ACA Open Enrollment Starts Sunday Amid 13% Price Hikes and Stricter Rules
The sign-up period begins this week in most states, bringing higher premiums, reduced subsidies, and new eligibility restrictions for millions of Americans seeking 2027 coverage.
By Andrew Kovalenko ·
The Affordable Care Act open enrollment period begins Sunday in most states and continues through Jan. 15. Individuals preparing to purchase health insurance for 2027 should anticipate higher monthly costs and a narrower selection of available plans. The shift comes as federal financial assistance for many previously eligible groups expires, altering the cost structure for the marketplace.
According to an analysis of new Centers for Medicare & Medicaid Services data by the Kaiser Family Foundation, the average price of health insurance bought through the marketplaces is projected to increase by 13% in 2027. Cynthia Cox, vice president and director of the ACA program at KFF, attributes the rise to climbing healthcare costs, increased hospital market concentration, and the growing influence of the No Surprises Act. She also cited the rising availability of GLP-1 drugs as a contributing factor to the price adjustment.
The financial burden falls most heavily on consumers who do not qualify for government subsidies. Cox noted that many of these individuals have already switched to bronze plans, the lowest tier of coverage available. She stated that these shoppers may struggle to afford continued coverage into next year due to the steep rate increases.
A fact sheet distributed by CMS on Friday asserts that Americans using HealthCare.gov will have strong access to low-cost options. However, the current environment differs sharply from previous years. During the administration of former President Joe Biden, enhanced subsidies offset costs for most enrollees. After Republicans opposed extending those temporary measures, the number of people signing up for coverage dropped by 1.2 million.
Roughly 19.2 million people in the United States were actively enrolled in ACA marketplace plans as of February, according to the Department of Health and Human Services. This figure grew during the pandemic when the American Rescue Plan Act and the Inflation Reduction Act provided expanded financial support. New regulations taking effect in 2027 will limit tax credits for certain lawfully present immigrants, a change that could leave an additional 1 million individuals without coverage over time.
The Trump administration is also actively removing enrollees from the program as part of a campaign to identify waste, fraud, and abuse. In September, Vice President JD Vance and other officials announced plans to remove 760,000 individuals from public healthcare exchanges. Vance alleged that many of these individuals were fraudulently enrolled or did not exist. He stated that canceling subsidy payments for these accounts would result in $2.2 billion in cost savings.
It remains difficult to predict the total number of people who will drop off ACA coverage in 2027. Cox indicated that the combined effect of higher premiums, immigration eligibility changes, and anti-fraud efforts will likely reduce enrollment numbers. She added that the specific reasons for the decline will be harder to distinguish as the year progresses.
