Healthcare Insurance Changes for 2027 That You Should Be Aware Of

Mark your calendar: confirmed 2027 dates

Federal regulators had proposed shortening the ACA open enrollment window for 2027 coverage, but a federal judge blocked that change in June 2026. CMS subsequently confirmed in early August 2026 that open enrollment on HealthCare.gov will run November 1, 2026 through January 15, 2027, the same length as prior years. A small number of state-run marketplaces set their own schedules, so it's worth confirming your specific state's exact dates rather than assuming the federal timeline applies everywhere.

This back-and-forth over the enrollment window's length is worth understanding briefly, since it illustrates how much uncertainty surrounded this year's rules even a few months before enrollment actually opened. The originally proposed shorter window would have ended enrollment on December 15 in states using HealthCare.gov, and would have eliminated the previously available February 1 coverage start date for anyone enrolling later in the window without a special enrollment period. With the court's ruling, both the longer enrollment period and the later coverage start date option remain available for 2027, at least for now.

Why premiums are rising again

ACA Marketplace premiums are on track to rise by approximately 15% on average for 2027, according to a KFF analysis of insurer rate filings across all 50 states and Washington, D.C. This follows an even steeper roughly 26% average increase for 2026, the steepest single-year jump in nearly a decade. A significant driver behind both years' increases: the enhanced premium tax credits that had reduced costs for millions of Americans since 2021 expired at the end of 2025, and their absence led ACA enrollment to fall by an estimated 3 million people, disproportionately among younger, healthier enrollees who are more likely to forgo coverage once it becomes less affordable.

Beyond the subsidy expiration itself, insurers are also citing rising underlying medical costs, hospital and pharmaceutical price growth, and a smaller, comparatively sicker enrollee base as contributing factors in their 2027 rate filings. Insurers are also exiting the Marketplace entirely in more than 20 states for 2027, which means some shoppers will find fewer plan choices available in their area than in past years, making it especially worthwhile to compare whatever options remain rather than simply re-enrolling in last year's plan without checking.

The subsidy cliff is still here for 2027

As covered in more detail in our comparison of coverage options, the expiration of enhanced subsidies restored the 400% federal poverty level income cliff: households above that threshold receive zero premium tax credit for 2027, rather than a reduced one. Congress has debated restoring the enhanced credits, but as of this writing, no extension has been finalized, so anyone shopping for 2027 coverage should check their actual subsidy eligibility under the current rules rather than assuming last year's or prior years' subsidy amounts still apply.

New state subsidy help: Virginia joins the list

Not every change for 2027 makes coverage more expensive. Virginia is introducing its own state-funded subsidy program, the Virginia Premium Savings program, starting with coverage that begins November 1, 2026. It's available to Virginia residents with household incomes between 138% and 250% of the federal poverty level who buy coverage through the Virginia Marketplace, and the subsidy applies automatically to any metal-tier plan selected there, though not to Catastrophic plans or coverage purchased outside the Marketplace. Virginia joins a small handful of other states that have created their own supplemental subsidy programs to help offset the federal subsidy cliff's return.

Stricter verification and a permanently ended SEP

The federal rule governing 2027 ACA plans also introduces more burdensome income and eligibility verification requirements, which federal regulators themselves estimate could reduce enrollment by up to 2 million people nationally, largely due to added paperwork and verification friction rather than a change in who's technically eligible. The same rule permanently eliminates a special enrollment period that had previously been available to certain low-income individuals outside the standard open enrollment window, meaning some people who previously could enroll mid-year under that provision no longer have that option.

These verification changes also intersect with new eligibility restrictions affecting certain immigrant populations, aligning with broader federal legislation passed earlier in 2026 that limits which lawfully present, non-citizen individuals can receive Marketplace subsidies. Anyone whose immigration or residency status has changed since they last enrolled should specifically confirm their current eligibility before assuming their prior year's enrollment status still applies, since these rules shifted meaningfully for the 2027 plan year.

Medicare changes for 2027

Medicare beneficiaries face their own set of changes for 2027. As covered in our guide to the Medicare Part D coverage gap's continued elimination, the confirmed 2027 Part D out-of-pocket cap rises to $2,400, with a maximum deductible of $700, both increases from 2026. Some beneficiaries could also see changes to their Part D premiums after a temporary federal program that had helped keep certain premiums in check was discontinued. On the Medicare Advantage side, CMS's Contract Year 2027 final rule eliminated eleven Star Ratings quality measures, including several tied to call center performance and appeals handling, and reinstated a general performance reward factor in place of a health equity-focused scoring measure used in recent years. For beneficiaries comparing plans this fall, a plan's star rating may look different than in past years, reflecting a change in the underlying scoring formula rather than necessarily a change in the plan's actual quality of care.

These scoring changes matter beyond simple bragging rights for insurers, since Star Ratings of four stars or higher qualify Medicare Advantage plans for quality bonus payments from the federal government, money that plans typically funnel into supplemental benefits like dental, vision, hearing coverage, or reduced out-of-pocket costs. A shift in the underlying formula can therefore change which specific plans qualify for that bonus funding, even without any actual change in the day-to-day care those plans provide to members.

Expect more marketing calls this year

• CMS loosened several restrictions on how insurance agents, brokers, and third-party marketing organizations can contact Medicare beneficiaries, effective October 1, 2026.
• This timing lines up directly with the ramp-up of marketing activity ahead of Medicare's Annual Enrollment Period.
• Expect a noticeable increase in calls, mailers, and advertising this fall compared to recent years.
• Working with a licensed agent you already trust can help you filter genuinely useful outreach from generic marketing volume.

How Apollo can help you navigate all of this

With premiums rising, subsidy rules shifting, new state programs appearing in some places, and Medicare scoring formulas changing underneath familiar star ratings, this year's open enrollment genuinely rewards getting personalized help rather than guessing at general information alone. A licensed Apollo Health Insurance agent can check your actual subsidy eligibility under the current rules, compare ACA plans against your specific budget and provider needs, and help Medicare beneficiaries make sense of this year's Part D and Star Ratings changes, all at no cost to you.

Whether you're shopping the ACA Marketplace as an individual, comparing options for a small business, or weighing Medicare Supplement coverage against Medicare Advantage, Apollo's licensed advisors are compensated by insurance carriers rather than by you directly, so getting this kind of personalized guidance costs nothing extra regardless of which plan you ultimately choose.

Common questions about 2027 health insurance changes

Have a question that isn't answered below? Our full health insurance FAQ page covers more general coverage questions.