ACA open enrollment 2027: Higher premiums, insurer exits and subsidy changes could reshape coverage choices

healthinsurance.org outlines key changes before open enrollment begins Nov. 1

Minneapolis, MN, Sept. 29, 2026 (GLOBE NEWSWIRE) -- Consumers shopping for Affordable Care Act coverage this fall will face several important changes, including higher premiums, insurer exits and new rules affecting subsidies and out-of-pocket costs.

It’s always a good idea to compare options during open enrollment rather than just letting coverage renew automatically. That’s especially important this year for people whose premiums are increasing or whose insurer is leaving the Marketplace. The open enrollment period for Marketplace coverage begins Nov. 1 in most states.

“Even if you’re happy with your coverage, it’s important to compare plans during open enrollment,” said Louise Norris, health policy analyst for healthinsurance.org. “Insurers and premiums can change, and the plan that offered the best value this year may not be the best choice for next year.” 

Premiums are rising; subsidies should too. The nationwide median proposed rate increase for individual-market plans is about 15% for 2027, meaning roughly half of insurers have proposed increases above that level and half below it. Weighted average increases range from less than 7% in Vermont, New York, Iowa and Utah to a proposed 29% increase in Arizona. See 2027 rate increases by state.

Most Marketplace enrollees, however, do not pay the full cost of their premiums. In fact, 87% of Marketplace enrollees qualified for premium subsidies during the open enrollment period for 2026 coverage. Subsidies are based on the cost of the benchmark plan, so higher benchmark premiums should also result in larger subsidies. But changes in benchmark premiums will not necessarily match changes in other plans, and consumers who do not receive subsidies will bear the full impact of premium increases.

Insurers are exiting ACA Marketplaces in 24 states. Hundreds of thousands of Marketplace enrollees have plans that will terminate at the end of 2026 because of carrier exits. If a plan is ending, the Marketplace may automatically assign the enrollee to another plan, but healthinsurance.org recommends consumers review their options and choose replacement coverage themselves or with the help of a broker. Learn what to do if your health insurer is leaving the market.

Seven states — California, Colorado, Georgia, Indiana, Minnesota, Ohio and Texas — will each see one new carrier join the Marketplace. 

Maximum out-of-pocket costs and health savings account (HSA) limits are increasing. For 2027, the out-of-pocket maximum for an individual will rise to $12,000, up from $10,600 in 2026. Plans can have lower limits, so consumers should compare deductibles and other cost-sharing as well as monthly premiums.

Health savings account contribution limits are also increasing. In 2027, consumers with HSA-eligible coverage will be able to contribute up to $4,500 for themselves and $9,000 for family coverage. That’s up from $4,400 and $8,750, respectively, in 2026. 

Fewer lawfully present immigrants will qualify for Marketplace subsidies. Starting with 2027 coverage, subsidy eligibility for non-citizens will be limited to lawful permanent residents, Cuban-Haitian Entrants and Compact of Free Association migrants. Other lawfully present immigrants who previously qualified — including refugees, asylees, people with Temporary Protected Status, and those with work or student visas — will no longer qualify for federal Marketplace subsidies.

Identity verification may add a step for some consumers. Consumers living in states that use HealthCare.gov may need to take additional steps to confirm their identity before enrolling in 2027 coverage. The requirements are intended to protect consumers and reduce fraudulent enrollments. Consumers should make sure their contact information is current and allow extra time to complete enrollment.

Some states are also making their own Marketplace changes. Oregon is moving from HealthCare.gov to its new state-run Explore Health enrollment platform for 2027. Virginia is joining the list of states offering state-funded health insurance subsidies; and Rhode Island has allocated $19 million to replace some of the federal subsidy enhancements that expired at the end of 2025.

Another change for 2027 is more limited access to Catastrophic plans. Consumers age 30 and older generally will need a hardship or affordability exemption to purchase Catastrophic coverage. Rules that expanded eligibility last fall are no longer in effect following a court ruling. 

Healthinsurance.org has published a comprehensive guide to what’s changing for the 2027 ACA open enrollment period, along with state-by-state Marketplace resources with information about participating insurers, premiums, enrollment and coverage rules.

Healthinsurance.org provides online resources for consumers about individual and family health insurance. Healthinsurance.org, owned by HealthInsurance.org, LLC, has been providing consumer information about health insurance and health reform for over 25 years.

Attachment

• 2027 ACA open enrollment: What’s changing

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