Open enrollment for 2027 Affordable Care Act marketplace coverage began on Sunday, Nov. 1, two days before the midterm elections. It is the second sign-up season since the pandemic-era enhanced premium tax credits expired at the end of 2025, and the first in which several provisions of the 2025 reconciliation law change who can get help paying premiums.
The federal government and independent analysts describe the season in very different terms. The Centers for Medicare & Medicaid Services (CMS) says most HealthCare.gov shoppers will find a plan for $50 a month or less after subsidies and points to a sharp rise in plans that can be paired with a health savings account. KFF, a health policy research group, reports that benchmark premiums before subsidies are rising again after a large jump this year, that enrollment has already fallen, and that more people will lose eligibility for tax credits in January.
This story sets out the dates, the numbers each side is citing, and the arguments over why the marketplace looks the way it does. Readers can follow our wider coverage on the US healthcare issue page.
Dates and deadlines
On HealthCare.gov, the federal marketplace used by most states, open enrollment runs from Nov. 1, 2026, to Jan. 15, 2027, according to a CMS fact sheet released on Oct. 30. HealthCare.gov's own deadline guide says people must pick a plan by Dec. 15 for coverage that starts on Jan. 1. Plans chosen between Dec. 16 and Jan. 15 start on Feb. 1. States that run their own marketplaces can set different dates. KFF notes that a shorter, nine-week enrollment window planned by the administration was vacated in litigation, so the longer federal schedule remains in place for this season.
What CMS says buyers will find
The CMS fact sheet, titled "Plan Year 2027 Marketplace Plans and Prices," makes several claims about the federal marketplace:
- More than 75% of HealthCare.gov consumers will have access to a plan with a premium of $50 or less a month after tax credits.
- Subsidized enrollees can buy a plan for which the federal government pays nearly 90% of the lowest-cost premium, compared with 85% in 2020, according to the agency.
- Buyers will see about 100 plans from five to six insurers on average.
- An average of 35 plans per consumer are eligible to be paired with a health savings account, which CMS describes as an increase of more than 1,000%.
- The lowest-cost catastrophic plan is nearly 10% cheaper than last year, the agency says.
CMS credits the 2025 reconciliation law, which the administration calls the "Working Families Tax Cuts," for expanding access to health savings accounts on the marketplace. In December 2025, White House press secretary Karoline Leavitt made a similar argument, saying the law "significantly expanded access to health savings accounts for those on Obamacare," according to a report by The National Desk. She also described the ACA as "a Democrat-written program" that "has led to higher health care costs."
What independent analysts are tracking
KFF's Oct. 30 preview of the season, "9 Things to Watch for the 2027 ACA Open Enrollment Period," puts the focus on prices before subsidies and on enrollment. Its main figures:
- The average benchmark silver premium, the plan that sets the size of tax credits, is rising 13% for 2027, after a 26% increase for 2026. KFF calculates that benchmark premiums are up 42% from 2025 to 2027.
- The increase averages 11% in HealthCare.gov states and 16% in states that run their own marketplaces.
- In an August analysis of 276 insurers' filings, KFF found a median proposed increase of 15%. Insurers named rising health care prices as the main driver. KFF says changes in the risk pool, as healthier people drop coverage, add about 4 percentage points.
- People with incomes above 400% of the federal poverty level are no longer eligible for any tax credit, a cutoff that the enhanced credits had removed.
- As of Oct. 29, KFF counted 11 insurers leaving at least one state's marketplace and 7 entering. Cigna is leaving all 11 of the states where it sold marketplace plans.
The Center on Budget and Policy Priorities (CBPP), a left-leaning think tank, published a similar outlook on Oct. 27. Analyst Claire Heyison wrote that insurers attributed about 10 percentage points of the proposed median increase to medical costs and about 4 points to the expiration of the enhanced credits. She also wrote that net premiums, what enrollees pay after credits, may not rise as sharply as last year because the underlying credit formula is not changing again, so credits will grow along with the benchmark premium.
type: column
title: Benchmark silver premiums rose again for 2027, but more slowly than for 2026
note: Average percent increase in the benchmark silver premium, the plan that sets the size of tax credits. These are premiums before subsidies. KFF gives the 2025 to 2026 state-run figure as roughly 17%.
suffix: %
source: [KFF, 9 Things to Watch for the 2027 ACA Open Enrollment Period](https://www.kff.org/affordable-care-act/9-things-to-watch-for-the-2027-aca-open-enrollment-period/)
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Year | All states | HealthCare.gov states | State-run marketplaces
2025 to 2026 | 26 | 30 | 17
2026 to 2027 | 13 | 11 | 16
Enrollment has already dropped
The enrollment figures are where the two sides' arguments diverge most.
KFF reports that plan selections in the 2026 open enrollment period fell by 1.2 million. Effectuated enrollment, which counts people whose coverage actually took effect, was 19.2 million in February 2026, down 2.6 million, or 12%, from a year earlier. KFF says the broader individual market fell 18% by June 2026, from 25.2 million to 20.5 million. It cites a Congressional Budget Office projection that marketplace enrollment will fall from 22.4 million in 2025 to 13.1 million in 2027.
CBPP describes the same trend, saying marketplace enrollment fell by nearly 3 million people, or 13%, between February 2025 and February 2026, with some states losing nearly a third of enrollees. CBPP says some of those people likely moved to Medicaid or job-based coverage but "many are likely uninsured."
The Paragon Health Institute, a conservative health policy group, reads the decline differently. In a report published ahead of open enrollment, "State of the Affordable Care Act Exchanges Heading into 2027," Paragon argues that much of the enrollment growth from 2022 through 2025 included "improper and phantom enrollees," meaning people signed up without their knowledge or people who do not exist. It says more than 6 million people were improperly enrolled after both the 2025 and 2026 open enrollment periods.
Paragon points to three pieces of evidence. First, it says 56% of 2026 HealthCare.gov plan selections reported incomes between 100% and 150% of the poverty line, and that in 13 states enrollment in that band was more than twice the estimated eligible population. Second, it cites CMS data showing that the share of individual-market enrollees with no medical claims rose from 19% in 2021 to 35% in 2024, while the small-group market stayed near 20%. Third, it finds that states with higher zero-claim rates in 2024 generally saw larger enrollment declines from February 2024 to February 2026. Paragon says that correlation does not by itself prove causation.
KFF reports that HHS canceled about 760,000 enrollments it described as phantom in September 2026, after sending insurers a list of about 1.2 million. CMS has also paused new agent and broker registrations until February 2027, affecting about 19,000 applicants, according to KFF.
The argument from the right
Republicans and conservative analysts argue that the enhanced credits were a temporary pandemic measure that made coverage free for millions, invited fraud and sent more taxpayer money to insurers without fixing underlying costs.
Paragon's report says that from 2014 to 2026 benchmark premiums for a 50-year-old rose 129%, compared with 63% for employer coverage and 39% for overall inflation. It says federal subsidies paid about 86% of insurers' premium revenue in HealthCare.gov states in 2025, up from about 77% before the pandemic. For a 50-year-old at 200% of the poverty line, it estimates taxpayers will cover about $10,000 of a $12,000 benchmark premium in 2027. Paragon also argues that ACA subsidies are now larger than the tax break for employer coverage for many lower- and middle-income workers, which it says gives employers a reason to drop coverage.
The report concludes that policymakers "should focus not simply on how many people enroll, but on whether coverage provides value, whether subsidies are properly targeted, and whether taxpayers are financing coverage for real and legally eligible people."
The administration's case, as set out by CMS, is that buyers have more low-cost options and more plans compatible with health savings accounts, and that integrity checks are removing ineligible enrollees.
The argument from the left
Democrats and left-leaning analysts argue that the expiration of the enhanced credits and the 2025 law are pushing people out of coverage and raising costs for those who stay.
CBPP says continued premium increases "will likely put coverage out of reach for even more people." It notes that from Jan. 1, 2027, many immigrants who are lawfully present, including refugees, people granted asylum and people granted humanitarian parole, will lose eligibility for tax credits. CBPP cites an estimate that this change will cause 900,000 people to become uninsured by 2034. KFF cites a CBO estimate of about 1 million more uninsured by 2035 from the same provision.
CBPP also warns that higher marketplace premiums may push more people toward short-term plans and other products that are not required to follow ACA consumer protections, such as coverage for pre-existing conditions. It says the administration's response has been to weaken "financial and other consumer protections" in an effort to bring premiums down, and notes that several of those changes have been blocked by federal courts.
KFF lists other changes that take effect for tax year 2026 or 2027. Caps on how much enrollees must repay if their income ends up higher than estimated have been eliminated, starting with tax year 2026. People who lose Medicaid for failing to meet the new work requirements will be ineligible for marketplace tax credits from 2027. KFF says 43 states and the District of Columbia must put those requirements in place. Our earlier report on a federal ruling over Medicaid's "medically frail" exemption covers one of the legal fights over those rules.
How Congress got here
The enhanced credits were the central issue of the fall 2025 government shutdown, the longest on record, according to CBS News. On Dec. 11, 2025, the Senate rejected two competing bills, each on a 51 to 48 vote, short of the 60 needed to advance. The Democratic bill would have extended the enhanced credits for three years. The Republican alternative would have directed federal money into health savings accounts. Four Republicans voted for the Democratic bill.
On Jan. 8, 2026, the House passed a three-year extension 230 to 196, with 17 Republicans joining Democrats, after a discharge petition led by House Democratic Leader Hakeem Jeffries [Funding: tracked labor-related PAC receipts $10,000.00 (2026 cycle; retrieved 2026-10-30; partial topic registry)] [FEC source] forced the vote, CBS reported. The Senate did not take up that bill.
Senate negotiators then tried a compromise. Sen. Bernie Moreno, an Ohio Republican, circulated a proposal in late January that Semafor described as a one-year extension followed by a phase-down over 2027 and 2028, a cap at 700% of the poverty line, a $5 minimum monthly premium, fraud penalties, a bar on benefits for people "not lawfully present" and audits of compliance with the Hyde Amendment, which bars federal funding for most abortions. Moreno told reporters it was the "maximum" his party could support. His chief of staff, Philip Letsou, told Semafor that Democrats could "come to the table" or "walk away." [Funding: tracked labor-related PAC receipts $0.00 (2026 cycle; retrieved 2026-10-30; partial topic registry)] [FEC source]
The talks did not produce a bill. On Feb. 4, 2026, Moreno told reporters "It's effectively over," according to The Wall Street Journal, as summarized by KFF Health News, which reported that negotiators could not find common ground on how to handle abortion coverage. No extension has passed since, and KFF's Oct. 30 preview treats the enhanced credits as expired for 2027.
The issue forms part of the backdrop to Tuesday's elections. Our coverage of the national generic ballot polls and the US elections hub tracks the broader contest.
Pending litigation
KFF summarizes several lawsuits over a 2025 marketplace rule. Because of court orders, a rule that would have denied credits to people who failed to reconcile past credits on their tax returns is not being applied for 2027. A planned expansion of catastrophic plans was paused by a June decision. A provision on coverage of gender-affirming care as an essential health benefit, and the nine-week enrollment period, were vacated. Further rulings could change rules during the plan year.
State actions
Some states are using their own money to replace part of the lost federal help, according to KFF. New Mexico is fully replacing the enhanced credits. California is partly doing so for people with incomes between 165% and 200% of the poverty line. New Jersey also offers state help, and Rhode Island and Virginia have added new programs. People in states without such programs will see only the federal credit.
Funding note
Under our methodology, we check federal campaign finance records for politicians discussed in a policy context.
For Jeffries [Funding: campaign funding data not verified], the 567 Politics funding snapshot for the 2026 cycle, drawn from Federal Election Commission data and retrieved on Oct. 30, lists contributions from other political committees to Jeffries [Funding: campaign funding data not verified] for Congress. They include PACs of insurers that sell marketplace plans. We confirmed several in FEC itemized receipts: the Centene Corporation PAC gave $5,000 on Sept. 16, 2025, and $5,000 on Sept. 30, 2025. The UnitedHealth Group PAC gave $5,000 on Jan. 12, 2026, and $5,000 on March 25, 2026. The Elevance Health PAC gave $5,000 on Feb. 10, 2025, and $2,500 each on Sept. 30, 2025, and June 2, 2026. The Molina Healthcare PAC gave $5,000 on May 27, 2026.
For Moreno, the snapshot for the 2026 cycle, also retrieved on Oct. 30, lists committee contributions to Bernie Moreno [Funding: tracked labor-related PAC receipts $0.00 (2026 cycle; retrieved 2026-10-30; partial topic registry)] [FEC source] for Senate. FEC itemized receipts show $2,500 from the Elevance Health PAC on Dec. 12, 2025, and $2,500 from The Cigna Group Employee PAC on May 14, 2025.
These figures cover only committee contributions captured in the snapshot, not individual donors or full totals. Contributions do not show that any vote or position was influenced. President Donald Trump [Funding: campaign funding data not verified], whose administration runs HealthCare.gov and issued the CMS fact sheet, has no verified FEC snapshot on his 567 Politics profile, so this story includes no campaign finance figures for him. Missing data should not be read as zero.