact that Iowa is one of 16 states and the District of Columbia with publicly available rate filings for 2027, and while some Iowans will see double-digit premium increases, most will fall below the projected 14% national average. This raises a deeper question: How can we ensure that health insurance remains accessible and affordable for all Iowans, especially as the cost of living continues to rise?
