Maryland Insurance Administration Approves 2027 Affordable Care Act Premium Rates

The Maryland Insurance Administration (MIA), under Commissioner Marie Grant, approved 2027 premium rates for individual and small group health insurance plans sold in Maryland. Unsubsidized individual ACA plan premiums will increase by an average of 14.6% in 2027. The MIA attributes this increase to the expiration of enhanced federal premium tax credits, eligibility changes made by federal H.R. 1 affecting who qualifies for Exchange coverage, and rising hospitalization and pharmaceutical costs. In the small group market, covering employers with 50 or fewer full-time employees, premiums will increase by an average of 10.2%, which is approximately 3 percentage points below the 13.1% average increase originally requested by carriers. Cost trend drivers include hospital costs trending upward by 7.8%, professional services by 8.6%, and prescription drugs by 14.8%. Approximately 199,000 Marylanders are covered through the small group market and approximately 274,000 through the individual market. Maryland's Section 1332 State Innovation Waiver, which established a state-backed reinsurance program, remains approved by CMS through 2028 and continues to hold premiums 30% to 35% lower than they would otherwise be. Maryland also operates a state premium assistance program through Maryland Health Connection for residents with household incomes below 400% of the federal poverty level, and approximately 70% of Maryland Health Connection users receive a premium subsidy. Enrollment in the individual market declined from 294,000 to 274,000, with the MIA attributing the decline largely to loss of subsidy eligibility in Maryland's immigrant community under H.R. 1. The MIA also approved a 3.0% average rate increase for stand-alone dental plans in the individual market, compared to the 6.5% initially filed by carriers. Approximately 103,000 Marylanders purchase stand-alone dental plans. Approved rate summaries for each carrier are available on the MIA's premium review website.