ACA Open Enrollment 2027: 7 Money Moves Before You Renew

Open enrollment for 2027 ACA coverage starts on 1 November 2026 — and it arrives with the steepest proposed premium rises in years. A KFF analysis of insurer filings puts the median proposed increase for 2027 at 15%, and the enhanced subsidies that softened premiums have now expired. Auto-renewing last year’s plan without checking could be one of the most expensive things you do this autumn. Here is what changed, and seven money moves to make before you renew.

The dates

On HealthCare.gov, open enrollment runs 1 November 2026 – 15 January 2027. Enrol by 15 December 2026 if you want coverage to start on 1 January 2027; leave it later and your start date slips to February. State-based exchanges have their own deadlines — check your state’s exchange site.

What changed this year

• Premiums are up — sharply. KFF’s analysis of 276 insurers’ filings found a median proposed 15% increase for 2027 (ranging from −1% to +54%). These are proposals from filings, not final rates, but it is the second straight year of double-digit rises.
• The enhanced subsidies are gone. The pandemic-era enhanced premium tax credits expired at the end of 2025. Average monthly premium payments for marketplace enrollees jumped from about $113 to $178 (≈+58%), and enrolment fell by more than a million (roughly 23.1m to 17.5m).
• Deductibles climbed too. The average marketplace deductible rose roughly 37% to about $3,786.
• The subsidy cliff is back. Eligibility is back to roughly 100%–400% of the federal poverty level with no cap on repaying excess advance credits — so estimating your 2027 income accurately matters more than it did for the last few years.
• The 2027 out-of-pocket maximum is $12,000 for an individual and $24,000 for a family plan, up from $10,600.
• Some insurers are leaving. Seven insurers — including Cigna, Medica and CareSource — are exiting 2027 marketplace business in some states. If you are affected, your plan disappears and you must actively pick a new one.

Seven money moves before you renew

1. Do not auto-renew without shopping. Your plan’s premium, network and formulary can all change. Log in to HealthCare.gov (or your state exchange) and re-run the comparison — this is the single most valuable step.
2. Update your income estimate carefully. Because the subsidy cliff is back, an optimistic income guess can mean repaying thousands in advance credits at tax time, while underestimating can cost you help you were entitled to. Use your best 2027 figure, not last year’s.
3. Compare across metal tiers. A Bronze plan is not automatically cheapest — a Silver plan with cost-sharing reductions can beat it on total cost if your income qualifies, and deductibles of ~$3,786 make Bronze’s low premium expensive in a high-care year.
4. Budget the 15% rise explicitly. If your premium was $178 a month, a 15% rise adds roughly $320 a year. Put that number into your monthly budget now rather than discovering it in January.
5. Check your insurer is staying put. If your insurer is one of the seven exiting, look at which insurers are entering or expanding in your area and compare networks — your doctors may not be in every network.
6. Know your Special Enrollment Period triggers. Divorce, the birth of a baby, a job change, a move, or an immigration status change can open a 60-day window outside open enrollment — you do not have to wait a year after a life event.
7. Review HSA eligibility before you decide. High-deductible plans can pair with a health savings account (2026: $4,400 self-only / $8,750 family) — but only if the plan is HSA-qualified. Do not assume it is.

For readers in the UK and Canada

The ACA is a US-only system — but the planning habit travels.