Thousands of Iowans will likely see their health insurance premiums rise next year after insurers in the state recently released proposed rate increases for 2027.
These higher rates would mark the second straight year where some Iowans see double-digit premium hikes — the result of the expired expanded Affordable Care Act subsidies and rising medical costs.
Premiums will see average increases of 4.98% to 16.84% across multiple Iowa insurers offering ACA-compliant individual plans next year, according to rates filed with the Iowa Insurance Division in June. The 2026 rate increases ranged from 12.5% to more than 25%.
The hikes also come as nearly a fifth of Iowans with ACA plans dropped their coverage as of February following January’s expiration of enhanced subsidies, according to a KFF analysis.
How much are premiums projected to increase in Iowa?
Iowa is one of 16 states and the District of Columbia that have publicly available rate filings for 2027.
While some Iowans will see double-digit premium increases, most will fall below the projected 14% national average increase across 77 providers.
In their filings with the state, five Iowa insurance providers cite a myriad of reasons for rising rates, including increasing medical service costs and reimbursement rates to healthcare providers, more people seeking medical care, the expiration of expanded ACA premium tax credits and state and federal taxes and fees.
Iowans can submit public comments on rate increases through the Iowa Insurance Division website. The agency will also hold a public hearing on the proposed individual health insurance rates at 5 p.m. Aug. 20. A location and webcast link will be posted on the division’s website closer to the hearing.
Here are the proposed rate increases from each provider, effective Jan. 1, 2027:
∎ Avera Health Plans: 14.82% average increase for 438 Iowans, with individual plan changes ranging from 12.3% to 21.7%.
∎ Iowa Total Care: 16.84% average increase for 6,982 Iowans, with individual plan changes ranging from 9.39% to 21.75%.
∎ Oscar: 11.94% average increase for 11,971 Iowans, with individual plan changes ranging from 4.63% to 28.17%.
∎ UnitedHealthcare Plan of the River Valley: 11.77% average increase for 546 Iowans, with individual plan changes ranging from 9.66% to 12.53%.
∎ Wellmark Health Plan of Iowa: 4.98% average increase for approximately 80,000 Iowans, with individual plan changes ranging from -2.27% to 10.73%.
Iowa ACA enrollments drop
The new enrollment numbers give a first look at how the expiration of expanded ACA premium tax credits impacted Iowa enrollees.
Recently released federal data on ACA enrollment from February shows a 17% drop-off — roughly 21,000 fewer people —compared with the same time last year. In February 2025, 124,311 Iowans were covered by the ACA, compared with 103,253 last February.
It is unclear how many of those Iowans found coverage elsewhere or are going without.
Enrollment in the ACA Marketplace climbed when enhanced subsidies were implemented during the Biden administration in response to the pandemic.
The enrollment spike was fueled in part by higher-income individuals, taxpayers whose household income exceeded 400% of the federal poverty line, accessing ACA Marketplace plans. The federal subsidies lowered the share of a person’s annual income that had to be contributed to their insurance premium.
Now, drop-off is being blamed on lower-income enrollees who tend to be healthier and younger abandoning ACA coverage as too expensive without the subsidies, according to KFF.
This exodus of younger, healthier enrollees could also contribute to increased premiums as health insurance providers are left with a sicker, more expensive pool of people to insure.
Rapid Response Politics Reporter Maya Marchel Hoff can be reached at mmarchelHoff@usatodayco.com. You can find her on X (formerly Twitter) at @mmarchelhoff.
This article originally appeared on Des Moines Register: Iowans will likely see ACA health insurance premiums rise again
Reporting by Maya Marchel Hoff, Des Moines Register / Des Moines Register
USA TODAY Network via Reuters Connect
By Maya Marchel Hoff, Des Moines Register | USA TODAY Network
