Payer Instability and Healthcare Cost Volatility Raise Access and Essential-Service Risk

KFF estimates 2027 Marketplace premiums will rise 13% on average across 30 federally run marketplaces, following a reported 26% rise the prior year; subsidy expiration and enrollment barriers add uncertainty. Michigan separately finalized average increases of 14.2% for individual plans and 9.6% for small groups, while reported enrollment-cancellation, Medicaid, and rural maternity-care impacts still require verification.