Insurers have sought a median 15% premium increase for Affordable Care Act plans in 2027, as consumers face federal enrollment changes affecting agent verification and subsidy access.
Federal sign-ups through HealthCare.gov are scheduled for Nov. 1, 2026, through Jan. 15, 2027, the Centers for Medicare & Medicaid Services (CMS) says. Consumers who choose a plan by Dec. 15 can start coverage Jan. 1; later selections take effect Feb. 1. State schedules vary: Your Health Idaho lists Oct. 15-Dec. 15, Access Health CT Oct. 23-Jan. 15, and the Massachusetts Health Connector Oct. 23-Jan. 23.
KFF’s Aug. 3 review covered rate submissions from 276 insurers across the 50 states and the District of Columbia. The midpoint of the requested increases for 2027 was 15%, the group found. For 2026, KFF reported a median proposed increase of 18% and a median finalized increase of 20%. Insurers cited medical cost growth, inflation, labor shortages, the expiration of enhanced premium tax credits at the end of 2025 and a risk pool expected to be less healthy. The proposed figures do not determine what an individual household pays; costs depend on the plan and eligibility for assistance.
CMS set 2027 annual out-of-pocket limits at $12,000 for self-only coverage and $24,000 for other-than-self-only coverage, about 13.2% above the 2026 limits.
For applications handled through the federal Marketplace’s Enhanced Direct Enrollment agent/broker pathway, consumers must authorize the agent for each application. CMS requires identity proofing before authorization for cases it classifies as high-risk. Its criteria include a new application, coverage sought in a different state, an existing plan with a net monthly premium of $30 or less after advance tax credits, or an application handled by a new or different agent. Depending on the platform, identity checks may come by text, email or automated call.
CMS said it canceled about 315,000 enrollments covering more than 760,000 people on Aug. 31 after confirming the enrollments were unauthorized. The agency expects to recover about $2.2 billion in related advance premium tax credit payments. Agents and brokers assisted with about 76% of active plan selections during the 2026 federal Marketplace enrollment period, CMS said.
CMS has paused federal-platform registration through Feb. 1, 2027, for agents and brokers who lacked a Plan Year 2026 Exchange agreement when the pause took effect. The pause does not cover registration with state marketplaces that do not use the federal platform. CMS said agents who first registered for 2026 made up about 11% of agents with active enrollments and about 30% of 569 agents sent notices of intent to terminate in July and August; those notices were not final termination decisions.
The National Association of Benefits and Insurance Professionals sued on Oct. 15, seeking a temporary restraining order and preliminary injunction. Its filing said nearly 19,000 agents and brokers could be affected, citing a CMS estimate. In a statement accompanying the lawsuit, association president Mychal Walker said, “The existence of fraud is not in dispute.” Georgetown Law’s case tracker listed briefing as ongoing on Oct. 23.
Federal law also narrows subsidy eligibility for some lawfully present noncitizens in 2027. CMS guidance lists U.S. citizens and nationals, lawful permanent residents, Cuban or Haitian Entrants, and people lawfully residing under a Compact of Free Association as eligible for advance premium tax credits and income-based cost-sharing reductions. Other lawfully present noncitizens may still enroll if otherwise eligible, but cannot receive those forms of assistance. HealthCare.gov’s enrollment period opens Nov. 1.
