ACA Enrollment Opens With Benchmark Premiums Up 13% for 2027

Affordable Care Act open enrollment began November 1 with higher premiums, fewer participating insurers in some markets and changes to financial help that could make 2027 coverage harder to afford for some households.

Finalized benchmark silver-plan premiums are rising 13% on average nationally, according to KFF’s October 30 analysis. That figure measures the benchmark used to determine premium assistance; it is not a uniform increase across every plan or a prediction of each enrollee’s bill.

Most marketplace enrollees receive subsidies that cushion premium increases. People above the income limit for federal premium tax credits face the full price, following the expiration of the enhanced credits that previously expanded assistance.

For HealthCare.gov users, December 15 is the deadline to enroll for coverage beginning January 1. The federal platform’s open-enrollment period continues through January 15, with plans selected after December 15 generally starting February 1. State-run marketplaces may have different schedules.

Price Increases Follow Last Year’s Jump

KFF found that average benchmark premiums increased 11% in states using HealthCare.gov and 16% in states operating their own enrollment platforms. Nationwide, the 2027 increase follows a 26% rise in benchmark premiums for 2026.

Insurers cite higher underlying medical costs and changes in the insured population after enhanced subsidies expired. KFF’s review found that insurers attributed about four percentage points of the 2026 increase to changes in the risk pool and expected a similar additional effect in 2027.

The concern is that healthier people may leave when coverage becomes more expensive, increasing the average cost of care among those who remain.

Premium credits still help many households. But people earning more than 400% of the federal poverty level no longer qualify for those credits, KFF reported, exposing them to the full premium.

Plan Options Are Also Changing

As of October 29, KFF counted 11 insurers planning to exit at least one state for 2027 and seven entering a new state. Cigna is leaving the individual market in all 11 states where it participates.

An insurer’s departure can mean a different network or replacement plan even for someone whose health needs have not changed. Comparing the monthly premium alone will not show whether a doctor, hospital or prescription remains covered.

Some states are adding their own assistance. New Mexico is continuing a program that fully replaced lost enhanced federal aid in 2026. California is expanding eligibility for its more limited premium support, while New Jersey maintains subsidies and Rhode Island and Virginia have moved to establish new assistance for 2027.

New Tax and Eligibility Rules Add Stakes

Beginning with the 2026 tax year, limits on repayment of excess premium tax credits were eliminated. People whose actual income exceeds their estimate may therefore owe more when they file taxes in early 2027.

KFF also reported that certain lawfully present immigrants, including refugees and asylees, will lose eligibility for premium tax credits in 2027 while remaining eligible to buy marketplace coverage at full price.

Other proposed enrollment restrictions have been paused or vacated through litigation. Consumers should use the current rules shown by their marketplace rather than assume every announced change has taken effect.

HealthCare.gov says coverage begins only after the required first premium is paid. Its immediate date for shoppers seeking uninterrupted January coverage is December 15, not the final January 15 enrollment deadline.

References: 9 Things to Watch for the 2027 ACA Open Enrollment Period | When can you get health insurance?