On Sunday, Nov. 1, millions of Americans can start shopping for 2027 health coverage. Many will not like what they see. ACA open enrollment begins in most states with benchmark premiums rising 13% on average, according to a KFF analysis published Oct. 30. That comes on top of a 26% jump the year before.
Put those two years together, and a benchmark plan costs 42% more than it did in 2025. Washington’s favorite answer is a bigger subsidy. However, that treats the symptom. The real problem is the price of care itself, and conservatives should say so.
Key Takeaways
- ACA open enrollment on HealthCare.gov runs from Nov. 1, 2026, to Jan. 15, 2027. Pick a plan by Dec. 15 for coverage that starts Jan. 1.
- Benchmark silver premiums are up 13% on average for 2027, after a 26% increase for 2026, KFF says.
- Above 400% of the poverty line, or $63,840 for a single person, buyers get no premium tax credit and pay full price.
- Cigna is leaving the individual market in all 11 states where it sells, and insurer exits outnumber new entrants.
- Every HealthCare.gov shopper can now choose an HSA-eligible plan, CMS says.
What ACA Open Enrollment Looks Like This Year
First, the dates. On HealthCare.gov, enrollment runs from Nov. 1 through Jan. 15, 2027. To get coverage that starts Jan. 1, you need to pick a plan by Dec. 15, according to HealthCare.gov. Some states that run their own exchanges set different dates, so check yours.
Next, the bill. Insurers asked for a median increase of 15%. After review, KFF found benchmark silver premiums rising 13% on average. That breaks down to 11% in HealthCare.gov states and 16% in states that run their own exchanges. The benchmark is the second-lowest-cost silver plan in an area, and it sets the size of most subsidies.
Meanwhile, the out-of-pocket cap is climbing too. It rises 13%, to $12,000 for an individual and $24,000 for a family, KFF Health News reported. That is the most a household can owe for covered in-network care in a year, and it is a lot of money for a working household.
Why ACA Premiums Keep Climbing
Heading into ACA open enrollment, Democrats blame the end of the enhanced premium tax credits, which expired after 2025. They have a point, but only part of one. Insurers estimated that changes in the risk pool added about four percentage points to 2026 premiums, and they expect a similar bump in 2027, KFF says. When healthier people drop coverage, the people who remain cost more to insure.
Still, that is not the main driver. In their filings, insurers point first to the rising cost of care, plus inflation and labor shortages. KFF notes that this pressure is not unique to the ACA marketplaces. Employer plans feel it too, as we saw when workers’ share of family premiums jumped 9%.
In other words, subsidies do not make health care cheaper. They move the bill from the patient to the taxpayer. Because the tax credit grows when the benchmark premium grows, taxpayers absorb much of each increase for subsidized buyers. As a result, insurers and hospitals feel less pressure to hold the line on price.
The Middle-Class Cliff Is Real
To be fair, conservatives should not pretend everyone is fine. The people hit hardest are the ones who earn a decent living and buy their own coverage. Subsidies stop above 400% of the federal poverty line. This season, that line is $63,840 for a single person, $86,560 for a couple and $109,280 for a family of three, KFF Health News reported.
Think of a self-employed welder, a family farmer or a small-business owner just over that line. When ACA open enrollment opens, they pay full price, and benchmark premiums are up 42% on average since 2025, KFF found. Those are exactly the workers a free-market health system should serve best. Instead, they are often the ones paying the most.
Notably, each ACA open enrollment now serves a shrinking market. Individual market enrollment fell 18% by June 2026, from 25.2 million to 20.5 million people. The Congressional Budget Office expects marketplace enrollment to drop from a 2025 peak of 22.4 million to 13.1 million in 2027.
The Fraud Cleanup Was Overdue
Part of that drop is good news, though. This year, HHS canceled coverage for about 760,000 people it called phantom enrollees, meaning a broker may have signed them up without their knowledge. According to KFF, those accounts had no premium payment and no Social Security number or immigration document that could be verified in real time. A plan with no paying customer and no verifiable person should not keep drawing federal money.
Of course, the cleanup has not been perfect. Some people have already had their coverage reinstated, which suggests the screen also caught some legitimate enrollees. During this ACA open enrollment, high-risk shoppers who use an agent in the federal marketplace must verify their identity, and new brokers cannot register until February. That will slow some families down, so CMS should staff its help lines and fix mistakes fast.
Even so, it is the same lesson we drew from ghost student fraud in federal student aid: check first, then pay. Honest enrollees are the ones who lose when fraud drives up the cost of the whole program.
A Better Fix for ACA Open Enrollment
So what should Washington do before the next ACA open enrollment, instead of writing a bigger check? First, let people buy cheaper coverage. A 2025 policy expanded who could enroll in low-cost catastrophic plans, but a June court decision paused it, KFF reports. Congress should write that expansion into law so a court cannot take it away.
Second, build on health savings accounts. Under the 2025 tax law, every HealthCare.gov shopper has access to HSA-eligible plans, with 35 such plans on average for eligible enrollees, according to CMS. Money in an HSA belongs to the family, not the insurer. That puts the patient back in charge of the spending.
Third, push for more competition. Insurer exits now outnumber new entrants, and Cigna is leaving the individual market in all 11 states where it sells. Fewer insurers mean fewer choices and less pressure on price. States should clear the red tape that keeps new carriers and new kinds of plans out.
Finally, go after the cost of care itself, from hospital prices to drug prices. A bigger subsidy paid to an insurer does nothing about a $12,000 out-of-pocket cap.
Your ACA Open Enrollment Checklist
Here is the practical part. Don’t let your plan auto-renew without looking. Premiums, networks and drug coverage change every year, even for the same plan, and a new insurer may offer a lower price. If you use an agent, have your ID ready and book early, because there will be fewer agents this season.
Also, estimate your 2027 income carefully. The 2025 law ended the caps on paying back excess tax credits, KFF notes, so an unreported raise could mean a bigger tax bill. HSA contributions can lower your taxable income and may increase your credit. With prices rising this fast, every dollar counts, just as it does for retirees watching inflation eat their Social Security COLA.
Frequently Asked Questions
When does ACA open enrollment start and end?
On HealthCare.gov, it runs from Nov. 1, 2026, through Jan. 15, 2027. Pick a plan by Dec. 15 for coverage that starts Jan. 1. Some state-run exchanges set their own dates.
How much are ACA premiums going up for 2027?
KFF finds benchmark silver premiums rising 13% on average, after a 26% increase for 2026. Most enrollees still get a tax credit that cushions the increase.
Who no longer qualifies for ACA subsidies?
Households above 400% of the poverty line get no premium tax credit. The 2025 law also ended credits for many lawfully present immigrants, such as refugees and asylees, though green card holders still qualify.
What do you think? Should Congress bring back the bigger subsidies, or let families buy cheaper plans? Tell us in the comments.
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