The Affordable Care Act is set to raise health-plan premiums.

Insurers in ACA marketplaces are proposing a 10% increase in average monthly premiums, according to a Kaiser Family Foundation review of proposals submitted by 72 insurers in 13 states. Some insurers require an increase of up to 20 percent.

The proposed increases vary widely among insurers and markets. Also, state regulators don’t always approve the full increases required by insurers.

Insurers generally submit rates to state regulators, who have varying timelines for review and approval. The federal government is expected to approve ACA plans in early October.

The increases reflect situations like these High prices for medical servicesWhich hospitals and other health care providers are looking to cover their own growing labor and other costs, actuaries and insurance-company regulatory documents.

“It’s energy, but also supplies. The cost of everything is going up,” said Debbie Ashford, CEO of North American Health Solutions. Yes Pvt. Ltd., a health consultant and insurance broker.

Many consumers won’t pay the surcharge because Congress passed a law in 2014. As part of the premium financing extended until 2025 Inflation Reduction Act It was approved in August.

The bill provides for the 2021 subsidy expansion, allowing individuals for the first time to qualify for subsidies if they earn more than four times the federal poverty level, or $54,000 for an individual and $110,000 for a family of four. Previously, under the ACA, individuals earning more than four times the poverty level were barred from subsidies.

The improved subsidy means that more than 13.8 million people will be enrolled in the exchange plan. Cheryl Fish-Parcham, director of private coverage at Families USA, a consumer health advocacy organization, said out-of-pocket costs remain. Many of them will be barred from premium increases, she said.

The extra help means about 13 million people covered under the ACA will save $800 a year than they would have spent without the extended subsidies. According to the Biden administration. After subsidies, the average monthly premium in 2022 was $133, according to the Department of Health and Human Services.

Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, said, “Small businesses are going to be hit the hardest” because large companies don’t have the bargaining power they have in negotiations with health insurers.

Bob Jennings, CEO of 3D Ink, a Cincinnati-based consumer goods brand with 21 employees, sees growth of 14 percent to 23 percent by 2023.

But Mr. Jennings said he doesn’t want to stop offering benefits in such a competitive job market. Instead, the company announced a 3% increase in premiums for workers and agreed to cover their expenses above the out-of-pocket maximum.

3D’s health-insurance plan ended in August, so the company recently went through the enrollment process for the new year. Most small businesses have health plans that renew at the end of the year, but some have plans that start any month, said Gary Claxton, senior vice president of the Kaiser Family Foundation. He said that if companies do not have open enrollment in the fall, they will start hearing soon, so they have time to decide what to do.

Insurers selling plans in the small group market to employers of 50 or fewer are seeking rate increases of 2% to 15% in Minnesota by 2023, according to federal data.

The asking price for the small group market in Florida will increase from 4 percent to about 12 percent. In New York, insurers are asking for price increases for plans ranging from 11 percent to 46 percent.

Small employers are not required to offer health insurance under the ACA, so the rate hike increases the risk that some may lose coverage, according to Moody’s Investors Services.

The Biden administration is gearing up for open enrollment with $98.9 million in grants to help individuals sign up for health insurance under the ACA.

Health-insurance specialists say enrollment in ACA plans could swell if the administration ends the epidemic as a public health emergency in 2023. The process of verifying current enrollees’ eligibility for Medicaid was halted at the time of the proclamation. Millions of people are expected to lose Medicaid coverage if eligibility is reintroduced.

The current public health emergency ends Oct. 13, and the Department of Health and Human Services said it will give states 60 days notice before it ends. So far, some state officials said they have not received any notification.

Write to Stephanie Armor at Stephanie.Armour@wsj.com and Anna Wilde Mathews Anna.Mathews@wsj.com