ACA Open Enrollment Begins As 2027 Premiums Rise And Subsidy Rules Tighten

Open enrollment for 2027 Affordable Care Act marketplace coverage begins Sunday, Nov. 8, 2026, in most states and runs through January 15, 2027, as premiums climb and subsidy rules tighten.^[1]

A KFF analysis of new Centers for Medicare & Medicaid Services data projects an average 13 percent increase in 2027 marketplace premiums, with unsubsidized enrollees set to take the biggest hit. Roughly 19.2 million people were actively enrolled in ACA marketplace plans as of February 2026. New 2027 rules will limit premium tax credits for certain lawfully present immigrants, a change analysts say could eventually add about one million uninsured people. In September 2026 Vice President JD Vance and other officials announced plans to remove 760,000 alleged fraudulent or nonexistent enrollees, projecting $2.2 billion in savings.

KFF's analysis of the CMS filings is the latest signal that higher insurer prices and rule changes will shape the coming season. The premium projections come from insurer rate submissions and CMS updates that regulators used to set 2027 plan options. The new eligibility limits for some lawfully present immigrants were adopted as part of 2027 rulemaking and are expected to narrow who can claim premium tax credits.

Consumers should shop plans, compare premiums and out-of-pocket costs, and update income and household information before the deadlines to secure subsidies or coverage.^[1]

1. PBS