These states are offering extra ACA premium subsidies in 2027

Several states are offering extra, state-funded help with Affordable Care Act premiums in 2027, following the expiry of enhanced federal subsidies. The support aims to cushion higher costs and declining enrolment; Rhode Island and Virginia are newly joining states that offered assistance in 2026.

These states run their own insurance marketplaces rather than using HealthCare.gov and are largely Democratic-leaning, according to health policy experts. After the federal subsidies ended in 2025, average monthly premiums rose 58%, from $113 in 2025 to $178 in 2026, KFF said. ACA enrolment was 19.2 million in February 2026, down 13% from 22.1 million a year earlier, and KFF says it may have fallen further since.