Healthcare shoppers face costlier plans and fewer choices this year
Benchmark silver plan costs are rising for the second consecutive year, and enrollment numbers are declining as insurers exit multiple states.
By Alexei Brooks ·
Open enrollment for Affordable Care Act marketplace plans began on Nov. 1, 2026, in most states. The standard deadline to shop for coverage is Jan. 15, 2027. Three states, Connecticut, Idaho, and Massachusetts, started their enrollment periods in October. Massachusetts residents have until Jan. 23, while Virginia residents have until Jan. 29. California, the District of Columbia, New York, and Rhode Island extend their deadline to Jan. 31. Idaho closes its window earlier, on Dec. 15, 2026.
Premiums for mid-tier silver plans are increasing. A KFF analysis published on Friday projects an average 13% rise in benchmark silver premiums for next year. This marks the second consecutive year of double-digit percentage increases. KFF reported that these premiums have climbed by an average of 42% between 2025 and 2027. Most buyers will receive subsidies to offset these costs, but those earning more than 400% of the federal poverty level will not qualify for such assistance.
Enrollment numbers are trending downward. Data from the Department of Health and Human Services shows that 19.2 million people were enrolled in ACA plans during the first two months of 2026. This represents a drop of approximately 3 million people compared to the same period last year. KFF noted that several insurers anticipate further declines in 2027 following the expiration of enhanced premium tax credits.
Insurer participation in the marketplace is also shrinking. As of Oct. 28, 11 carriers announced they would stop offering coverage in at least one state in 2027, according to KFF. The organization suggested that insurers are reevaluating their profitability as unenrollment rates rise. Cigna is among the carriers making major cuts. It plans to exit all 11 states where it currently offers ACA plans, a move that will affect more than 350,000 people.
Eligibility rules for certain immigrants have changed under the reconciliation bill signed into law in July 2025. Some lawfully present groups, including refugees, asylum applicants, and green card applicants, will lose access to ACA tax credits and cost-sharing help. They may be required to pay full price for coverage in 2027. The National Immigration Law Center stated that these groups are no longer eligible. Only lawful permanent residents, specific Cuban and Haitian entrants, and residents from Compact of Free Association nations retain eligibility.
The Congressional Budget Office estimates that this provision will leave about 1 million more people uninsured by 2035.
