Open enrollment for 2027 Affordable Care Act coverage begins on Sunday, November 1, in most states, and millions of shoppers will open their marketplace accounts to find higher prices, fewer insurers and, in many cases, a plan that no longer exists.
It is the second straight year of double-digit premium increases, and it arrives after the expiration of enhanced federal subsidies that had kept coverage affordable for many middle-income families.
When enrollment opens — and the deadline that matters
On HealthCare.gov, open enrollment runs from November 1 to January 15. Shoppers must pick a plan by December 15 for coverage starting January 1; miss it, and coverage may not start until February. Some states run their own exchanges with different dates — Oregon, for example, joins the list of state-run marketplaces in 2027, so its residents can no longer sign up through HealthCare.gov.
Why premiums are rising again
Insurers proposed a median premium increase of 15 percent for 2027, according to KFF’s analysis of filings from 276 insurers in every state and Washington, D.C. — the second consecutive year of double-digit proposed increases. Finalized benchmark silver premiums rose by an average of 13 percent for 2027, KFF found, with HealthCare.gov states up 11 percent and state-run marketplaces up 16 percent.
The increases follow an even steeper jump going into 2026, when benchmark premiums rose 26 percent from 2025 and the median finalized increase was 20 percent. A plan that rose by the median in both years would have gone from about $500 a month in 2025 to about $600 in 2026 and roughly $690 in 2027 — a 38 percent jump in two years.
Insurers point to rising underlying health care costs, including higher provider fees and soaring prescription drug prices. They also cite the expiration of the enhanced premium tax credits and the resulting change in who stays insured.
The subsidy cliff
Most enrollees still receive a subsidy that cushions the increase. But people with incomes above 400 percent of the federal poverty level are particularly hard hit, KFF notes, because they no longer qualify for premium tax credits at all and must pay the full cost of coverage.
The consequences of the subsidy expiration are already visible in enrollment. Individual market enrollment fell 18 percent by June 2026, from 25.2 million to 20.5 million people — a loss of more than 4.6 million. Marketplace enrollment had already fallen from a high of 22.1 million in 2025 to 19.2 million in February 2026, the first drop since President Trump’s first term.
Fewer insurers, disappearing plans
At least seven health insurers have announced they will stop selling marketplace coverage in 2027, according to a Commonwealth Fund analysis, forcing enrollees in 20 states to pick new plans. A separate tally by healthinsurance.org put the number of states with insurer exits at 24.
Final approved increases vary widely by state, from about 3 percent in Vermont to nearly 28 percent in Arizona, according to healthinsurance.org’s state-by-state tracker. Out-of-pocket exposure is growing too: the most an individual can be required to pay for covered care in 2027 rises to $12,000, up from $10,600 in 2026, and to $24,000 for families.
A plan that renews automatically can cost far more next year, and a plan that disappears may be replaced with one that does not cover a family’s doctors or prescriptions, so experts urge shoppers to compare actively rather than letting coverage roll over. First, check whether your current plan still exists and whether your doctors and prescriptions are still covered. Second, compare the full cost — premium plus deductible — not just the monthly price: the average deductible for a bronze plan in 2026 was about $7,500, according to KFF.
| Enrollment opens | November 1, 2026 (most states) |
| Deadline for January 1 coverage | December 15 |
| Enrollment closes (HealthCare.gov) | January 15, 2027 |
| Median proposed premium increase | 15 percent |
| Average finalized benchmark silver increase | 13 percent |
| Individual out-of-pocket maximum | $12,000 (up from $10,600) |
| Family out-of-pocket maximum | $24,000 |
| Enrollment change by June 2026 | 25.2 million down to 20.5 million |
Sources: KFF, “9 Things to Watch for the 2027 ACA Open Enrollment Period,” October 2026; KFF/Peterson Health System Tracker analysis of 2027 premiums; Commonwealth Fund analysis, October 8, 2026; healthinsurance.org 2027 rate tracker; HealthCare.gov dates and deadlines; AARP, October 2026.
