Millions of Americans shopping for health insurance through the Obamacare/ Affordable Care Act marketplace face higher premiums, fewer coverage options, and stricter eligibility requirements as open enrollment for 2027 gets underway, The Associated Press reports.
The enrollment period began Nov. 1 in most states and runs through Jan. 15. According to The Associated Press, benchmark health insurance premiums are projected to increase an average of 13% in 2027, based on an analysis of federal data by health policy research organization KFF.
The rising costs follow the expiration of enhanced federal subsidies introduced during the COVID-19 pandemic under former President Joe Biden. Republicans opposed extending the financial assistance, which helped millions of Americans afford coverage.
According to KFF, marketplace plan selections fell by 1.2 million in 2026 after the subsidies expired.
Consumers who no longer qualify for financial assistance face some of the greatest challenges. Many may be forced to switch to less expensive bronze plans, which typically carry higher out-of-pocket costs, or drop their coverage entirely.
Cynthia Cox, a KFF vice president and director of its Affordable Care Act program, attributed the premium increases largely to rising medical expenses and hospital market concentration.
The financial pressures come as enrollment continues to decline. Approximately 19.2 million Americans had active ACA marketplace coverage as of February 2026, down 2.6 million from the previous year, according to KFF.
Additional changes taking effect in 2027 will restrict premium tax credits for certain lawfully present immigrants. The Congressional Budget Office estimates the restrictions could leave another 1 million people uninsured by 2035.
Meanwhile, the Trump administration has intensified efforts to combat alleged enrollment fraud. In September, Vice President JD Vance announced the removal of approximately 760,000 people from ACA exchanges, citing suspected fraudulent enrollments. The administration projected $2.2 billion in federal savings.
Despite rising costs, the Centers for Medicare and Medicaid Services maintains that consumers will continue to have access to affordable coverage options.
Health policy experts warn that rising premiums, reduced financial assistance, and tighter eligibility requirements could drive additional Americans out of the insurance marketplace in 2027.
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