What to Know About Financial Assistance, Plan Choices, and Coverage Before Open Enrollment Gets Underway.
ACA Open Enrollment is just around the corner. If you’ll be shopping for individual or family health insurance through the Marketplace for 2027, now is a good time to understand what may look different this year.
While the basic structure of ACA Marketplace coverage remains familiar, there are some important things to know before Open Enrollment begins.
Premium Tax Credits Are Still Available, but the Enhanced Subsidies Are Still Gone
Premium tax credits are still available to help eligible households lower the cost of Marketplace coverage in 2027.
However, the temporary
enhanced premium tax credits that were available from 2021 through 2025 have expired. Those enhanced credits provided additional financial assistance and temporarily allowed some households with incomes above 400% of the federal poverty level to qualify for help.
For 2027, the traditional ACA income limits remain in place. In general, households with incomes between
100% and 400% of the federal poverty level may qualify for premium tax credits if they meet the other eligibility requirements.
Even if your income hasn't changed, don't assume your financial assistance or monthly premium will be the same for 2027.
The Metal Tiers Aren’t Going Away
The familiar
Bronze, Silver, Gold, and Platinum metal levels will still be available for 2027. These categories indicate how you and your insurance plan generally share healthcare costs; they aren't ratings of the quality of care.
Plans within the same metal level can still differ in their premiums, deductibles, copayments, provider networks, prescription coverage, and other details. When Open Enrollment begins, look beyond the metal level and compare how each plan would work for your healthcare needs and budget.
Cost-Sharing Reductions Are Still Available
Cost-sharing reductions, or CSRs, are also sticking around. These additional savings can help eligible consumers lower out-of-pocket costs such as deductibles, copayments, coinsurance, and out-of-pocket maximums.
During the Marketplace enrollment process, you’ll find out whether you qualify based on your income and household information. If you do, you’ll need to choose an eligible
Silver plan to take advantage of these additional savings.
Many ACA Protections Haven’t Changed
Despite these changes, many of the fundamentals of Marketplace coverage remain the same.
ACA-compliant Marketplace plans still cover essential health benefits, and insurers generally cannot deny you coverage or charge you more because of a pre-existing health condition.
You'll also still be able to compare plans based on premiums, deductibles, provider networks, prescription coverage, and other out-of-pocket costs.
Get Ready for November 1
You don't need to choose your 2027 plan yet, but you can start getting prepared.
Review how your current coverage has worked for you, gather a list of your doctors and prescriptions, and think about your expected household income for 2027. When Open Enrollment begins, you'll be in a better position to compare your choices and understand how this year's changes may affect you.
ACA Open Enrollment begins November 1 in most states. If you have questions about what's changing for 2027 or want help preparing to review your options, we're here to help.
