Open Enrollment 2027: What Changed and What to Do

Open enrollment for 2027 health insurance starts November 1 — and this year's sign-up season looks different from anything buyers have seen in five years. The expanded federal subsidies that softened premiums from 2021 through 2025 have expired, insurers have asked for a median premium increase of about 15%, and a returned income limit could wipe out your entire tax credit if a raise pushes you just over the line. If you buy your own coverage through the Health Insurance Marketplace, the few minutes you spend shopping this fall matter more than ever.

If you buy your own coverage through the Health Insurance Marketplace, the few minutes you spend shopping this fall matter more than ever. Here is what changed, the dates you cannot miss, and how to enroll smart before December 15.

The dates that matter

On HealthCare.gov — the marketplace used by most states — open enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027. Enroll by December 15 and coverage starts January 1; enroll December 16 through January 15 and it starts February 1. A federal proposal to end enrollment on December 15 was vacated in court in June 2026, so the January 15 deadline stands. State-run marketplaces set their own windows — check your state's site if you don't use HealthCare.gov. And if you are on Medicare: Annual Enrollment runs October 15 through December 7, 2026 — it is happening right now.

The biggest change: the subsidy cliff is back

From 2021 through 2025, enhanced premium tax credits expanded Marketplace subsidies beyond the original Affordable Care Act income limits. Those credits expired on December 31, 2025, and Congress has not renewed them.

For 2027, federal premium tax credits are again limited to households with income between 100% and 400% of the federal poverty level — roughly $15,960 to $63,840 for a single person. Above that threshold, the credit drops to zero. A raise, a bonus, or side-business income can move a household over the line — licensed agent Jack DeBrabander calls the 400% cliff "the change that most often surprises people."

Your credit equals the benchmark plan premium minus your "expected contribution," a share of income set by IRS Rev. Proc. 2026-26: from 2.15% at the lowest eligible incomes up to 10.22% for households between 300% and 400% of the poverty line. The exact dollar amount also depends on your county, age, and which carriers sell plans near you.

There is also a sting in the tax rules this year: the old cap on repaying excess advance credits is gone. If you underestimate your 2027 income when you enroll, you repay every dollar of extra subsidy at tax time. When in doubt, project slightly high — and update your application mid-year if your income changes.

Most people let their plan renew automatically because it worked last year. This year, the plan they have may cost more, may have a different network, or may not be offered at all. — Jack DeBrabander, licensed health insurance agent

Premiums are rising — and last year was a preview

Insurers have proposed a median premium increase of about 15% for 2027 plans. That follows a painful 2026: when the enhanced credits ended, the average premium payment rose 58%, and deductibles jumped 37% as shoppers shifted to cheaper Bronze plans. The 2027 out-of-pocket maximum rises to $12,000 for an individual and $24,000 for a family.

Several carriers are also leaving the marketplace in some areas. Automatic re-enrollment continues for 2027, but it will not update your premium, your network, or your subsidy eligibility. Letting last year's plan roll over blindly is the most expensive mistake you can make this season.

What to do before December 15

Here is a practical checklist, in order:

1. Estimate your 2027 income honestly — raises, bonuses, freelance income, a spouse's earnings. The income you enter sets your monthly credit; if in doubt, project slightly high, since you reconcile at tax time.
2. Read your renewal notice. Confirm the plan still exists, the new premium, and that your doctors remain in-network. Assume nothing.
3. Shop actively and compare on total cost. After your credit is applied, compare premium plus deductible plus out-of-pocket maximum — not the monthly premium alone.
4. Check your network and prescriptions. Narrower networks are a common cost-cutting move; verify your doctors and drugs before switching.
5. Get free help if it is complicated. Navigators and licensed agents help at no cost — worth it near the 400% cliff or with immigration-status questions.

Metal tier	Typical trade-off	Good fit if
Bronze	Lowest premium, highest deductible	You are healthy, rarely need care, and can handle a big bill
Silver	Balanced premium and deductible; only tier with extra cost-sharing reductions	You qualify for cost-sharing reductions or expect moderate care
Gold	Higher premium, lower deductible	You expect regular care or a planned procedure in 2027

Frequently asked questions

Are the enhanced ACA subsidies coming back for 2027?

Not unless Congress acts. The enhanced premium tax credits available from 2021 through 2025 expired at the end of 2025 and remain unavailable for 2027. The House has debated an extension, but nothing has been signed into law. Standard premium tax credits still exist within the 100–400% poverty-level range.

What happens if I miss the January 15 deadline?

You generally cannot enroll in a Marketplace plan until next fall unless you qualify for a Special Enrollment Period — triggered by events like losing coverage, moving, getting married, or having a baby. Missing the window can mean going without coverage for most of the year.

Why did my premium jump if my plan looks the same?

Two forces: the expired enhanced subsidies, which had been absorbing part of the premium, and roughly 15% median insurer rate requests for 2027. Your income, age, and location also move the benchmark math each year.

Does any of this apply in the UK?

Not directly — the UK has the NHS, so there is no open enrollment season for basic health cover, though employer benefit windows and private insurance renewals are still worth reviewing each autumn.

The throughline for 2027 is simple: enroll on purpose. Update your income, read the renewal notice, re-shop the tiers, and confirm your network — all before December 15. The households that get hurt this season will not be the ones with the worst plans, but the ones that never looked.