For millions of American families, the season of health insurance decisions is here, and the price tags for 2027 are higher again. Affordable Care Act marketplace open enrollment began Nov. 1 in most states, Medicare’s annual enrollment window closes Dec. 7, and many workers are choosing employer benefits right now. Across all three, the newest figures point the same direction: families will pay more, which makes shopping carefully more valuable than ever.
The numbers right now
- ACA marketplace premiums: The average benchmark silver premium is rising 13% for 2027, to about $703 a month before subsidies, according to KFF. It is the second straight year of double-digit increases and about 42% higher than in 2025. Increases are about 11% on average in HealthCare.gov states and 16% in states running their own exchanges.
- Wide state differences: Average pre-subsidy rate changes range from about 3% in Vermont to nearly 28% in Arizona, healthinsurance.org reports.
- Out-of-pocket limit: The maximum out-of-pocket for marketplace plans rises to $12,000 in 2027, up from $10,600.
- Employer coverage: Family premiums at work averaged $28,303 in 2026, up 5%, with workers paying $7,471 of that, up 9%, according to KFF’s annual employer survey. Workers at small firms paid $9,687 on average. The average single-coverage deductible was $1,955.
- Medicare drug plans: The Part D out-of-pocket cap rises to $2,400 in 2027 from $2,100, and the standard deductible rises to $700 from $615. CMS projects the average stand-alone drug plan premium at about $36 a month, and the average Medicare Advantage premium falling to about $12.
- Medicare Part B: CMS had not announced the 2027 Part B premium as of this writing; it typically does so in mid-November. The Medicare Trustees projected about $209.50 a month, up from $202.90 in 2026.
What’s changing for marketplace shoppers
The enhanced federal premium tax credits that had lowered marketplace costs expired at the end of 2025. Most enrollees still get a subsidy, but households earning above 400% of the federal poverty level no longer qualify and pay the full price, KFF notes. Some lawfully present immigrants also lost eligibility for tax credits under the 2025 reconciliation law.
Fewer people are buying coverage. Marketplace enrollment was 19.2 million in early 2026, down about 12%, and the Congressional Budget Office projects further drops. About 11 insurers announced exits from at least one state for 2027, including Cigna, which is leaving the individual market in all 11 states where it sells plans, affecting more than 350,000 people, ABC News reported. If your insurer is leaving, you will need to pick a new plan.
The subsidy expiration has been a major point of debate in Washington. Democrats have pushed to extend the enhanced credits, arguing that families face sharp premium increases without them. Many Republicans and conservative groups have argued the credits were meant as a temporary pandemic measure and that the program needs a different approach, while some Republicans have backed an extension or an alternative to prevent steep increases, NPR reported. A handful of states, including New Mexico, California, New Jersey, Rhode Island and Virginia, are using state money to help fill some of the gap.
Key dates
- Medicare: Annual enrollment runs Oct. 15 through Dec. 7, with changes taking effect Jan. 1.
- HealthCare.gov states: Enroll by Dec. 15 for coverage starting Jan. 1; enroll by Jan. 15 for coverage starting Feb. 1.
- State-run exchanges: Deadlines vary. ABC News reports Massachusetts runs to Jan. 23, Virginia to Jan. 29, and California, D.C., New York and Rhode Island to Jan. 31. Check your state’s exchange.
What’s helping: some relief on prescriptions
There is good news on drug costs for older Americans. Medicare-negotiated prices for 15 more high-cost drugs, including the diabetes and weight-loss medicines Ozempic, Rybelsus and Wegovy, take effect in January 2027. CMS projects about $685 million in out-of-pocket savings for beneficiaries next year, Newsweek reported, and the $2,400 annual cap still limits what Part D enrollees pay for covered drugs. CMS also says about eight in 10 Medicare Advantage members can keep their current plan with the same or lower premium.
What you can do
- Do not auto-renew without looking. Premiums, networks and drug lists change every year, and some insurers are leaving markets.
- Update your income on HealthCare.gov or your state exchange. Subsidies are based on expected income, and a lower-cost plan may be available.
- Compare total costs, not just premiums. Add the deductible and out-of-pocket maximum; a gold plan can sometimes cost about the same as silver, KFF’s figures show ($694 versus $681 for the lowest-cost options on average).
- Medicare enrollees: Use the plan comparison tool at Medicare.gov to check that your prescriptions and doctors are covered before Dec. 7.
- At work: Compare each plan’s deductible and network, and check whether a health savings or flexible spending account fits your budget.
- Beware of unsolicited sales calls. KFF notes federal officials canceled about 760,000 marketplace enrollments flagged as possible unauthorized sign-ups this year. Enroll through official sites or a licensed helper you choose.
For questions about your own coverage or medications, talk with your doctor, pharmacist or a licensed insurance counselor.
Why it matters for families
Health coverage is one of the largest bills in many household budgets, and it is rising faster than paychecks for some families. A few hours of comparison shopping before the deadlines can mean hundreds or even thousands of dollars in savings, or a plan that actually covers the doctors and drugs your family needs.
What to watch next
CMS is expected to announce the official 2027 Medicare Part B premium and deductible in the coming days. Marketplace sign-up totals will show how many families keep coverage as costs rise, and Congress could revisit health care subsidies. Upstormed News will follow these developments.
How are rising health insurance costs affecting your family’s budget? Tell us in the comments.
This story is part of America Right Now, Upstormed News’ series on the changes American families are living through. Read the full series.
Related coverage: ACA Open Enrollment Is Here: Higher Premiums and Insurer Exits for 2027 · Radon: The Invisible Gas Every Family Should Test For This Winter
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Sources: KFF, “9 Things to Watch for the 2027 ACA Open Enrollment Period” (accessed Nov. 11, 2026); ABC News via ABC7, “With premiums on the rise, what to know as ACA coverage open enrollment begins” (Nov. 2, 2026); HealthCare.gov, “Health Insurance Marketplace” (accessed Nov. 11, 2026); healthinsurance.org, “2027 ACA open enrollment: what’s changing” (updated Nov. 9, 2026); KFF, “Workers now pay $7,471 on average annually for family health coverage, up 9%” (Oct. 22, 2026); CMS, “Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027” (Sept. 28, 2026); Newsweek, “Medicare open enrollment started: 3 major changes will hit seniors in 2027” (Oct. 20, 2026); BenefitsUSA, “Medicare Costs 2027: Part D Figures Announced, Part B Premium Due in November” (updated Oct. 26, 2026); NPR via WAMC, “5 things to know about the health care fight behind the shutdown” (Oct. 12, 2025)
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