Open enrollment for Affordable Care Act marketplace plans began on Sunday, November 1, 2026, in most states and runs through January 15. Shoppers logging on to HealthCare.gov this week are meeting higher prices, fewer plan choices and, for some of them, no financial help at all.
Health policy analysts expect the average price of marketplace coverage to rise about 13% for 2027, based on KFF's reading of newly released data from the Centers for Medicare & Medicaid Services. Earlier in the year, insurers' proposed rate filings pointed to a median increase of roughly 15%, with weighted averages ranging from under 7% in Vermont, Iowa and Utah to 29% in Arizona.
Most enrollees receive premium tax credits that rise along with the benchmark plan's price, which softens the blow. Buyers who do not qualify absorb the whole increase.
The subsidy cliff is now two years deep
The enhanced subsidies created during the pandemic under the American Rescue Plan Act and extended by the Inflation Reduction Act expired at the end of 2025, and Republicans in Congress declined to renew them. By the Associated Press's account, that cost the exchanges 1.2 million sign-ups.
About 19.2 million people were actively enrolled in marketplace plans as of February, according to the Department of Health and Human Services — a figure built up over years in which the extra help was available. At the start of 2026, 87% of marketplace enrollees were getting premium subsidies.
"They may or may not be able to afford to continue to keep their coverage into next year," said Cynthia Cox, vice president and director of the ACA program at KFF, noting that "a lot of them have already moved into bronze plans, which are the cheapest plans." Her expectation for this season is blunt: "I think there's going to be fewer people enrolled in this market, but it's going to be harder to understand why."
A CMS fact sheet distributed on Friday took the opposite tone, saying that "Americans using HealthCare.gov will have robust access to low-cost plans."
Who loses eligibility in 2027
The rule change with the sharpest edge is about immigration status. Starting with the 2027 plan year, marketplace subsidies are limited to lawful permanent residents, Cuban-Haitian Entrants and migrants under the Compacts of Free Association. Asylees, refugees, holders of Temporary Protected Status and most people on temporary visas lose eligibility, even though they remain lawfully present in the country.
KFF estimates that roughly 1 million people will become uninsured by 2035 as a result. Cost-sharing reductions, which lower deductibles and copays, are restricted along the same lines.
The administration has also been trimming the rolls directly. In September, Vice President JD Vance and other officials announced a plan to remove 760,000 enrollees whom they alleged were fraudulent or did not exist; Vance put the saving at $2.2 billion.
What some states are doing
A handful of states are trying to patch the gap with their own money. Rhode Island's fiscal 2027 budget sets aside $19 million to replace part of the lost federal help, and Virginia is standing up a state subsidy program. Oregon is moving to a state-run platform called Explore Health, where window shopping opened on October 15.
For everyone else, the arithmetic of this enrollment season is simple and unforgiving: a 13% average increase lands on a market where the main cushion against increases was removed two years ago.
Reporting from the Associated Press, KFF and healthinsurance.org.
