Why Did My Health Insurance Go Up So Much in 2027? A South Carolina Explainer

Your health insurance went up in 2027 for three reasons that hit at once: the enhanced federal tax credits expired after 2025, carriers raised their full-price rates again for 2027, and several carriers left South Carolina counties. In South Carolina, the full-price benchmark silver premium for a 40-year-old, before subsidies, rises in all 46 counties, from +11.0% in Beaufort to +46.8% in Lee, with an enrollment-weighted average of +24.8%.

From 2021 through 2025, Congress boosted Marketplace tax credits. Those enhanced credits lowered what people paid at every income level and removed the income cap entirely. They expired at the end of 2025.

The effect showed up in 2026. KFF estimated that Marketplace enrollees faced an average premium payment increase of 114% to keep the same plan once the enhanced credits ended. Average monthly net premium payments rose 58%, and national Marketplace enrollment fell from 22.1 million in 2025 to 19.2 million in February 2026.

For 2027, the credit is generally limited to households between 100% and 400% of the federal poverty level, unless Congress acts. That is the "subsidy cliff." For a single person, 400% of the 2026 poverty guideline is $63,840. Earn a dollar more and you generally get no credit at all.

At the other end, South Carolina did not expand Medicaid. Adults below 100% of the poverty level generally do not qualify for Marketplace tax credits or Medicaid, which leaves some of our lowest-income neighbors without an affordable option.

Separate from the tax credits, carriers raised the underlying price of their plans. Nationally, KFF's review of 276 insurers' filings found a median proposed increase of 15% for 2027. Insurers pointed to rising health care prices as the primary driver, along with the end of the enhanced credits and a related increase in the risk pool's morbidity. That means carriers expect the people who keep coverage to be sicker on average.

In South Carolina, our analysis of PY2027 SC Marketplace data shows the benchmark silver plan up +24.8% on an enrollment-weighted basis. See every county in our 2027 rate changes by county report.

Fewer carriers means less price competition and, for many people, a forced plan change:

• Molina offered plans in 37 South Carolina counties in 2026 and none in 2027.
• UnitedHealthcare leaves Cherokee, Chester, Colleton, Lancaster, Laurens, Lee, Marlboro and Union.
• InStil Health leaves Spartanburg.

When carriers come and go, the second-lowest-cost silver plan in your county can change. In 22 of South Carolina's 46 counties, the 2027 benchmark comes from a different carrier than in 2026. Since that benchmark plan sets your tax credit, a new benchmark can change your net price even if your own plan barely moved. More in Don't auto-renew.

Greenville County

Greenville kept all three of its 2026 carriers, yet its benchmark still rose $149 a month to $741. The benchmark did change hands, though: it was a BCBS plan in 2026 and is First Choice Next Silver Signature for 2027.

For our single 40-year-old earning $55,860, the credit grows with the benchmark. If they pick the benchmark plan, they pay roughly $476 a month. If they earn just over $63,840, though, they get no credit and pay the full $741, or $8,896 a year.

Lee County

Lee has the steepest increase in the state. The benchmark rose $251 a month, from $536 to $787. Lee also lost Molina and UnitedHealthcare, so only Ambetter and BlueCross BlueShield of SC remain. Anyone who had a Molina or UnitedHealthcare plan in Lee must pick a new plan.

A Lee County resident above the 400% line pays $9,450 a year at full price for the benchmark plan. Below the line, the larger benchmark means a larger credit, which softens most of the increase.

• People earning over 400% FPL. They pay the full price, and the full price went up.
• People who keep a plan that rose faster than the benchmark. The credit only grows as much as the benchmark does.
• People whose carrier left. Their replacement plan may cost more or have a different network.
• People who don't update their income. An outdated estimate can mean the wrong credit now and a surprise at tax time.

If you fall into one of these groups, a short review with one of our agents can usually find a better fit. We compare every carrier in your county, check your doctors and prescriptions, and update your income estimate with you.

1. Log in to HealthCare.gov and review the 2027 price of your current plan after your credit.
2. Update your 2027 income estimate. See how to estimate your 2027 income.
3. Check whether you are near the 400% FPL subsidy cliff. Small changes, like a retirement contribution, can matter. Ask your CPA.
4. Compare all carriers in your county, including Bronze, Silver and Gold options.
5. Enroll by December 15 for a January 1 start. Open Enrollment ends January 15, 2027, but later enrollments start February 1.