ACA Open Enrollment Opens With 13% Premium Hikes

The open enrollment period for the Affordable Care Act begins Sunday in most states and runs through January 15.

People signing up for health insurance in 2027 should expect higher premiums and fewer coverage options. A major shift in the marketplace involves the expiration of financial assistance for many groups that were previously eligible. This includes changes to premium tax credits and cost-sharing reductions. Stricter enrollment checks and new restrictions on immigrants will also take effect during this period.

Healthcare experts predict that less coverage and higher prices will be the norm. The average price of health insurance bought through the marketplaces is expected to rise by 13% in 2027, according to an analysis of new CMS data by the KFF. This nonprofit healthcare research group cites several drivers for the increase. These include rising healthcare costs, hospital market concentration, and the impact of the No Surprises Act. The availability of GLP-1 drugs also plays a role in the rising costs.

Cynthia Cox, a vice president and director of the ACA program at KFF, said those who do not qualify for a subsidy will be most affected. She noted that many of these individuals have already moved into bronze plans, which are the cheapest options available. "They may or may not be able to afford to continue to keep their coverage into next year," Cox said.

The price of ACA insurance has risen sharply for many people during the current administration. This follows a decision by Republicans not to extend COVID-era subsidies that had offset costs for most enrollees under the previous administration. As a result, 1.2 million fewer people signed up for coverage in the exchanges. As of February, roughly 19.2 million people in the United States were actively enrolled in ACA marketplace health plans, according to the Department of Health and Human Services.

New regulations starting in 2027 will limit tax credits for certain lawfully present immigrants. This change could lead to an additional 1 million uninsured individuals over time. The administration has also been removing ACA enrollees from the program as part of a campaign to address what it calls waste, fraud, and abuse. In September, Vice President JD Vance and other officials announced plans to remove 760,000 ACA enrollees. They alleged these individuals were fraudulently enrolled or did not exist. Vance said these actions would result in $2.2 billion in cost savings.

A CMS fact sheet distributed Friday states that Americans using HealthCare.gov will have access to low-cost plans. However, Cox said it is unclear how many more people will drop off ACA coverage in 2027. She noted that with higher premiums and new eligibility changes, there will likely be fewer people enrolled in the market. "It's going to be harder to understand why," she said.

The sign-up window for the marketplace is now open. Consumers can begin applying for plans that start on January 1, 2027.