Montanans who get their health insurance through the state's health insurance marketplace may see another significant premium spike in 2027.
Montana has not yet released its rates but analysts said the 16 states that have are showing 10% to 20% premium increases on average for next year.
Louise Norris, health policy analyst for the consumer information website HealthInsurance.org, said it is because of higher health care and drug costs, along with continued enrollment drops after federal subsidies for the Affordable Care Act expired at the end of 2025.
"That is continuing to suppress enrollment," Norris explained. "Basically, the healthiest people have been dropping their coverage, leaving a sicker risk pool.
"Norris added it drives up prices for people who continue their coverage, noting the double-digit increases will mostly affect people above 400% of the poverty rate and do not qualify for subsidies, which is about 13% of enrollees, with a household income of just under $64,000 for singles or $132,480 for a family of four.
Norris added many people who continued their coverage in 2026 switched to lower-tier plans with lower premiums but higher out-of-pocket costs.
Another change for Montanans in 2027 is health insurance provider PacificSource is leaving the state's marketplace. The company said higher costs and financial strain led to the decision. Norris explained PacificSource customers will default to a new plan if they do not choose one themselves.
"It's in your best interest to actively shop and pick your own plan rather than just letting the algorithm pick a plan for you," Norris advised. "So anyone with PacificSource Insurance needs to be planning to go and pick their own replacement plan."
Norris stressed it is a good idea for all enrollees, because plan prices, out-of-pocket costs, in-network providers and prescription coverage change every year.
Montana will release its rate filings for 2027 this summer. The state will then review them and prices will be finalized closer to the start of the open enrollment period Nov. 1.