ACA Open Enrollment 2026: How to Pick the Right Health Plan for 2027

ACA open enrollment for 2027 health coverage runs from November 1, 2026 to January 15, 2027 on HealthCare.gov, and you must pick a plan by December 15 if you want coverage to start on January 1. This guide explains what changed for 2027, including the expired enhanced subsidies and the return of the income “cliff,” and gives you a step-by-step way to compare plans on total yearly cost rather than premium alone.

2027 Open Enrollment Dates and Deadlines

A 2025 federal rule would have shortened open enrollment in HealthCare.gov states to end on December 15. A federal judge vacated that provision, and the Centers for Medicare & Medicaid Services has confirmed the longer window for this season, although litigation over the rule has continued. Here are the dates that apply in states using HealthCare.gov:

Date	What happens
Late October 2026	2027 plans and prices typically become available to preview on HealthCare.gov
November 1, 2026	Open enrollment begins
December 15, 2026	Last day to enroll or change plans for coverage starting January 1, 2027
December 16, 2026 – January 15, 2027	Enrollments in this window start coverage February 1, 2027
January 15, 2027	Open enrollment ends; after this you need a qualifying life event for a Special Enrollment Period

If you live in a state with its own exchange, such as California, New York, New Jersey, Pennsylvania or Washington, your state sets its own deadlines, and some run later than January 15. Always confirm on the official HealthCare.gov dates and deadlines page or your state exchange’s website.

What Changed for 2027 Coverage

Enhanced subsidies are gone (for now)

From 2021 through 2025, temporary enhanced premium tax credits capped benchmark premiums at a percentage of income for everyone, with no upper income limit. Those enhancements expired at the end of 2025. The House passed a three-year extension in January 2026, but as of this writing it has not become law. Unless Congress acts, the original ACA rules apply for 2027:

• Premium tax credits are generally available only to households with incomes between 100% and 400% of the federal poverty level (FPL).
• Above 400% FPL there is no credit at all. One extra dollar of income can mean paying the full premium.
• People who do qualify are expected to pay a larger share of income toward the benchmark plan than under the enhanced rules.

Subsidies for 2027 coverage are based on the 2026 poverty guidelines. In the 48 contiguous states, 100% FPL is $15,960 for one person and $33,000 for a family of four, so the 400% line is $63,840 and $132,000 respectively. Alaska and Hawaii have higher figures. You can check the current numbers on the HHS poverty guidelines page.

No cap on subsidy repayment

Premium tax credits are usually paid in advance to your insurer, based on the income you estimate. If your actual income ends up higher, you owe some back at tax time. Previously that repayment was capped for many households. Beginning with the 2026 tax year, those caps are gone: you repay the full excess. For 2027 coverage, this makes an accurate, even slightly conservative income estimate essential, and it makes updating your application during the year important if your income rises.

Higher premiums and a higher out-of-pocket maximum

According to KFF’s analysis of preliminary rate filings, marketplace insurers proposed a median premium increase of about 15% for 2027, after a 20% median increase for 2026. Final rates vary by state and insurer. The maximum out-of-pocket limit for 2027 plans is $12,000 for self-only coverage and $24,000 for family coverage, up from $10,600 and $21,200 in 2026.

If you receive a subsidy, much of the premium increase on the benchmark silver plan is absorbed by a larger credit. If you are unsubsidized, you pay the full increase.

Bronze and catastrophic plans are HSA-eligible

Under the 2025 tax law, bronze and catastrophic marketplace plans are treated as HSA-compatible, starting in 2026. That means you can pair one with a health savings account. The IRS set 2027 HSA contribution limits at $4,500 for self-only coverage and $9,000 for family coverage, plus a $1,000 catch-up for people 55 and older. HSA contributions are tax-deductible and can also lower the income used to calculate your subsidy.

Other changes to watch

• Immigrant eligibility: Starting in 2027, premium tax credit eligibility narrows for several groups of lawfully present immigrants. If this may apply to your household, review the rules carefully or get help from a certified navigator.
• Insurer exits: Some insurers are leaving certain states or shrinking their marketplace footprint for 2027. If yours is leaving, you may be automatically reassigned to another plan, which may have a different network.
• Medicaid changes: New Medicaid work and reporting requirements for the expansion adult group are scheduled to begin around the start of 2027, with details varying by state. If you are near Medicaid income limits, check your state’s rules.

Understand the Metal Tiers

Marketplace plans are grouped into metal tiers based on how costs are split between you and the insurer on average. The tier says nothing about the quality of care; the network and drug list determine that.

Tier	Plan pays on average	Premium	Costs when you get care	Often best for
Bronze	About 60%	Lowest	Highest deductibles	Healthy people who want protection from big bills, and HSA savers
Silver	About 70%	Moderate	Moderate; much lower if you qualify for cost-sharing reductions	Incomes up to 250% FPL, who get extra savings only on silver
Gold	About 80%	Higher	Lower deductibles and copays	People who expect regular care, prescriptions or a planned procedure
Platinum	About 90%	Highest	Lowest	Heavy users of care, where available
Catastrophic	Very low until the deductible	Low	You pay almost everything until the out-of-pocket max	Under 30, or those with a hardship exemption

How to Pick the Right Health Insurance Plan: Step by Step

Step 1: Estimate your 2027 income carefully

Your subsidy depends on your projected modified adjusted gross income for 2027. Start with last year’s tax return, then adjust for expected raises, job changes, side income and retirement withdrawals. Remember that pre-tax retirement contributions and HSA contributions reduce this figure. If you are close to the 400% FPL line, increasing a 401(k) or traditional IRA contribution could keep you eligible for a credit. Talk to a tax professional if your income is irregular.

Step 2: List your doctors, hospitals and prescriptions

Before you look at prices, write down every doctor you want to keep, your preferred hospital, and every medication you take, with dosage. These are deal-breakers. A cheap plan that does not include your doctor or covers your medication at a high tier can cost much more in practice.

Step 3: Estimate how much care you will use

Think about the past year and the year ahead. Low use means a few checkups and maybe a prescription. Moderate use means ongoing prescriptions, specialist visits or managing a chronic condition. High use means a planned surgery, pregnancy or expensive treatment.

Step 4: Compare total yearly cost, not just premium

For each plan you are considering, estimate:

1. Annual premium after subsidy (monthly premium times 12)
2. Plus the expected out-of-pocket costs for the care you expect to use
3. Plus a worst-case figure: annual premium plus the plan’s out-of-pocket maximum

A bronze plan with a low premium can look cheapest until you add a $7,000-plus deductible. A gold plan can end up cheaper overall for someone with regular prescriptions and specialist visits. HealthCare.gov’s plan comparison tool lets you enter expected usage and shows estimated yearly costs.

Step 5: Check silver first if your income is below 250% FPL

If your income is between 100% and 250% FPL, you may qualify for cost-sharing reductions, which lower your deductible, copays and out-of-pocket maximum, but only on silver plans. For people below 200% FPL especially, an enhanced silver plan can offer coverage close to gold or platinum levels.

Step 6: Check the network type

HMOs and EPOs usually require you to stay in network and may need referrals; PPOs cover some out-of-network care at a higher cost. If you travel often or have family in another state, understand what is covered outside your area.

Step 7: Update your application and choose actively

If you do nothing, you will likely be automatically re-enrolled in your current plan or a similar one. With subsidies changing, premiums rising and some insurers exiting, auto-renewal can leave you in a plan that is no longer the best deal. Log in, update your income and household information, and compare plans every year.

Common Mistakes to Avoid

• Picking by premium alone. The lowest premium often means the highest bills when you get care.
• Underestimating income. With repayment caps gone, a low estimate can mean a large tax bill.
• Not reporting changes. Report income, marriage, divorce, a new baby or a move within 30 days, so your subsidy stays accurate.
• Ignoring employer coverage. If you have an affordable offer of employer coverage, you generally cannot get a marketplace subsidy.
• Missing December 15. Enrolling after it pushes your start date to February 1 and leaves a gap if your current coverage ends December 31.
• Falling for look-alike plans. Short-term plans and health-sharing ministries are not ACA plans and may not cover preexisting conditions or essential benefits. Enroll through HealthCare.gov, your state exchange, or a licensed agent.

Where to Get Free Help

You do not need to do this alone. Certified navigators provide free, unbiased help with applications and plan choices, and you can find local assisters through HealthCare.gov. Licensed agents and brokers can also help at no direct cost to you, though they may be paid by insurers. Watch out for anyone who asks for payment to enroll you or who pressures you to switch plans quickly.

Frequently Asked Questions

When is ACA open enrollment for 2027 coverage?

On HealthCare.gov, open enrollment runs from November 1, 2026 through January 15, 2027. Enroll by December 15 for coverage beginning January 1. State-run exchanges may have different dates, so check your state’s site.

Did the enhanced ACA subsidies get extended for 2027?

As of this writing, no. The enhanced credits expired at the end of 2025, and an extension passed by the House in January 2026 has not become law. Check HealthCare.gov or news from official sources for any last-minute changes before you enroll.

What is the income limit for ACA subsidies in 2027?

Under current rules, premium tax credits are generally available up to 400% of the federal poverty level. For 2027 coverage, that is $63,840 for a single person and $132,000 for a family of four in the 48 contiguous states, based on 2026 guidelines.

Is a bronze or silver plan better?

It depends on income and health needs. If your income is below 250% FPL, silver plans with cost-sharing reductions often offer the best value. If you are healthy, above that income, and want to save in an HSA, a bronze plan may make sense, but be sure you can handle the deductible.

What happens if I miss the open enrollment deadline?

You generally cannot enroll until the next open enrollment unless you have a qualifying life event, such as losing other coverage, moving, marriage or having a baby, which opens a Special Enrollment Period. Medicaid and CHIP enrollment is available year-round if you qualify.

Will I have to pay back my subsidy?

If your actual income for the year is higher than you estimated, you will owe the difference when you file taxes, and starting with the 2026 tax year there is no cap on that repayment. Update your application promptly when your income changes.

Make Your Choice Before December 15

This year, the plan you had last year may no longer be the right one. Estimate your income carefully, list your must-have doctors and drugs, compare total yearly cost across tiers, and enroll by December 15 to avoid a gap. Health insurance rules, subsidy amounts and deadlines can change, including through new legislation or court rulings, so confirm details on HealthCare.gov or your state exchange before you enroll. For decisions about your own health needs, talk with your doctor, and for tax questions, consult a qualified tax professional.