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Open enrollment for 2027 coverage on HealthCare.gov will run from November 1, 2026 through January 15, 2027, with a December 15, 2026 deadline for coverage to start on January 1, 2027, the Centers for Medicare and Medicaid Services confirmed. The announcement comes as insurers seek a median 15% premium increase for the second consecutive year, deepening affordability concerns for millions of Americans who rely on the marketplace for health coverage.
Enrollment Window Locked In
The timeline had been in doubt. A federal judge vacated a rule that would have cut the 2027 open enrollment period short, ending it at December 15 instead of mid-January. CMS Deputy Administrator Peter Nelson confirmed in August 2026 that the window will run through January 15, 2027 regardless of the outcome of a pending appeal. That decision preserves an extra month for consumers to shop, compare plans, and enroll, a window advocates had warned was at risk of disappearing just as costs are rising sharply.
Key dates for 2027 coverage:
- November 1, 2026: Open enrollment begins
- December 15, 2026: Deadline for coverage starting January 1, 2027
- January 15, 2027: Open enrollment closes
Premiums and Costs Keep Rising
An analysis of publicly available filings from 276 ACA Marketplace insurers found a median proposed premium increase of 15% for 2027, according to the health policy research organization KFF. Proposed changes ranged widely, from a 1% decrease to a 54% increase, though KFF found most insurers proposed changes falling between 10% and 25%. It marks the second straight year of double-digit increases, following a similarly steep rise tied to the loss of enhanced federal subsidies.
The numbers behind that shift are stark. Average monthly marketplace premium payments rose from $113 to $178 over the past year, a 58 percent jump, according to a KFF analysis of CMS and state-based marketplace data. Average marketplace deductibles climbed 37%, or $1,027 per person, reaching a record high of $3,786 in 2026, KFF reported. The out-of-pocket maximum is also increasing, rising to $12,000 for an individual and $24,000 for a family in 2027, up from $10,600 the prior year, according to CMS.
Those rising costs have already pushed people out of the market. Marketplace plan sign-ups fell by more than a million, to 23.1 million people, during the 2026 Open Enrollment Period — the sharpest single-year drop since the ACA Marketplaces launched, KFF said. A separate review of insurer filings found that roughly 3 million people have dropped marketplace coverage since the enhanced credits expired.
Subsidies Expire, Impact Varies by State
At the center of the cost surge is the expiration of enhanced premium tax credits, which had lowered marketplace premiums for more than 20 million enrollees since 2021. Those credits expired on December 31, 2025, after Congress failed to reach an agreement to extend them, according to reporting on CMS and congressional records. The House passed a three-year extension of the enhanced subsidies in January 2026, with support from some Republicans who broke with their party leadership, but the Senate has not taken up or passed the bill, leaving the issue unresolved as the new enrollment period approaches.
Without renewal, premium tax credits for 2027 revert to the original ACA formula. Under that formula, assistance phases out as income rises and stops entirely for anyone earning above four times the federal poverty level, according to policy analysis cited alongside CMS records. That reversal effectively restores a hard income cliff that the enhanced credits had eliminated, meaning many middle-income families who previously qualified for help will now pay full price for coverage.
The effects have not been uniform across the country. New Mexico replaced the lost federal credits entirely with state funding and was the only state where marketplace enrollment grew, increasing by 14%, according to state enrollment data. By contrast, Ohio and Oklahoma each lost 32% of their marketplace enrollment, illustrating how heavily outcomes now depend on whether individual states step in to fill the gap left by Washington’s inaction.
For consumers, the combination of a shorter-than-expected scare over enrollment dates, rising premiums, higher deductibles, and the loss of enhanced subsidies adds up to a more expensive and more complicated sign-up season. With the Senate yet to act on the House-passed extension, the original ACA subsidy structure is expected to remain in place for 2027, leaving the size of a household’s tax credit — and ultimately its monthly bill — tied once again to the income cliffs that enhanced subsidies had been designed to erase. Enrollees have from November 1 through January 15 to weigh their options before coverage decisions lock in for the new year.
