ACA Marketplace shoppers face tighter 2027 deadline and proposed rate hikes

People who buy health insurance through the Affordable Care Act Marketplace will face a shorter federal enrollment window for 2027 coverage as insurers propose another year of double-digit rate increases and enhanced financial assistance remains expired.

For plans sold through the federally facilitated Marketplace, open enrollment will run from November 1 through December 15, 2026. Under a rule finalized by the Centers for Medicare & Medicaid Services, enrollments made during the open-enrollment period must begin January 1, 2027.

The tighter calendar does not automatically mean consumers will lose coverage. It does give shoppers less time to review plan changes, update household information and compare the full cost of coverage before the deadline.

What CMS changed

CMS changed the annual open-enrollment rules beginning with the 2027 plan year. Marketplace open-enrollment periods must start no later than November 1, end no later than December 31 and last no more than nine calendar weeks. Enrollments made during open enrollment must begin January 1.

The federal Marketplace will use the November 1-December 15 schedule. State-based exchanges may set different dates within those federal limits, so consumers should check whether their state uses HealthCare.gov or operates its own Marketplace before relying on the federal dates.

CMS said the shorter schedule is intended to reduce confusion, encourage continuous coverage and limit incentives for people to wait until they need medical care before enrolling. Those are the agency’s stated goals; the rule does not establish that a shorter enrollment period will automatically produce coverage gains or losses.

Why premiums are under pressure

KFF’s analysis of publicly available filings from 276 insurers across all 50 states and Washington, D.C., found a 15% median proposed premium increase for 2027. KFF said that would be the second consecutive year of double-digit proposed increases.

The 15% figure is a national median of requested rate changes, not a final increase for every plan or enrollee. State regulators may approve different rates, and the effect on a household will depend on its location, plan, income, age, family size and eligibility for financial assistance.

A proposed insurer rate also is not the same as the final premium a consumer will see when 2027 plans are published. Insurers cited rising health care prices, broader inflation and labor shortages in their filings, according to KFF. They also pointed to individual-market factors, including the expiration of enhanced premium tax credits and a potentially sicker risk pool after those larger subsidies ended.

Why the subsidy change matters

The enhanced premium tax credits that began in 2021 expired at the end of 2025 and have not been renewed by Congress, according to KFF’s consumer guidance. Many Marketplace enrollees who still qualify for premium tax credits receive less assistance, while some people may no longer qualify for a credit at all.

That change can raise a household’s monthly payment even when an insurer’s underlying premium changes by less than the national median. Consumers should update projected income and household information rather than assume last year’s subsidy will continue.

What shoppers should check

A lower monthly premium is not necessarily the least expensive plan overall. Before choosing coverage, compare the deductible, copayments, coinsurance and annual out-of-pocket maximum. A plan with a cheaper premium may require more spending when medical care is used.

Consumers should also confirm that their doctors, hospitals and prescription medications remain covered. Provider networks, drug formularies and plan designs can change from one year to the next.

Do not assume an automatically renewed plan will remain the best or cheapest option. Review the renewal information and compare it with all available plans during the applicable enrollment period.

People who lose qualifying coverage or experience another qualifying household or residence change may be eligible for a Special Enrollment Period. Eligibility depends on the event and, in some cases, prior coverage or documentation. CMS guidance says eligible consumers generally have 60 days from a qualifying event to select or change Marketplace coverage, but event-specific rules apply.

For case-specific information, consumers should use HealthCare.gov or their state Marketplace. The next major steps are for regulators to finalize insurer rates and for exchanges to publish the 2027 plans and subsidy amounts consumers will see during enrollment.

Sources

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