Health Insurance Premiums Are Rising in 35 States—Is Yours One of Them?

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Key Takeaways Apply for Subsidies to Lower Your Costs Dramatically Why Are Prices Going Up More in Some States?

Key Takeaways

Premiums are rising in 2025 in 35 states across bronze, silver, and gold Affordable Care Act (ACA) plans (aka Obamacare). They’re falling in six states for those three categories.
Prices will spike as much as 35% for at least some coverage categories—with Vermont, Alaska, and North Dakota seeing double-digit increases in bronze, silver, and gold.
The average premium for the lowest-cost silver plan is $320 in New Hampshire, and the highest is $1,275 in neighboring Vermont.
Price changes depend on state-specific regulations, market conditions, and broad trends such as rising prescription costs and higher service usage by enrollees.
Tax credits can significantly cut Marketplace premium costs for most enrollees, but expanded federal subsidies are scheduled to end in 2026.

First, the good news. In a handful of states, premiums for plans on the Health Insurance Marketplace are falling in 2025. But premiums are rapidly rising in most others—some up to 35%, according to KFF analysis of state and federal data.

Average premiums are decreasing across gold, silver, and bronze plans in these six states:

Louisiana
Iowa
Alabama
Oklahoma
Missouri
South Carolina

However, 35 states and the District of Columbia show premiums increasing across the board, and the rest show a mix of increasing and decreasing premiums, depending on the metal level. Nationwide, premiums for the lowest-cost silver plans are rising 4% on average.

In three states—Vermont, Alaska, and North Dakota—double-digit premium percentage increases will impact all metal tier levels, ranging from 13% (North Dakota, lowest-cost silver plan) to 35% (Vermont, lowest-cost silver).

The increase might not be surprising if premiums were low, but Vermont already has the highest ACA premiums in the nation. In 2024, Vermont’s average lowest-cost silver plan costs $948. Next year, that premium will rise to $1,275.

Interestingly, ACA Marketplace shoppers across the state border in New Hampshire may see average premiums of around $950 less than their neighbors pay. Here are the highest and lowest average premiums per metal level across the U.S.

Highest and Lowest Average Premiums Per Metal Level
	State	Cost	Change 2024-2025, Rounded
Lowest-Cost Bronze	Maryland	$265	4%
Highest-Cost Bronze	Vermont	$808	11%
Lowest-Cost Silver	New Hampshire	$320	-1%
Highest-Cost Silver	Vermont	$1,275	35%
Lowest-Cost Gold	New Hampshire	$354	-3%
Highest-Cost Gold	Vermont	$1,139	12%

The five states with the highest-cost silver plans are:

Vermont
Alaska
West Virginia
Wyoming
New York

The least expensive states are:

New Hampshire
Minnesota
Maryland
Virginia
Indiana

Apply for Subsidies to Lower Your Costs Dramatically

As in most states, the vast majority of Vermont’s enrollees don’t pay those high premiums. They can use federal and state assistance programs or subsidies to help offset premium costs. For example, those using federal subsidies in Vermont pay only $243.

Federal premium tax credits lower how much you have to pay for Obamacare premiums. They were included in the Affordable Care Act and expanded under the American Rescue Plan Act of 2021. The expansion was extended until 2025 by the Inflation Reduction Act.

Now, 92% of enrollees get a premium tax credit, and half get a cost-sharing reduction (which lowers your out-of-pocket maximum). Four in five 2025 Obamacare enrollees should be able to find coverage for $10 a month or less after subsidies.

You can apply for the credits by reporting your income and other information when you enroll in coverage. Some states have their own subsidies, so check with your state health insurance marketplace if you have one.

This could be the final year many people are eligible for significant subsidies. According to the Center on Budget and Policy Priorities, premiums will rise sharply across all states for all ages and income levels in 2026 if the Inflation Reduction Act tax credit enhancements expire in late 2025 as scheduled. The incoming Congress will need to extend them, and Republicans have previously said they don’t support such efforts.

Why Are Prices Going Up More in Some States?

Premium changes vary by state depending on variations in factors such as:

How often enrollees are using services
Service costs, such as high-expense hospital stays
Cost of prescription drug medications, including Ozempic
Number of enrollees in metal-level plan categories
Provider competition in the state
State requirements for providers

For example, in Vermont, only two health insurance companies sell Marketplace plans, limiting competition and contributing to the high premiums.

Another has to do with regulations. In May, Vermont passed a law limiting insurance companies’ authority regarding prior authorization, claims, and medication step therapy, which insurers warned could lead to higher prices. Prior authorizations, for example, can delay access to care, but they’re intended to keep costs in check.

A state’s Medicaid policies can also impact ACA premiums. Oregon enacted a Medicaid expansion program this year, which meant some people no longer had to pay for insurance on the state marketplace. “Companies had to make an actuarial adjustment to account for the fewer individuals needing coverage, and they increased the cost of their bronze plans,” said insurance broker Joshua Brooker, National Association of Benefits and Insurance Professionals individual markets workgroup member.

Oregon’s bronze plan premiums will increase by almost 12% and are projected to cost $408 monthly in 2025.

Compare this to Idaho. “Idaho’s average percent of their enrollees in a bronze plan is much higher than national and regional benchmarks,” Brooker said. Therefore, competition for bronze plans “is more fierce.”

In Idaho, bronze premiums will decrease by 5% and cost an average of $307 monthly in 2025.

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