Thousands of Iowans on individual health plans are facing a second straight year of double-digit premium increases, according to 2027 rate requests filed with the Iowa Insurance Division.
Iowa Total Care requested an average increase of 16.84% for its roughly 7,000 members, with some plans rising as much as 21.75%. Avera Health Plans asked for an average 14.82% hike, topping out at 21.7%. Oscar Insurance Company’s request averages an 11.94% increase but reaches 28.17% on some plans, and UnitedHealthcare’s River Valley plan seeks a 11.77% surge. Wellmark, which covers about 80,000 Iowans, filed for an 4.98% hike—keeping the statewide average near 6.7%, a figure that masks what customers of every other carrier will pay.
The filings share a common thread: Insurers expect the expiration of enhanced federal premium tax credits, which Congress let lapse at the end of 2025, to keep pushing healthier people out of the market. Iowa’s ACA enrollment already dropped 17%—roughly 21,000 people—between February 2025 and February 2026. Insurers say those left behind are sicker and costlier to cover, so premiums go up.
What the filings don’t share are the details of how we got here. In Avera’s public justification, for example, the table breaking down the drivers of the increase are redacted.
Several insurers also cite state and federal taxes and fees months after Gov. Kim Reynolds said carriers didn’t have to pass along the state’s HMO tax increase to customers.
Iowa law requires a public hearing on increases above 5.6%. That hearing is set for 5 p.m. Aug. 20, and written comments are open now at iid.iowa.gov
