For millions of Americans, November 1st marks the start of a critical window — a chance to lock in health coverage for the coming year. But for families in Arizona, the decision about whether they can afford to stay insured just got a lot harder.
Open enrollment for Affordable Care Act Marketplace plans in 2027 is now underway, and Arizona is shaping up to be one of the most expensive states in the country for health insurance. On average, premiums for ACA Marketplace plans in Arizona are climbing roughly 28% — nearly double the national average increase of about 15%.
Katherine Hempstead, a senior policy officer with the Robert Wood Johnson Foundation, a healthcare-focused philanthropic organization, put it plainly:
“Unfortunately, Arizona is one of the very highest states in the country in terms of its increase.”
Why Are Costs Rising So Fast?
A few forces are driving premiums higher across the board. Inflation is pushing up costs for medical services and prescription drugs nationwide. But another major factor hit closer to home: when enhanced federal subsidies for ACA plans expired last year after Congress could not agree on a plan to extend them, many healthy, lower-cost enrollees dropped their coverage. That left a sicker, more expensive pool of patients on the rolls — a dynamic that pushes premiums up for everyone who stays.
The result was devastating for Arizona families already stretched thin. When subsidies disappeared and premiums surged last year, monthly costs for enrollees increased 58% on average, according to health policy research organization KFF. And Arizona paid a steep price: the state recorded one of the nation’s biggest decreases in enrollment in ACA Marketplace plans, with about 30% of enrollees dropping out compared to the year before.
Hempstead noted that while the underlying pressures are similar to those in other states, Arizona’s situation is uniquely severe:
“It’s the same factors that are true in other states, but it just seems like, for whatever reason, in Arizona it’s worse.”
What Happens When People Lose Coverage
The consequences of losing health insurance ripple far beyond an individual’s monthly budget. When people go without coverage, they tend to skip preventive care and delay treatment — sometimes until a manageable health problem becomes a medical emergency.
Dr. Sarah Lee-Davisson, a Tucson emergency room surgeon, sees this play out firsthand. She warns that a healthcare system strained by uninsured patients becomes weaker for everyone:
“When we are using resources for people that need it because they’ve gotten sicker because they didn’t have access to care immediately or preventive care, then we all are going to have a weaker healthcare system.”
The strain doesn’t end in the exam room. Hospitals that treat uninsured patients absorb what’s called uncompensated care — costs they can’t recover — which can lead to budget cuts, staffing reductions, or scaled-back services. For emergency rooms already under pressure, each uninsured patient who arrives sicker than they needed to be compounds the problem.
Lee-Davisson described the real-world impact inside the ER:
“That case is going to take more of my and my staff’s time; they’re going to be in the hospital for longer; the emergency room is going to be more backed up. That’s how our ER times in Phoenix and Tucson are going up. Everybody’s complaining about that, and I don’t know that everybody understands some of the reasons that is happening.”
How to Shop Smarter This Enrollment Season
With costs rising steeply, health policy experts are urging consumers not to simply auto-renew their existing coverage. Hempstead recommends taking the time to compare all available plans carefully — because the cheapest monthly premium isn’t always the best deal for a family’s overall health spending.
A slightly higher monthly premium might actually save money throughout the year if it comes with lower copays, a smaller deductible, or a reduced out-of-pocket maximum. As Hempstead explained:
“It’ll make your copays less, your deductible less, your maximum out-of-pocket less.”
Arizonans looking for guidance on comparing and choosing plans can find resources through the Arizona Department of Insurance and Financial Institutions’ open enrollment page. Taking the time to review options now could make a significant difference in both coverage quality and total costs for the year ahead.
Separately, medically frail Arizonans enrolled in Medicaid are also facing new verification hurdles under recent program changes, adding another layer of uncertainty for some of the state’s most vulnerable residents. For broader health coverage news, including a new study on health risks for airline crews and research on breaking down “forever chemicals” in water, reporting from Greg Hahne, Dr. Joseph Sirven, Mark Brodie, and Katherine Davis-Young continues to track how policy and science intersect with everyday health in Arizona, spanning science, education, and public affairs coverage. Other recent stories include the new ASU hockey coach taking over after a player’s on-field collapse and the family of a toddler found alive in a morgue who plans to sue the hospital.
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