ACA marketplace opens with 13% premium jump for 2027
The enrollment period begins Sunday with tighter subsidy rules and stricter checks on immigrants and existing enrollees.
By Tyler Khalil ·
The Affordable Care Act open enrollment period started Sunday in most states.
The sign-up window runs through January 15. People who sign up for 2027 coverage face higher prices and fewer options than in previous years.
The average price of health insurance bought through the marketplaces is expected to rise by 13 percent in 2027. KFF, a healthcare research nonprofit, calculated that figure using new data from the Centers for Medicare & Medicaid Services.
Cynthia Cox, vice president and director of the ACA program at KFF, said rising healthcare costs and hospital market concentration drive the increases. She also cited the No Surprises Act and the growing use of GLP-1 drugs as factors. The act, which took effect in 2022, bans surprise billing.
The price hikes hurt people who do not qualify for subsidies the most. Cox noted that many of these individuals have already switched to bronze plans, the cheapest tier. "They may or may not be able to afford to continue to keep their coverage into next year," she said.
Financial assistance has narrowed. Premium tax credits and cost-sharing reductions are now restricted for groups that previously qualified. Republicans opposed extending the subsidies enacted during the Biden administration. That decision led to 1.2 million fewer people signing up for coverage on the exchanges.
New regulations starting in 2027 will limit tax credits for certain lawfully present immigrants. That change could leave an additional 1 million people uninsured over time. The Trump administration is also removing enrollees from the program to cut 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 those individuals were fraudulently enrolled or did not exist. Vance said the cancellations would save the government $2.2 billion.
As of February, roughly 19.2 million people were actively enrolled in ACA marketplace plans. That number grew during the pandemic when the American Rescue Plan Act and Inflation Reduction Act provided enhanced subsidies. A CMS fact sheet distributed Friday says Americans using HealthCare.gov will have access to low-cost plans.
Cox expects fewer people to remain enrolled in the market in 2027. She said it will be harder to understand why enrollment drops because of the combined effects of higher premiums, immigration changes, and anti-fraud efforts.
