Missouri Releases 2027 ACA Rate Filings as Some Health Insurance Premium Hikes Approach 32%
shalesh kumar Missouri residents shopping for health insurance next year are getting an early look at what 2027 coverage could cost. The state has released preliminary Affordable Care Act (ACA) health insurance rate filinMissouri residents now have their first official look at proposed health insurance premiums for 2027 after the Missouri Department of Commerce and Insurance (DCI) released preliminary Affordable Care Act (ACA) rate filings on July 31, 2026. While the filings show that eight insurers are expected to remain in the state’s individual marketplace, some companies are seeking premium increases of nearly 32%. Those proposed rates are not final and remain subject to state review before taking effect.
The release marks the beginning of Missouri’s annual rate review process, giving consumers, insurers, and regulators several months to review the proposed premiums before Open Enrollment begins later this year.
The preliminary filings apply only to ACA-compliant major medical health plans sold in Missouri’s individual and small-group markets. Other health insurance products are not included in this review and will be released separately at a later date.
The review process follows the filing deadline of June 3, 2026, when insurers submitted their proposed premium rates to the state. Since then, regulators have been examining each filing to determine whether the requested increases are actuarially justified, reasonable, and compliant with both Missouri law and federal insurance regulations.
According to the preliminary filings, eight insurers are expected to continue offering coverage in Missouri’s individual marketplace for 2027. Every county is also expected to have at least two participating insurance companies, allowing residents to choose between multiple ACA marketplace plans regardless of where they live.
The filings also outline Missouri’s small-group health insurance market, which serves employers with 2 to 50 employees. For the 2027 plan year, four insurers have submitted filings to offer off-exchange small-group coverage.
Although insurer participation remains stable, premium increases are likely to receive the most attention. Several insurers have proposed double-digit premium increases, with some individual marketplace plans requesting increases approaching 32%. Nationwide, marketplace filings are also pointing to higher premiums, with one analysis estimating a median proposed increase of about 14%, reflecting continued growth in medical costs and changes in insurance risk.
State officials emphasized that the figures released this week represent proposed rates only. Every filing will undergo a detailed regulatory review before approval, and insurers may be required to revise their requests if regulators determine the proposed premiums are not adequately supported.
Angela Nelson, Director of the Missouri Department of Commerce and Insurance, said the review process serves as an important front-end consumer protection safeguard. She noted that final premium rates may differ from the preliminary filings and encouraged Missouri residents to begin reviewing their available health insurance options before enrollment opens.
Residents can also take part in the review process. The department is accepting public comments through August 31, 2026, allowing consumers and other stakeholders to provide feedback before regulators complete their review.
Missouri will continue using the federally facilitated HealthCare.gov marketplace for the 2027 coverage year rather than launching its own state-based exchange. The department also provides an online coverage map that allows residents to see which insurers will be available in their county once marketplace plans are finalized.
Alongside Missouri’s rate review, several federal marketplace changes are scheduled to take effect for 2027. These include new multi-year catastrophic plan options, greater flexibility for certain non-network plan designs, stricter verification requirements for some Special Enrollment Periods, updates to Premium Tax Credit eligibility reviews, the elimination of standardized plan requirements, and a reduction in the federal marketplace user fee to 1.9%.
What Consumers Should Know
The proposed premiums released on July 31 should be viewed as an early estimate rather than the final cost of 2027 coverage. Consumers should avoid making enrollment decisions based solely on these filings because regulators may approve, reduce, or modify requested rate increases before the review process concludes.
For many Missouri residents, the preliminary filings provide an opportunity to start comparing insurers, reviewing available coverage options, and planning ahead for open enrollment. Once final rates are published, consumers will be able to make side-by-side comparisons through HealthCare.gov.
What’s Next?
The public comment period will remain open until August 31, 2026. After reviewing insurer filings, actuarial data, and public feedback, the Missouri Department of Commerce and Insurance plans to publish final approved premium rates on October 31, 2026.
Open Enrollment for 2027 ACA health insurance coverage is scheduled to begin on November 1, 2026, and will continue through January 15, 2027. Consumers shopping for marketplace coverage are encouraged to review their options early once final premiums become available.
The Bottom Line
Missouri’s preliminary 2027 ACA rate filings show that the marketplace is expected to remain competitive, with eight participating insurers and at least two insurance choices in every county. At the same time, some insurers are requesting premium increases approaching 32%, making this year’s regulatory review especially significant for consumers.
Because the released premiums are only preliminary, Missouri residents should monitor the state’s review process over the coming months. Final approved rates, expected by October 31, will determine what consumers actually pay when Open Enrollment begins in November.
Sources
- Missouri Department of Commerce and Insurance (DCI)
https://insurance.mo.gov/ - HealthCare.gov
https://www.healthcare.gov/ - Centers for Medicare & Medicaid Services (CMS)
https://www.cms.gov/
Frequently Asked Questions
Are Missouri’s 2027 health insurance rates final?
No. The rates released on July 31, 2026, are preliminary and remain under review by the Missouri Department of Commerce and Insurance.
Why are some insurers requesting premium increases of up to 32%?
The proposed increases vary by insurer and plan. Regulators will review whether each request is justified before approving final premiums.
How many insurers will offer ACA marketplace coverage in Missouri?
The preliminary filings show eight insurers are expected to participate in Missouri’s individual marketplace in 2027.
Will every Missouri county have multiple insurance options?
Yes. According to the preliminary filings, every county is expected to have at least two participating insurers.
When will Missouri announce the final 2027 premium rates?
The state expects to publish final approved rates on October 31, 2026.
When does open enrollment begin?
Open Enrollment for 2027 ACA Marketplace coverage is scheduled to begin on November 1, 2026, with enrollment ending on January 15, 2027.
