The State of Healthcare Costs in Southwest Florida for 2027

Heading into 2027, Southwest Florida families and employers are facing a second straight year of steep health insurance cost increases — driven by the expiration of enhanced federal subsidies, double-digit rate hikes filed by Florida carriers, rising medical and drug costs, and a shrinking set of plan options. On top of the statewide picture, Lee County is absorbing a major local disruption: Lee Health is set to leave UnitedHealthcare's network on January 1, 2027. Here's an honest, data-driven look at where costs stand and what you can do about it.

(Figures below are current as of September 2026. Florida's 2027 rates were still being reviewed and finalized by the Florida Office of Insurance Regulation at the time of writing.)

The national backdrop

Two forces are pushing costs up nationwide:

• Enhanced subsidies expired. The enhanced premium tax credits that made ACA coverage cheaper from 2021 through 2025 ended January 1, 2026. According to KFF, that pushed average out-of-pocket premium payments up roughly 58% in 2026, with deductibles rising as well.
• Underlying medical costs are climbing. The cost of hospital care, physician visits, and prescription drugs — including high-cost specialty medications like GLP-1s — has risen faster than in recent years. Insurers have priced that into 2027, proposing a national median premium increase of around 14–15%, on the heels of roughly 20% in 2026.

Put together, Peterson-KFF estimates that typical premiums for ACA Marketplace insurers could climb by more than one-third from 2025 to 2027; benchmark-silver premiums are a separate measure.

Florida's 2027 numbers

Florida matters more than almost any other state in this story. It has by far the largest ACA marketplace in the country — close to one in five marketplace enrollees nationwide are Floridians.

For 2027, Florida's participating insurers filed a wide range of proposed increases. Based on publicly available filings, requested rate changes ran from under 4% at the low end to more than 39% at the high end, with the state's Office of Insurance Regulation reviewing and approving final rates this fall. Because the published filings were heavily redacted and did not provide usable enrollment weights, the published straight-average calculation is unweighted; HealthInsurance.org calculated an average proposed increase of about 15.9%.

The market is also getting smaller. For 2027, at least one national carrier is exiting Florida's marketplace entirely, and another Florida plan is being discontinued (with members transitioned to a sister company). One large Blue Cross Blue Shield insurer is returning to the marketplace. The net effect for many consumers: your current plan may not exist next year, forcing an active choice.

The human cost: Florida's coverage losses

The subsidy change didn't just raise prices — it pushed people out of coverage. Florida led the nation in coverage losses after the enhanced credits expired. An Associated Press analysis of federal data found that about 443,000 fewer Floridians had ACA Marketplace coverage in 2026 than in 2025—a drop of about 10%; the data do not show how many obtained other coverage, although analysts said many likely became uninsured. When healthier people drop out, the remaining risk pool gets older and costlier, which feeds directly into next year's rate increases. It's a cycle, and Southwest Florida is in it.

What's happening locally in Lee and Collier County

Beyond the statewide numbers, Southwest Florida has its own cost story:

• The Lee Health–UnitedHealthcare split. Starting January 1, 2027, Lee Health hospitals and physicians will be out-of-network for many UnitedHealthcare plans across Lee County. For a region where Lee Health is the dominant provider, this reshapes which plans actually give you affordable access to local care. (Full details in our Lee Health network change guide [blocked].)
• A competitive labor market for employers. Construction, trades, and service businesses across Fort Myers, Cape Coral, Naples, and Bonita Springs are all competing for the same workers — and benefits are a deciding factor. Rising costs make it tempting to cut benefits, but that's often the fastest way to lose good people.

What families can do

• Don't auto-renew. Reshop during open enrollment [blocked] (November 1, 2026–January 15, 2027) — especially since some plans are disappearing.
• Estimate your income carefully; the 400%-of-poverty subsidy cliff is back, and crossing it can cost you every dollar of assistance.
• Confirm your doctors and hospital are in-network for 2027 before you enroll — the Lee Health change makes this critical.
• Consider working with a licensed agent; the help is free to you. See our individual and family coverage [blocked] page.

What employers can do

Rising costs don't have to mean worse benefits. The employers who come out ahead treat health spend as something to manage, not just absorb:

• Alternative funding. Level-funded and self-funded plans price your coverage on your own group's claims rather than a broad risk pool. See group health insurance [blocked].
• ICHRA. Give employees tax-free dollars to buy their own plans, with your cost capped and predictable. See our ICHRA guide [blocked].
• Attacking the real cost drivers. Pharmacy optimization, direct primary care, and healthcare advocacy target the claims that actually move your premium — which is how we approach cost [blocked].

The bottom line

2027 is shaping up to be another expensive, disruptive year for healthcare in Southwest Florida — higher rates, fewer plan choices, and a major local network change all at once. But cost pressure rewards preparation. Whether you're a family reshopping your plan or a business owner staring at a rough renewal, the move is the same: review your options early, with someone who knows this market. If you'd like that review at no cost, contact us [blocked] or call (239) 273-9173.

Frequently Asked Questions

How much are health insurance costs going up in Florida for 2027? Florida carriers filed a wide range of proposed increases for 2027 — from under 4% to more than 39%, with an unweighted statewide average in the mid-teens. Final rates are set by the Florida Office of Insurance Regulation in the fall of 2026.

Why are so many Floridians losing coverage? The enhanced federal subsidies expired at the start of 2026, sharply raising out-of-pocket premiums. Florida led the nation in coverage losses, with roughly 442,000 residents who had marketplace coverage in 2025 becoming uninsured in 2026, per an AP analysis of federal data.

How does the Lee Health–UnitedHealthcare change affect costs in Southwest Florida? Starting January 1, 2027, Lee Health will be out-of-network for many UnitedHealthcare plans in Lee County, which can mean much higher out-of-pocket costs for affected patients. Checking your network before choosing a 2027 plan is essential.

What can a small business do about rising healthcare costs? Alternative funding (level-funded/self-funded), ICHRA, and strategic plan design can all reduce cost without cutting benefits. The right approach depends on your workforce and is worth modeling with a consultant.

Roger Aboytes is the founder of Vantage Pointe Consulting, an independent benefits firm helping Southwest Florida families and businesses navigate healthcare costs. Sources: KFF, Associated Press/CMS, Florida Office of Insurance Regulation. Last updated: September 2026.