Health Coverage Open Enrollment Opens for 2027 as Benchmark Premiums Rise 13 Percent After Subsidy Expiry

Open enrollment for 2027 health coverage through HealthCare.gov begins on Sunday, November 1, 2026, and shoppers are entering the market at a moment of sharply higher prices. A KFF analysis published on October 30 found that premiums for the benchmark silver plan will rise by 13 percent on average for 2027, the second large increase in a row after a 26 percent rise from 2025 to 2026.

The new enrollment window runs through January 15, 2027, on HealthCare.gov, with a December 15 deadline for coverage that starts on January 1. It is also the second year of marketplace coverage without the enhanced federal premium help that expired at the end of 2025, a change that shapes what many households will actually pay. 2027 health premiums open enrollment November 2026

What Opens on November 1

The HealthCare.gov Window

On HealthCare.gov, the enrollment period for 2027 coverage runs from November 1, 2026, through January 15, 2027, according to the federal marketplace and the Centers for Medicare and Medicaid Services. During that window, people can enroll in a new plan, renew an existing plan, or change to a different plan for the coming year. State-run marketplaces may set their own dates, so shoppers outside the federal system need to check their own state’s timetable rather than assuming the federal dates apply everywhere.

The length of the window matters because health coverage decisions are rarely simple, and many households need time to compare monthly premiums, deductibles and networks. A longer window gives people room to update their income details, check whether a preferred doctor or hospital is covered, and weigh a lower monthly payment against higher costs when care is needed. It also gives enrollment helpers time to work through questions that often arise late in the process.

The December 15 Deadline

The key date inside the window is December 15, 2026, the last day to choose a plan for coverage that starts on January 1, 2027. People who enroll from December 16 through January 15 will generally see their coverage start on February 1 instead, once the first premium is paid. That split means the same plan can have a different start date depending on when the choice is made, and a late decision can leave a gap at the start of the year.

Shoppers who already have marketplace coverage should not assume that doing nothing is cost-free. Plans, prices and networks can change from year to year, and a plan that auto-renews may carry a higher bill in January than the household expected. Checking the new price before December 15 is therefore the practical step that protects both the start date and the monthly cost, even for people who intend to stay with the same insurer.

What the 13 Percent Rise Means

The Benchmark Silver Plan Explained

The benchmark silver plan is the second-lowest-cost silver plan available in an area, and it matters because federal premium tax credits are calculated from its price. When KFF reports a 13 percent average rise in benchmark premiums, it is describing that reference price, not the exact bill that any one household will receive. A person’s own premium will depend on where they live, their age, their income, the plan they choose and whether they qualify for help.

That distinction helps explain why two neighbours can see very different changes. One household may qualify for a larger tax credit that absorbs much of the benchmark rise, while another household above the subsidy limit may face the full increase. The benchmark figure is therefore best read as a signal about the market as a whole, rather than as a prediction for any single shopper’s monthly payment.

The Two Year Increase

The 2027 rise follows a 26 percent increase in benchmark premiums from 2025 to 2026, and KFF calculates that the two years together amount to about a 42 percent increase between 2025 and 2027. That two-year figure captures a rapid change in the cost of marketplace coverage, and it frames the current enrollment period as part of a longer affordability shift rather than a one-year blip. Households that enrolled in 2025 and stayed in the market have now faced two large annual increases in succession.

The split between marketplace types adds detail to the national average. In states that use HealthCare.gov, benchmark premiums are rising by 11 percent for 2027, after a 30 percent rise the previous year. In states that run their own marketplaces, the rise is 16 percent for 2027, after roughly 17 percent the previous year. Those differences show that the national average hides wide variation by state and by marketplace structure.

Why Premiums Are Rising Again

Higher Costs of Care

Insurers point to a higher-than-usual increase in the underlying cost of care as a central reason for the higher premiums, according to KFF’s review of rate filings. Medical care costs affect more than the marketplace, and some employer plans have also seen steep increases, which suggests the pressure is broader than one part of the health system. When hospitals, medicines and other services cost more, insurers pass part of that increase through in the premiums they charge.

The proposed rates tell a similar story at the filing stage. Insurers had proposed a median increase of about 15 percent for 2027, so the final average of 13 percent for benchmark plans came in slightly lower than the median proposal. Proposed changes varied widely across insurers, with most falling between 10 percent and 25 percent in the filings reviewed, which underlines how different the experience can be from one insurer and one state to another.

The Risk Pool Effect

A second factor cited in the filings is a change in who stays in the risk pool, meaning the mix of healthier and sicker people covered by marketplace plans. When healthier people leave the market, the average cost of covering those who remain tends to rise, because the remaining group uses more care on average. Insurers estimated that risk-pool changes added about four percentage points to premiums in 2026, and they expect a similar additional effect in 2027, according to KFF’s analysis of the filings.

That effect is closely linked to the end of the enhanced premium help, because the extra help had encouraged more people, including healthier shoppers, to enroll and stay covered. As that help expired, some people left the market, and the pool that remained became more expensive to insure. The result is a cycle in which higher prices push some people out, and their departure then pushes prices higher for those who stay.

The Subsidy Cliff Returns

The 400 Percent Cutoff

For 2027 coverage, the original Affordable Care Act rules apply again, and they include a hard cutoff for premium tax credits at 400 percent of the federal poverty level. Households above that line generally receive no premium tax credit at all, even if they are only slightly above it. The return of that cliff is one of the most consequential changes for shoppers in 2027, because a small change in income near the line can mean the loss of the entire credit rather than a gradual reduction.

Using the 2026 poverty guidelines for the 48 contiguous states and Washington, D.C., the cutoff works out to about 63,840 dollars for a single person and about 132,000 dollars for a family of four, according to the guidance summarised in reporting on the 2027 rules. Those figures are for 2027 coverage and depend on household size and the guidelines in force, so households near the line need to check their own position carefully. State-specific poverty guidelines can differ, notably for Alaska and Hawaii.

Who Pays the Full Price

Households above the cutoff pay the full, higher 2027 premium, with no tax credit to soften the increase. That group includes people who previously received help under the enhanced credits, which had extended assistance above 400 percent of poverty and capped what recipients paid at 8.5 percent of income. With that extra help gone, a household that was previously protected from the full price may now face it for the first time, and the jump can be large.

For households below the cutoff, help still exists, but it is calculated under the older, less generous formula. The amount a household is expected to contribute toward a benchmark silver plan ranges from 2.15 percent of income for those below 133 percent of poverty to 10.22 percent for those between 300 percent and 400 percent, under the revenue procedure figures reported for 2027. That range means the burden still rises with income, and it rises more steeply near the top of the eligible range.

What Has Changed Since 2025

The Enhanced Credits Expire

From 2021 through 2025, Congress boosted the premium tax credits that lower monthly marketplace payments, and those boosts helped more than 20 million enrollees, according to reporting on the programme. The enhanced credits lapsed at the end of 2025, and 2026 was the first year of marketplace coverage without them. The 2027 enrollment period is therefore the second year in which shoppers are buying coverage under the older rules, and the effects of that change are now visible in both prices and enrollment.

The expiry did not remove premium tax credits entirely, but it changed who qualifies and how much help they receive. People who previously benefited from the broader eligibility and the income cap may now qualify for less help or for none at all, depending on their income. That shift is a major reason why the same plan can cost a household considerably more in 2027 than it did in 2025, even before the latest premium increase is taken into account.

The Congressional Standoff

The political background to the expiry is a standoff in Congress over whether to extend the enhanced credits. Reporting describes the House passing an extension in early 2026, while the Senate had not acted on it as of mid-October 2026, so no extension had become law in time for 2027 pricing. That leaves the 2027 market priced without the enhanced help, unless Congress acts separately, and it leaves shoppers planning around the current rules rather than a possible future change.

The uncertainty itself creates a problem for households. People must choose a plan during open enrollment based on the law as it stands, even though a later congressional decision could change the help available. Insurers, too, must set prices without knowing whether extra help will return, which feeds into the cautious pricing seen in the filings. Any future extension would therefore arrive after many shoppers had already made their 2027 choices.

How Enrollment Has Already Moved

The Fall in Plan Selections

The enrollment figures from the last cycle already show the market shrinking. Plan selections fell by 1.2 million during the 2026 open enrollment period, according to KFF, and paid-up marketplace enrollment was down by 12 percent, or 2.6 million people, to 19.2 million by February 2026. Those figures describe a market that lost a significant share of its participants in a single year, at the same time as prices rose sharply.

The fall matters because it is both a consequence of higher prices and a cause of further pressure. When people drop coverage because they cannot afford it, the remaining pool becomes more expensive to insure, which can push prices higher again. It also means more people without coverage, with the health and financial risks that uninsurance brings, and it raises questions about whether the market can stabilise without a change in the help available.

The Enrollment Projection

Looking further ahead, the Congressional Budget Office has projected that marketplace participation will fall from a peak of 22.4 million people in 2025 to 13.1 million in 2027. That projection, reported in coverage of the 2027 enrollment period, is a forecast rather than a final count, and it will depend on prices, congressional action and how many people find other coverage. Even so, the scale of the projected fall shows how seriously analysts view the current affordability squeeze.

The projection also puts the 2027 enrollment window in context. This is not only a period for renewing coverage, but a test of how many people will stay in a market that is now considerably more expensive than it was two years ago. The final 2027 enrollment count, when it is published after the window closes, will be one of the clearest measures of whether the market has found a new, smaller level or whether further falls are still to come.

What Shoppers Can Still Find

The 50 Dollar Claim Explained

The Centers for Medicare and Medicaid Services, in its Plan Year 2027 fact sheet dated October 30, did not give an average premium change, but it did highlight affordability for shoppers who qualify for help. The fact sheet says more than 75 percent of HealthCare.gov shoppers will still have access to premiums at or below 50 dollars a month after tax credits. That figure applies to shoppers who are eligible for tax credits and who choose a plan at that price point, and it does not describe the experience of households above the subsidy cutoff.

The fact sheet also describes, in reporting on its contents, a position in which people eligible for tax credits can obtain a plan with nearly 90 percent of the lowest-cost premium paid by the federal government. Those claims are best read alongside the KFF benchmark figures, because they describe what is possible with help, while the benchmark rise describes the underlying price before help is applied. A shopper’s own result will depend on income, location and the plan chosen.

The Choice of Plans

For HealthCare.gov states, the fact sheet describes an average of about 100 plans from five to six insurers to choose from, including an average of 35 plans eligible for a health savings account. That breadth of choice means shoppers can compare monthly premiums, deductibles, networks and other features, rather than accepting a single price. It also means the cheapest premium is not always the best value for a household that expects to use care regularly.

State examples underline the variation hidden inside national averages. Michigan approved an average increase of 14.2 percent for individual-market coverage in 2027, and 9.6 percent for small businesses, according to its state insurance department. In North Carolina, approved increases for individual plans ranged from 8.35 percent to 27.36 percent for 2027, according to its state insurance department. Those ranges show why a national average, on its own, cannot tell a household what its own bill will be.

What Happens Next

The Court Case Over Deadlines

The enrollment window itself has been shaped by a court case. A 2025 federal rule would have ended HealthCare.gov enrollment on December 15, 2026, but a federal court vacated that part of the rule in June 2026, and the marketplace currently lists January 15, 2027, as the last day to enroll. The government appealed that decision, and an appeals hearing was scheduled for October 30, according to reporting on the case, so the final legal position on the deadline remains subject to that appeal.

Reporting in August 2026 described a federal official confirming that the window would run through January 15, 2027, regardless of the appeal outcome, but the appeal itself means shoppers should still watch for any change. For now, the practical position is clear: HealthCare.gov lists January 15 as the closing date, with December 15 as the deadline for January 1 coverage. Any change to that position after the appeal would need to be communicated clearly to avoid confusion late in the window.

Questions Still Unanswered

Several important questions remain unanswered, and this post flags them rather than presenting them as settled. It is not yet known what the final 2027 enrollment total will be, whether Congress will extend the enhanced premium credits, or what the outcome of the deadline appeal will be. It is also not yet known how individual households will fare, because prices vary by state, age, income and plan, and the national averages cannot predict any single bill.

Other questions concern the longer-term shape of the market. It is not yet known whether the Congressional Budget Office projection of a fall to 13.1 million participants will prove accurate, whether risk-pool pressures will ease or intensify in 2028, or whether insurers will adjust their 2028 filings in response to the 2027 enrollment results. For now, shoppers face a clear set of dates, a higher benchmark price, and a return to the older subsidy rules, and the answers to those wider questions will emerge only as enrollment closes and Congress decides.

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