ACA open enrollment opens with benchmark premiums up 13% for 2027
Marketplace shoppers face a second straight year of double-digit premium increases, and a higher cap on what they can be asked to pay for care.
Open enrollment for 2027 coverage on the Affordable Care Act (ACA) marketplaces began Sunday, and the plans on offer cost more again. The benchmark silver premium, the plan that sets the size of federal tax credits, is up 13% on average for 2027, according to a KFF analysis of finalized rates1 published Oct. 30.
That follows a 26% increase for 2026. Taken together, benchmark premiums rose 42% on average between 2025 and 2027, KFF found. For a 40-year-old, the national average benchmark premium goes from $625 a month this year to $704 in 2027, according to KFF's state data2.
The increase lands hardest on people who get no help paying. The enhanced premium tax credits expired at the start of 2026, so households earning more than 400% of the federal poverty level receive no tax credit and pay the full premium. For this enrollment season that cutoff is $63,840 for a single person, $86,560 for a couple and $109,280 for a family of three, according to KFF Health News3. People who do qualify are partly shielded, because their tax credit is tied to the benchmark plan's price. Anyone whose chosen plan rose faster than the benchmark still pays the difference.
Where premiums are rising most
The increases depend on where people live. Benchmark premiums are rising about 11% on average in states that use HealthCare.gov and about 16% in states that run their own marketplaces, KFF found. In KFF's state figures, Montana's average benchmark premium for a 40-year-old rises from $692 to $889 a month, and New York's from $817 to $1,041.
Costs at the point of care can rise too. The most a marketplace plan can require someone to pay in deductibles, copays and coinsurance for covered in-network care in 2027 is $12,000 for one person and $24,000 for a family, according to federal guidance issued in January4. That is up about 13.2% from $10,600 and $21,200 in 2026. Lower limits apply to some lower-income enrollees.
The Centers for Medicare & Medicaid Services (CMS), which runs HealthCare.gov, did not give an average premium change in its Oct. 30 fact sheet5. It said more than 75% of people who buy through HealthCare.gov will have access to a plan at or below $50 a month in 2027, and that shoppers can choose from about 100 plans offered by five to six insurers on average.
A smaller market
Fewer people are expected to buy. KFF notes that the Congressional Budget Office projects marketplace enrollment falling from a peak of 22.4 million in 2025 to 13.1 million in 2027. Insurers estimated that changes in who is enrolling added about four percentage points to 2026 premiums, and they expect a similar effect in 2027, KFF reported.
Some insurers are pulling back. As of Oct. 29, 11 insurers had announced plans to leave at least one state for 2027, including Cigna, which is leaving the individual market in all 11 states where it sells plans. Seven had announced plans to enter a new state.
Signing up through an agent also works differently this year. On HealthCare.gov, a consumer must now authorize an agent or broker electronically before the agent can act on an application. CMS added the step after it canceled about 315,000 enrollments6 covering more than 760,000 people on Aug. 31 that it had confirmed were unauthorized. CMS has also paused 2027 registration for agents who did not have an active 2026 agreement. The National Association of Benefits and Insurance Professionals sued over that pause on Oct. 15, arguing it shuts out 19,000 agents, according to KFF Health News.
What comes next
Open enrollment on HealthCare.gov runs through Jan. 15, 2027, and dates can differ in states that run their own marketplaces. The first sign-up counts will show whether enrollment is falling as far as the budget office projects, and whether higher prices are pushing buyers toward cheaper plans with higher deductibles.
