ACA open enrollment starts with higher premiums and fewer plan choices

Tens of thousands of Mississippians enrolled in Affordable Care Act marketplace coverage are facing larger premiums and a narrower selection of plans during this year’s open enrollment period, experts say.

This marks the second straight year of double-digit premium hikes nationwide. In Mississippi, the average benchmark premium is projected to increase 23%, according to KFF data, following a 37% jump the year before.

Many marketplace enrollees qualify for income-based subsidies that are meant to soften the impact of rising prices. For a single person, the qualifying income range is roughly $16,000 to $64,000 a year.

Still, even subsidy-eligible consumers have been hit with steep cost increases after enhanced assistance that had made coverage more affordable for more than 22 million Americans expired. Many Mississippians moved to plans with higher out-of-pocket costs after those subsidies ended.

“It’s the same story we had last year,” said Michael Minor, who leads the Hernando-based Get Covered Mississippi, a statewide faith-based coalition that helps connect Mississippians to health insurance options. “People are already struggling.”

Open enrollment is underway and will run through Jan. 15.

Nationally, average premiums are rising 13%. Matthew McGough, a policy analyst at KFF, said health plans are seeing higher rates across the board because of inflation and rising healthcare costs.

McGough said marketplace prices are also being affected by the fallout from the loss of subsidies that had helped make insurance cheaper. As more people — especially healthier enrollees — dropped coverage, the remaining pool became smaller, sicker and more expensive to insure.

He said enrollment is likely to keep falling into 2027, though the extent remains unclear.

Mississippians shopping for coverage will also encounter fewer choices. Two insurers that had offered plans on the state marketplace will not participate in 2027: Cigna Healthcare and Molina Healthcare. Three insurers — UnitedHealthcare, Oscar Health and Ambetter from Magnolia Health — will continue offering coverage.

The reduced lineup comes alongside a temporary freeze on new broker registrations as part of a federal anti-fraud crackdown, as well as lower funding for navigators who help people compare and enroll in marketplace plans.

“Together, consumers are potentially going to have less choice and a more difficult time finding avenues to sign up,” McGough said.

Some lawfully present immigrants will no longer qualify for federal financial help with marketplace plans in 2027, including refugees and asylees without a green card and people on work visas. Lawful permanent residents, or green card holders, will still be eligible for subsidies.

Marketplace enrollment has fallen in Mississippi

When Congress expanded subsidies for marketplace plans in 2021 during the COVID-19 pandemic, Mississippi was among the biggest beneficiaries, in part because state lawmakers have declined for more than a decade to expand Medicaid.

Marketplace enrollment reached a high point in 2025, with more than 300,000 people enrolled statewide.

After the enhanced subsidies, premiums for people renewing coverage in 2026 more than doubled on average, according to KFF, and Mississippi experienced one of the sharpest drops in coverage.

Mississippi Insurance Commissioner Mike Chaney said enrollment has since been cut in half. As of Oct. 28, he said, enrollment stood at 135,000 people among the three insurers that will remain in the market next year. He added that the two carriers leaving the marketplace have only a small number of remaining beneficiaries.

The state’s shrinking marketplace enrollment may also have been influenced by federal anti-fraud efforts.

The Trump administration in September cancelled 315,000 “unauthorized” policies covering more than 760,000 people nationwide, saying the cancellations were tied to fraud and improper enrollment. A small number of people were mistakenly removed and later restored.

According to Beth Reiss, communications director for the Mississippi Insurance Department, marketplace insurers reported that more than 2,500 members were disenrolled in Mississippi.