ACA premiums rise 13% as open enrollment starts amid insurer exits

Open enrollment for Affordable Care Act health insurance began this week in most states, coinciding with a projected 13% average increase in benchmark silver premiums. The rise marks the second consecutive year of double-digit cost hikes for mid-tier coverage. The standard enrollment period runs through January 15, 2027, though several states have extended or shortened their timelines.

The current period follows the expiration of enhanced premium tax credits, a change that has altered the financial dynamics of the marketplace. KFF reported that benchmark silver premiums have climbed by an average of 42% between 2025 and 2027. Subsidies will continue to cover costs for most enrollees, but individuals earning more than 400% of the federal poverty level will no longer qualify for assistance.

Enrollment numbers have dropped as credit enhancements ended. Data from the Department of Health and Human Services indicates that 19.2 million people were enrolled in the first two months of 2026, a decrease of roughly 3 million from the same period last year. KFF noted that insurers anticipate further declines in 2027 coverage as a result of the credit expiration.

Insurers are also reducing their presence in the marketplace. As of October 28, 11 carriers announced they will stop offering plans in at least one state in 2027, according to KFF. Cigna will exit all 11 states where it currently sells ACA plans, affecting more than 350,000 people. The organization suggested that insurers are reassessing profitability as enrollment falls.

Eligibility rules for immigrants will change under a reconciliation bill signed into law in July 2025. Certain groups, including refugees and asylum applicants, will lose access to tax credits and cost-sharing help in 2027. Only lawful permanent residents and specific entrants from Cuba, Haiti, and nations under the Compact of Free Association will retain eligibility for subsidies.

The Congressional Budget Office estimates that this provision will leave approximately 1 million more people uninsured by 2035. Residents of Idaho have until December 15 to shop for coverage, while those in Massachusetts and Virginia have until January 23 and January 29, respectively. California, the District of Columbia, New York, and Rhode Island will close their enrollment periods on January 31.