Iowa ACA Health Insurance Premiums Could Rise by Nearly 17% in 2027 as Medical Costs Continue to Climb

Iowa ACA Health Insurance Premiums Rise: Thousands of people in Iowa may pay more for health insurance next year. Five insurance companies have asked the state for permission to raise prices on Affordable Care Act individual health plans starting January 1, 2027.

These prices are not final yet. The Iowa Insurance Division will review the requests before approving, lowering or rejecting them. The proposed average increases range from 4.98% to 16.84%. Some individual plans could rise by even more. This would be the second year in a row with large price increases for many Iowa customers. ACA plan rates in the state increased by about 12.5% to more than 25% for 2026.

Proposed 2027 Increases in Iowa

The Iowa Insurance Division lists the following proposed changes:

• Avera Health Plans: An average increase of 14.82% for 438 people. Depending on the plan, increases could range from 12.30% to 21.70%.
• Iowa Total Care: An average increase of 16.84% for 6,982 people. Plan changes range from 9.39% to 21.75%.
• Oscar Insurance Company: An average increase of 11.94% for 11,971 people. Some plans could rise by 4.63%, while others could increase by up to 28.17%.
• UnitedHealthcare Plan of the River Valley: An average increase of 11.77% for 546 people. Its individual plan increases range from 9.66% to 12.53%.
• Wellmark Health Plan of Iowa: An average increase of 4.98% for around 80,000 people. Some customers could see a small 2.27% decrease, while others could face an increase of up to 10.73%.

The state says the health spending growth level used for 2027 is 5.6%. Iowa law requires a public hearing when a proposed individual insurance rate increase is above that level.

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Why Insurance Companies Want Higher Prices

Insurance companies gave several reasons for asking for more money. Hospitals, doctor visits, and prescription medicines are becoming more expensive. Insurers also expect more people to use medical care.

The companies also pointed to higher payments for doctors and hospitals, government fees and the end of the expanded ACA premium tax credits. Those larger federal tax credits expired at the end of 2025. They had helped people pay a smaller part of their health insurance bill. After the extra help ended, average monthly payments made by ACA customers rose by 58% nationally in 2026. Average deductibles also increased by more than $1,000 per person.

KFF found that ACA insurers in 16 states and Washington, D.C., are requesting a median 14% increase for 2027. Most of the 77 insurance companies studied requested increases between 10% and 20%. Medical care and prescription drug costs are expected to rise by about 10% next year.

Fewer Iowans are keeping ACA Coverage

Iowa has also seen a large drop in ACA enrollment. Federal figures show that 124,311 Iowans had active Marketplace coverage in February 2025. That number fell to 103,253 in February 2026.

That is a drop of about 21,000 people or 17%. It is not clear how many found insurance through a job, Medicaid or another program. Some may now have no health coverage. Higher prices appear to be one major reason for the decline. Younger and healthier customers are often more likely to leave when insurance becomes too expensive. When they leave, insurers are left with a smaller group that may need more medical care. That can push prices higher for everyone who stays.

Nationally, the ACA Marketplace enrollment fell from about 22.1 million people in 2025 to 19.2 million in February 2026. KFF says the loss of enhanced tax credits was an important reason for the decline, although federal officials have also pointed to efforts to remove improper enrollments.

Iowans can Comment before Rates are Approved

People in Iowa can send written comments about the proposed increases through the Iowa Insurance Division’s public comment page. They should include the name of their insurance company, their own name and their town.

The state also plans to hold a public hearing on the increases. People will be able to attend in person or watch through a live webcast. The location and webcast information will be added to the Iowa Insurance Division website closer to the hearing. A transcript will also be published later.