If you buy your health plan on the ACA marketplace, your 2027 premium is being written this month, and the early numbers are ugly. UnitedHealthcare has asked New York regulators for a 52% rate hike for next year, per the Families USA rate tracker. Most state regulators finalize the rest through August. Open enrollment for 2027 coverage begins November 1, 2026.
This is the second bad year in a row, and it will hurt more than the first.
The enhanced premium tax credits expired December 31, 2025. Those were the pandemic-era subsidies from the 2021 American Rescue Plan and the 2022 Inflation Reduction Act, and they kept marketplace premiums flat or falling for four years. They are gone. Congress has left them expired.
The result for 2026 was already brutal. Per KFF, the average monthly premium payment across marketplace enrollees jumped 58%, from $113 to $178. Total effectuated enrollment fell from 22.3 million in 2025 to an estimated 17.5 million in 2026. About 4.8 million people dropped coverage. The cohort earning between four and five times the federal poverty level, roughly $60,000 to $75,000 for a single filer, saw a 44% drop in sign-ups. Most of that group just went without.
What the 2027 filings say so far
Insurers are filing on top of the 2026 base, not the 2025 base. That is the trap.
Families USA’s rate tracker is still filling in state by state, but the direction is set. UnitedHealthcare’s 52% ask in New York is the number to watch. Insurers are citing rising hospital and drug prices, provider consolidation, and continued uncertainty over whether Congress will bring back any version of the enhanced subsidies. Nobody expects them to, this year.
Here’s what they don’t tell you. If you were paying $178 a month for 2026 coverage and your carrier files a 30% raise, your same plan for 2027 is a $230 monthly premium. If your income puts you between 400% and 500% of the federal poverty level, you are back on the subsidy cliff. The credit does not phase out gently. It cuts off, and you pay full sticker on both sides of it.
Three moves this month
Log into HealthCare.gov (or your state marketplace) and confirm your current 2026 monthly premium after credits. That is your baseline. Screenshot it. When the 2027 renewal letter shows up in October, you want the two numbers side by side.
If your household income is anywhere close to 400% FPL, run the MAGI math. A traditional 401(k), traditional IRA, or HSA contribution cuts your modified adjusted gross income dollar for dollar. If you can drop under the cliff, you get a credit. If you cannot, you pay retail.
Know your alternative. If your spouse has employer coverage with open enrollment this fall, adding you may qualify as a special enrollment event on their side. Some employers only run a two-week window. Ask HR today what dates that window opens.
File this away. State regulators finalize 2027 rates in August. Open enrollment begins November 1. Do not wait for the renewal letter to think about it. The letter is the last step, not the first.
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