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:
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:
The least expensive states are:
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.
Premium changes vary by state depending on variations in factors such as:
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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