With premiums on the rise, what to know as ACA coverage open enrollment begins
Open enrollment ends for most states on Jan. 15, 2027.
Over the weekend, open enrollment began in most states for those who buy their health insurance though the Affordable Care Act (ACA) marketplace.
This year saw the expiration of the enhanced premium tax credits and further changes are expected in 2027.
Here's what to know about open enrollment for the upcoming year:
How long does open enrollment last?
Open enrollment typically runs from Nov. 1, 2026 through Jan. 15, 2027. Three states -- Connecticut, Idaho and Massachusetts -- saw their open enrollment period begin last month.
Massachusetts residents will have until Jan. 23 to shop for coverage while residents of Virginia will have until Jan. 29. Those who live in California, the District of Columbia, New York and Rhode Island will have until Jan. 31.
Idaho is the only state to have its open enrollment period end in 2026, closing on Dec. 15.
Increase of premiums
A new analysis from KFF published Friday found that finalized benchmark silver premiums -- for mid-tier health coverage -- under the ACA will rise by an average of 13% next year, marking the second year in a row of double-digit percentage increases.
KFF said ACA marketplace benchmark silver premiums have risen by an average of 42% between 2025 and 2027.
The organization noted that most enrollees will get a subsidy to help cover the cost of premiums, but not those with incomes 400% above the federal poverty level.
Enrollees and insurers exit the marketplace
Data published in June from the Department of Health and Human Services showed 19.2 million people were enrolled under the ACA in the first two months of 2026, down by about 3 million people compared to the same time last year.
KFF noted that several insurers expect declines in coverage in 2027 in the wake of enhanced premium tax credits expiring.
However, insurers are also exiting the marketplace. As of Oct. 28, about 11 carriers have said they will no longer be offering coverage in at least one state in 2027, according to KFF. Insurers may be reassessing the profitability of their participation in the marketplace as people unenroll, KFF suggested.
Among the carriers is Cigna, which will exit all 11 states where it offers ACA plans, affecting more than 350,000 people.
Some immigrants no longer qualify for tax credits
The Trump administration's reconciliation bill, which was signed into law in July 2025, is changing eligibility requirements for some immigrants.
Under the bill, certain groups will not be able to obtain ACA tax credits and cost-sharing help and may have to pay full price for coverage in 2027.
Only lawful permanent residents, certain Cuban and Haitian entrants and lawful residents living in the U.S. under the Compact of Free Association -- agreements that govern a relationship between the U.S. and three sovereign Pacific Island nations -- are still eligible.
Other lawfully present immigrants including, but not limited to, refugees, asylum applicants, survivors of domestic violence who petitioned for lawful immigration status and green card applicants, will lose eligibility, according to the non-profit National Immigration Law Center.
KFF said the Congressional Budget Office estimates that about 1 million more people will be uninsured due to this provision by 2035.
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