Key Changes to Understand for ACA Open Enrollment in 2027

Enrollment opens Nov. 1, and shoppers should be ready for several important shifts

More Ways to Benefit

Stricter rules for some immigrants

In 2027, many immigrants who once qualified for ACA plan savings will no longer be eligible.

• Lawful permanent residents
• Cuban-Haitian entrants
• Compact of Free Association (COFA) migrants

At the same time, six insurers are entering the ACA marketplace, while 11 say they plan to exit and will not offer coverage next year, according to KFF. In some states, several insurers have announced departures.

“Obviously, this varies widely by state in the U.S., but the result is that consumers are going to have fewer choices,” McGough says. “Maybe a plan that they’ve been enrolled in for a few years is now no longer available in their area, and they are going to have to put in the time to do their research and try to find the best next available option.”

Experts say the pattern could keep going now that the enhanced premium tax credits have ended. “During the enhanced premium tax credit era, there was this influx of enrollment, and we saw a lot of insurers joining. And as they’ve expired, we’re seeing some insurers really rethink their position,” McGough says.

Oregon is also set to join the states that run their own exchanges. Residents there will no longer be able to enroll in ACA coverage through healthcare.gov and will need to use the state exchange website instead.

Below is a list of states that operate their own exchanges, along with links to those sites.

AARP Calls for Consumer Protections in Marketplace Plans

By Miriam Cross

People ages 50 to 64 who depend on health insurance marketplaces often have greater medical needs than younger consumers, yet they can still be charged as much as three times more because of age. With premiums continuing to rise, keeping these plans affordable is becoming even more important.

For that reason, AARP is urging Congress to permanently restore the enhanced premium tax credits for Affordable Care Act marketplace plans, which ended after 2025, “so that small-business owners, self-employed older adults and early retirees can keep the coverage they count on,” Bill Sweeney, AARP’s senior vice president for government affairs, wrote in October in response to a request for information from the U.S. Senate Committee on Finance. The enhanced credits were introduced in 2021 and built on existing federal tax credits for lower-income enrollees, helping reduce the cost of marketplace coverage more broadly.

Sweeney also pointed to other steps that could help shield older adults who are not yet eligible for Medicare from high insurance costs.

AARP is also encouraging standardized plans. These plans use the same cost-sharing structure for covered benefits across insurers, which makes comparison shopping easier.

And AARP opposes any effort to allow catastrophic or short-term “junk” plans with weak consumer protections to be sold in marketplaces alongside ACA-compliant coverage. Those plans often advertise lower premiums, but they are not required to cover the 10 essential health benefits that marketplace plans must include, such as free preventive screenings and emergency care. They may also provide little or no coverage until a consumer meets a very high deductible. AARP also pushed back on a proposal to broaden access to these limited plans in a letter to the Center for Medicare & Medicaid Services earlier this year.

“Restoring enhanced tax credits while building on consumer protections must be the foundation of any effort to make coverage more affordable and more accessible,” Sweeney wrote.