Open enrollment for 2027 Affordable Care Act coverage began on Sunday, November 1, on HealthCare.gov, two days before Tuesday's midterm elections, with benchmark premiums up sharply for a second straight year and the extra federal help that held prices down now gone.
The benchmark silver plan — the plan federal subsidies are pegged to — costs 13% more on average for 2027, according to KFF's analysis of the finalized rates: 11% higher in states that use HealthCare.gov and 16% higher in states that run their own marketplaces. That follows a 26% jump for 2026, putting benchmark premiums up 42% in two years.
Insurers' own rate filings point to two drivers: the rising cost of medical care itself, and the changed pool of buyers since the enhanced premium tax credits expired at the end of 2025. Insurers estimated that shift alone added about four points to premiums. Households earning more than 400% of the federal poverty level — $63,840 for a single person — now get no federal help at all and pay the full price.
Most enrollees still qualify for a subsidy, and the Centers for Medicare and Medicaid Services says more than 75% of HealthCare.gov shoppers will have access to a plan at $50 a month or less after credits in 2027, with every shopper able to choose an HSA-eligible plan. The people exposed to the full increase are those above the cutoff — and anyone who lets a plan renew without comparing. Shoppers who enroll by December 15 are covered from January 1; the window runs through January 15.
Enrollment has already fallen: sign-ups dropped by 1.2 million for 2026, and paid enrollment stood at about 19.2 million in February, down 12% from a year earlier. Eleven insurers are leaving at least one state market for 2027 while seven are entering new ones, and the yearly out-of-pocket cap rises to $12,000 for an individual and $24,000 for a family. Some states are using their own money to replace part of the lost federal help — New Mexico in full, California in part, with Rhode Island and Virginia setting up new state subsidies for 2027.
The season also opens under the administration's fraud drive. CMS this year cancelled about 315,000 enrollments covering roughly 760,000 people it flagged as fraudulent or unauthorized, effective August 31 — a sweep Vice President JD Vance said returns about $2.2 billion in taxpayer subsidies. A small number of people wrongly cut have been put back, and about 419,000 more sign-ups are under review. Brokers now face identity re-verification and written consumer consent, and new broker registrations are frozen until February 1. "Federal subsidies should only go to eligible Americans, not to fraudsters gaming the system," CMS Administrator Dr. Mehmet Oz said in October. For taxpayers, every phantom enrollment removed is money that was going out the door for people who never asked for a plan, or never existed at all.
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