If you buy your own health insurance, this is the season to look closely. Open enrollment for 2027 Affordable Care Act (ACA) marketplace plans began Nov. 1, and this year shoppers face rising premiums, fewer insurers in some states and several rule changes. As of Wednesday, at least 11 insurers have announced plans to leave the ACA marketplace in at least one state next year, The Week reported.
Here is what families should know, in plain terms.
Premiums are up again
The benchmark silver plan, the plan used to calculate financial help, will cost an average of 13% more in 2027, according to health policy group KFF. That is the second straight year of double-digit increases. Benchmark premiums rose 26% in 2026 and are up 42% from 2025 to 2027, KFF found.
Most marketplace enrollees still qualify for a subsidy, called a premium tax credit, that lowers what they pay. But enhanced subsidies expired, and people with incomes above 400% of the federal poverty level no longer get any tax credit, ABC News and KFF reported.
Some insurers are leaving
KFF counted 11 carriers exiting at least one state for 2027, while seven announced they are entering a new state. The biggest exit is Cigna, which will leave all 11 states where it offers ACA plans, affecting more than 350,000 people, according to ABC News. The Week reported that UnitedHealth and PacificSource are among the others pulling back.
Experts warn the changes could disrupt care. University of Pittsburgh professor Miranda Yaver told NBC News, as quoted by The Week, “This is going to create a lot of discontinuities in care and coverage.”
If your insurer is leaving your state, you will need to choose a new plan. That can also mean a new list of in-network doctors and hospitals, so check before you switch.
Key deadlines
In most states, open enrollment runs from Nov. 1, 2026, through Jan. 15, 2027, ABC News reported. Some states differ:
- HealthCare.gov states: Pick a plan by Dec. 15, 2026, for coverage that starts Jan. 1, according to healthinsurance.org.
- Idaho: Enrollment closes Dec. 15, 2026.
- Massachusetts: Jan. 23. Virginia: Jan. 29.
- California, D.C., New York and Rhode Island: Jan. 31.
Other changes to know
- Tax-time surprises: Caps on paying back extra premium tax credits have been eliminated starting with the 2026 tax year, KFF reported. If your income ends up higher than you estimated, you could owe more when you file. Update your income on your application if it changes.
- Some immigrants lose subsidies: Under the 2025 reconciliation law, only lawful permanent residents, certain Cuban and Haitian entrants and residents under the Compact of Free Association keep eligibility for tax credits. Others, including refugees and asylees, can buy coverage but without help, KFF and ABC News reported.
- Medicaid work requirements: Starting in 2027, people denied Medicaid for not meeting work requirements also lose eligibility for marketplace tax credits, according to KFF.
- Fewer helpers: A pause on new agent and broker registrations runs until February 2027, and funding for navigators who help people sign up was cut, KFF said.
- State help: Some states, including New Mexico, California, New Jersey, Rhode Island and Virginia, are using their own money to replace some lost federal help, according to KFF.
Enrollment has been falling. About 19.2 million people were enrolled early in 2026, roughly 3 million fewer than a year earlier, ABC News reported. The Congressional Budget Office projects marketplace enrollment could drop to 13.1 million in 2027, KFF noted.
Why it matters for families
Health coverage protects your family from big medical bills, and an unexpected gap can be costly. Do not let your plan simply renew without checking it. Compare the monthly premium, the deductible, and whether your doctors and medicines are covered. Small differences can add up over a year.
A few simple steps can help:
- Log in early and review your current plan’s 2027 price and network.
- Update your household income and family size so your subsidy is accurate.
- Make a list of your doctors and regular prescriptions and check each plan.
- Write down your state’s deadline on the family calendar.
This article is general information, not medical, legal or financial advice. If you have a health condition or take regular medications, talk with your doctor or pharmacist about which coverage features matter most for you. For plan questions, contact your state marketplace or HealthCare.gov.
With flu season arriving early this year, it is also a good time to make sure your coverage is in place before winter. Our cold and flu season basics can help your family stay well.
What to watch next
Policy debates over health subsidies may return after Tuesday’s elections, and several court cases over marketplace rules are ongoing, according to KFF. Upstormed News will follow changes that affect what families pay.
Read more: Less From the Package: What New Research Says About Ultra-Processed Foods
Is your family shopping for a new health plan this year, and what matters most to you when you compare?
Sources: The Week, “Insurers flee healthcare markets ahead of open enrollment” (November 4, 2026); ABC News via Yahoo News, “With premiums on the rise, what to know as ACA coverage open enrollment begins” (November 2, 2026); KFF, “9 Things to Watch for the 2027 ACA Open Enrollment Period” (October 30, 2026); healthinsurance.org, “What are the deadlines for the ACA’s open enrollment period?” (updated October 28, 2026)
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