People who buy health insurance through the Affordable Care Act marketplace in Kansas and Missouri could be facing another year of sharp premium increases, according to preliminary filings submitted to state insurance regulators.
Every insurance company offering individual marketplace plans in the two states is seeking higher rates for 2027. Requested increases range from just over 10% to nearly 35%, following similar increases approved for 2026.
If regulators approve the requests, marketplace premiums will have increased by more than one-third over the past two years for many consumers.
Nationally, insurers are requesting a median premium increase of 15% for 2027, according to an analysis by Peterson-KFF. Last year, the median requested increase was 18%, with final approved increases averaging about 20%.
The largest proposed increase comes from UnitedHealthcare in Kansas, where the company wants premiums to rise between 29.7% and 36.5%, depending on the plan.
Kansas Requests Include Nearly 35% Increase
Kansas insurers are seeking some of the largest increases in the region:
- Blue Cross and Blue Shield of Kansas City: 15.4%
- Blue Cross and Blue Shield of Kansas: 16.0%
- Ambetter (Celtic Insurance): 16.7%
- Oscar Health: 20.0%
- UnitedHealthcare: 34.8%
Missouri insurers are requesting:
- Blue Cross and Blue Shield of Kansas City: 10.3%
- Ambetter (Celtic Insurance): 10.3%
- Anthem Blue Cross and Blue Shield: 12.7%
- Medica: 25.6%
- Oscar Health: 15.9%
- UnitedHealthcare: 16.5%
Why Insurers Say Rates Are Rising
Insurance companies point to several factors driving higher premiums.
Among them are higher payments to hospitals, physicians and drug manufacturers, increasing prescription drug costs, and patients receiving more expensive medical treatments and surgeries than in previous years. Insurers also say advances in medical technology, while improving care, are adding to healthcare spending.
UnitedHealthcare reported that nearly 96 cents of every premium dollar collected from its Kansas marketplace plans went toward paying medical claims in 2025—well above the Affordable Care Act’s required medical loss ratio of 80% to 85%.
Another factor cited by several insurers is a changing customer base in the ACA marketplace.
End of Federal Subsidies Is Affecting Enrollment
At the end of 2025, enhanced federal premium tax credits expired, making marketplace coverage significantly more expensive for many middle-income Americans.
As a result, many healthier people have dropped their ACA coverage, leaving behind a smaller pool of policyholders who generally require more medical care. Insurers say that shift raises overall costs and contributes to higher premiums.
The enrollment decline has already been significant.
Missouri’s ACA enrollment fell about 25%, dropping from 347,424 people to 260,999 by February.
Kansas enrollment declined about 20%, falling from 179,920 to 143,880.
Oscar Health’s Missouri filing specifically cited “anticipated changes in the underlying health of the marketplace” as one reason for its requested 15.9% premium increase.
Higher Costs Affect More Than Marketplace Plans
Advocates say rising premiums are causing some people to delay medical care altogether.
Lacey Kennett of the Alliance for a Healthy Kansas said families are postponing routine doctor visits or skipping medications because they cannot afford healthcare costs. Delaying treatment often leads to more serious illnesses that are even more expensive to treat.
The trend is also expected to affect employers.
Insurers are seeking premium increases of roughly 9% to 19% in the small-group market, which covers businesses with two to 50 employees. Those increases suggest many small businesses could also face substantially higher health insurance costs when they renew employee coverage next year.
State insurance departments in Kansas and Missouri are reviewing the proposed rates to determine whether they are justified and comply with state and federal law.
Missouri will accept public comments on the proposed increases through Aug. 31, with final rates expected to be announced by Oct. 31. Kansas regulators are also accepting public comments before making final decisions on 2027 premiums.
