What do CBO and CMS projections say about individual market premiums over the next 5–10 years?

1. Why CBO and CMS projections don’t give a single uniform premium path

CBO’s public work stresses that projections depend on current law assumptions, recent rulemaking, and economic forecasts — and that those inputs change the outlook for premiums and enrollment materially ^{[4] [3]}. CBO explicitly ties future marketplace subsidies, enrollment, and premiums to legislative choices (for example, whether enhanced premium tax credits expire or are extended) and to administrative rules that HHS issues and courts review ^{[3] [4]}. Because of that, CBO presents multiple scenario-based estimates rather than one definitive 5–10 year premium number ^{[3] [2]}.

2. The headline policy sensitivity: expanded premium tax credits cut benchmark premiums ~7.6%

In CBO’s analysis of permanently extending the pandemic-era, expanded premium tax credits, the agency (and reporting summarizing it) finds that gross benchmark premiums in the marketplaces would be, on average, 7.6% lower each year from 2026–2035 than in the baseline where those credits expire. That same CBO estimate also links the permanent expansion to an increase of roughly 3.8 million people with insurance and to a budgetary cost of about $350 billion from 2026–2035 ^{[1] [2]}.

3. Net premiums (what consumers actually pay) are even more sensitive to subsidies

Reporting based on CBO’s work shows that when subsidies are cut back, average net premiums — the part consumers pay after tax credits — can rise dramatically. For example, analyses project that without enhanced credits, average net premiums in 2026 would be much larger and that uninsured counts would increase; CBO and other analysts quantify large differences in both premiums and coverage tied to the subsidy policy choice ^{[1] [3]}. CBO therefore frames “premium projections” as two linked numbers: gross premiums set by insurers and net premiums faced by enrollees after subsidies ^{[3] [1]}.

4. Enrollment and market composition reshape premium pressure

CBO’s more recent projections revised marketplace enrollment projections up or down depending on policy and economic assumptions; those enrollment shifts change risk pools and thus affect premiums. For example, CBO raised its projected average marketplace enrollment for some windows and also noted shifts between subsidized and unsubsidized enrollees — differences that directly affect insurers’ pricing power and premium levels ^{[5] [3]}. CBO’s long‑term outlook also ties premium subsidy spending to broader health‑program cost growth, meaning demographic and programmatic trends will put upward pressure on gross premiums over decades absent offsetting policy changes ^{[6] [7]}.

5. Administrative rules and court actions matter — CBO flags legal uncertainty

CBO notes that HHS’s “Marketplace Integrity and Affordability” rule and other administrative actions are under legal review and that the agency often assumes implementation delays in its baseline; those judicial or implementation outcomes could shift projected premiums and subsidy spending materially ^[4]. Where a final rule is nullified or delayed, CBO quantifies both coverage and budget impacts in its scenario work ^{[2] [4]}.

6. What CMS projections add — enrollment and operational estimates, not a single premium forecast (limited in provided sources)

Available sources do not include a standalone CMS numeric forecast of national individual‑market premium growth over 5–10 years within this search set; instead, CBO’s public materials (and press summaries) are the primary documented sources in the provided results for premium scenarios and the coverage/budget tradeoffs that drive premium outcomes ^{[3] [1]}. Therefore, explicit CMS premium trajectories are not found in current reporting supplied here — say “not found in current reporting” if you need that specific CMS number ^[3].

7. Bottom line and what to watch next

If Congress or the administration extends the enhanced premium tax credits, CBO projects meaningful downward pressure on gross marketplace premiums (about 7.6% lower on average 2026–2035) and increases in insured counts but with substantial federal cost (around $350 billion through 2035) ^{[1] [2]}. If those credits expire and if HHS rule changes reduce subsidies or tighten eligibility, CBO projects higher net premiums for many households and higher uninsured rates ^{[3] [4]}. For a concrete 5–10 year premium projection, monitor CBO’s scenario updates and CMS technical releases because both policy actions and court rulings will determine which of CBO’s scenarios becomes the most relevant ^{[4] [3]}.