Open enrollment for Affordable Care Act health plans covering 2027 begins Nov. 1 in most states and runs through Jan. 15, and shoppers will notice changes both large and small, according to reporting from KFF Health News carried by NPR. Premiums are rising again, enrollment rules are tighter, and some immigrants have lost eligibility for subsidies.
Higher premiums, smaller subsidies
Enhanced subsidies expired at the end of 2025 after Congress did not renew them, and policy experts say millions of people dropped or lost coverage in the first months of this year. Premiums for 2027 are slated to rise about 15%, slightly less than last year's average increase of 26%, which was the largest in years.
Most people who buy ACA coverage will still receive a subsidy, but it is less generous than before. Subsidies are income-based and end for households earning more than four times the federal poverty level: $63,840 for a single person, $86,560 for a couple and $109,280 for a family of three. "For most folks, overall affordability will stay about the same," said Louise Norris, a health policy analyst at HealthInsurance.org, though she added that "that's not to say it's great."
The most a consumer can be required to pay out of pocket for in-network care is also growing. The cap rises 13% in 2027, to $12,000 for an individual and $24,000 for a family, up from $10,600 and $21,200.
More identity checks for people using brokers
The federal marketplace, which serves 29 states, is adding fraud protections for people who enroll through an agent or broker. All such consumers will need a one-time confirmation code or link, sent by text, email or automated call, to authorize a specific agent. Consumers CMS considers "high-risk," including first-time applicants, people changing states, people working with a new agent and those with a monthly premium of $30 or less, must also verify their own identity through an approved third party such as Experian. State-run exchanges are not covered by these requirements.
Experts see tradeoffs. Georgetown's Stacey Pogue said the changes may target fraud appropriately but "might also create extra hurdles" for people who lack a credit file or have moved or changed names.
A moratorium on new brokers
CMS has also barred agents who were not registered with the federal marketplace in 2026 from helping with 2027 enrollments until February at the earliest. Two agent groups have sued over the moratorium. Pogue's advice: don't delay. "I would reach out early," she said, since broker appointments may fill faster.
Immigrant eligibility
The One Big Beautiful Bill Act, passed last year, removes subsidy eligibility for many lawfully present immigrants, including refugees, asylees and people with temporary protected status. Green-card holders, certain Cuban and Haitian immigrants and citizens of Micronesia, the Marshall Islands and Palau can still receive subsidies.
Shopping tips
Experts urge consumers not to let plans auto-renew. Premiums, deductibles and coverage can change even for the same plan, some insurers, including Cigna, have dropped all or part of their ACA coverage areas, and cheaper options may exist.
Sources: NPR, KFF Health News