Open enrollment for 2027 health coverage on HealthCare.gov and the state marketplaces opened on 1 November 2026 and runs to 15 January 2027. To be covered from 1 January, you need to pick a plan by 15 December.
It is the second year without the enhanced subsidies that expired at the start of 2026, and premiums are rising again. This guide covers what has changed and what to check before you renew.
The short version
- Deadlines: sign up by 15 December 2026 for coverage from 1 January. Open enrollment ends 15 January 2027 in most states.
- Premiums: the average benchmark silver plan rises about 13%, after a 26% rise last year. About 11% in HealthCare.gov states, 16% in states with their own marketplace.
- Subsidy cliff: households above 400% of the poverty level get no premium tax credit at all.
- Repayment risk: caps on paying back excess subsidies are gone. If you underestimate your income, you repay every dollar at tax time.
- Insurer exits: Cigna is leaving the individual market in all 11 of its states. Check that your plan still exists.
- Out-of-pocket maximum: reported at $12,000 for an individual and $24,000 for a family in 2027.
When is open enrollment for 2027?
| Date | What it means |
|---|---|
| 1 November 2026 | Open enrollment opens |
| 15 December 2026 | Deadline for coverage starting 1 January 2027 |
| 15 January 2027 | Open enrollment ends (coverage starts 1 February) |
Some states that run their own marketplace set later deadlines, and a court case affecting the dates is under appeal, so confirm on HealthCare.gov or your state's site.
How much are ACA premiums going up for 2027?
Insurers asked for a median increase of 15%. The finalised average for the benchmark silver plan is 13%, according to KFF: about 11% in HealthCare.gov states and 16% in states that run their own platforms.
Most enrollees get a subsidy that rises with the benchmark premium, which shields them from much of the increase. CMS says more than 75% of HealthCare.gov shoppers will still have access to a plan for $50 a month or less after subsidies.
The people most exposed are those with income above 400% of the federal poverty level, who lost all subsidy when the enhanced credits expired. For them, every dollar of the increase is theirs.
What else changed for 2027?
KFF's list of things to watch includes:
- No repayment cap. Starting with the 2026 tax year, there is no limit on how much excess premium tax credit you must repay. Freelancers and anyone with variable income should estimate carefully and update their marketplace income if it changes during the year.
- Insurer exits outnumber entries. As of 29 October, 11 insurers had announced exits from at least one state and seven had announced entry somewhere new.
- Some states are filling the gap. New Mexico has fully replaced the lost federal help, California is expanding its state subsidy, and Rhode Island and Virginia have created new subsidies for 2027.
- Some lawfully present immigrants lose tax credits, including refugees and asylees, though they can still buy coverage.
- Medicaid work requirements begin on 1 January in most states. Adults denied Medicaid only for failing those rules are not eligible for marketplace subsidies. See what the six-month Medicaid delay changes.
- Fewer helpers. Navigator funding was cut, and new broker registrations are paused until February 2027.
What should I do before I renew?
- Do not auto-renew blind. If your insurer is leaving, you will be moved to another plan, possibly with a different network.
- Update your income estimate. With no repayment cap, an estimate that is too low can turn into a large tax bill in April 2028.
- Compare bronze and silver. If your income is below 250% of the poverty level, silver plans carry cost-sharing reductions that bronze plans do not.
- Check your doctors and prescriptions in the new plan's network and formulary.
- Look at catastrophic plans if you are under 30 or qualify for a hardship exemption.
This is general information, not advice on your situation. HealthCare.gov's window shopping tool shows real prices for your ZIP code.
What should small employers and self-employed people know?
If you run a small business, rising marketplace premiums affect you twice: as a cost for yourself if you are self-employed, and as a hiring issue if your staff buy their own cover.
Two arrangements let small employers contribute to individual-market premiums tax-free:
- QSEHRA, for employers with fewer than 50 staff, with annual contribution limits set by the IRS.
- ICHRA, for any size of employer, with no contribution cap and the option to vary amounts by employee class.
Both have notice and setup rules, and both interact with an employee's eligibility for marketplace subsidies. For a business that cannot afford a group plan, one of these is often the most practical benefit to offer. If benefits are part of a wider hiring and payroll setup you are building, talk to us.
Frequently asked questions
When is the deadline for ACA open enrollment 2027?
Choose a plan by 15 December 2026 for coverage from 1 January 2027. Open enrollment closes on 15 January 2027 in most states.
How much are Obamacare premiums going up in 2027?
The average benchmark silver premium rises about 13%, according to KFF: 11% in HealthCare.gov states and 16% in state-run marketplaces.
Do I have to pay back my ACA subsidy?
If your actual income is higher than your estimate, yes. From the 2026 tax year there is no cap on how much excess subsidy you repay.
Are the enhanced ACA subsidies coming back?
Not for 2027. They expired on 1 January 2026. The incoming Democratic Congress has named healthcare as a priority, but any new law would not change 2027 premiums already set.
Sources
KFF: 9 things to watch for 2027 open enrollment; CMS plan year 2027 fact sheet; NPR; healthinsurance.org for out-of-pocket limits; HealthCare.gov. As of 15 November 2026.
