If it wasn’t obvious before that the famous bill passed to make health care more affordable has done anything but, it should be now: Individual plans on the Affordable Care Act exchanges are projected to spike by about 14% in 2027, according to recent insurer filings.

The ACA imposed a wide array of mandates on health insurance. Those mandates are expensive. To make up for the increase in costs, the ACA distributes subsidies so consumers don’t feel the impact of the increase.

Many of these subsidies are “advance” subsidies that go directly from the federal government to insurers based on the customer’s income. That means insurers can raise premiums without customers having to pay more.

As of 2025, 93% of enrollees in the exchanges received subsidies, up from 86% in 2021. If nearly everyone on the exchanges needs subsidies, that’s a clear sign that the product being sold is not affordable.

Even with the expiration of the expanded subsidies that were adopted during the COVID pandemic, nearly all enrollees will still receive subsidies. Enrollees with incomes over four times the poverty level, who were previously not eligible for subsidies, only accounted for 7% of enrollees in 2024.

The ACA encourages insurers to raise costs. Take the medical loss ratio, which requires insurers to spend 80 to 85% of premium revenue on medical care. In theory, that limits spending on administration costs.

In practice, though, the policy means insurers make more money by spending more on medical care, regardless of whether it improves health outcomes or serves customers well. The higher spending translates to higher premiums. And because the vast majority of customers aren’t actually paying higher premiums as long as their incomes stay the same, the insurers just rake in the subsidies.

Analysis from the Paragon Health Institute finds that the average premium on ACA exchanges increased by $5,898 between 2014 and 2026, and federal taxpayers covered 90% of the increase. If the only way the ACA makes insurance affordable is by transferring an ever-increasing amount of money each year directly from the government to insurers, that’s an enormous failure in what was supposed to be a market-based system.

But that’s what has happened, and it’s happened on a larger scale than projected. In 2021, the Congressional Budget Office forecast that premium subsidies would cost $55 billion in 2027. The most recent projection is that they will actually cost $93 billion.

If the goal of the ACA was to funnel federal dollars to insurers while degrading whatever price signals were left in the health insurance market, it couldn’t have been designed much better.

ONLINE: https://www.washingtonpost.com/opinions/2026/07/10/aca-premium-increases-show-that-health-care-remains-unaffordable/