Insurers have proposed a median 15% increase in ACA Marketplace premiums for 2027, according to KFF’s analysis of filings. Open enrollment starts November 1, so the smart move is to compare plans by total yearly cost (premiums plus deductible plus expected out-of-pocket spending) and build the higher premium into your budget now.
What’s happening with open enrollment 2027 premiums
KFF’s early-July look at 14% grew to a median 15% once filings from 276 insurers across all 50 states were included. Insurers point to rising medical costs, federal rule changes, and the expiration of the enhanced subsidies. If the proposals hold, premiums will have climbed by more than a third over two years, after last year’s finalized median increase of 20%.
Key dates for 2027 coverage in most states:
- Nov 1, 2026: Marketplace enrollment opens.
- Dec 15, 2026: deadline for coverage starting Jan 1 (confirm your state’s date).
- Jan 15, 2027: federal deadline in most states, with coverage starting Feb 1. Some states run later, such as Jan 31 in California, New York, and New Jersey.
- Oct 15 to Dec 7: Medicare open enrollment.
Final rates are set in late summer, so check HealthCare.gov or your state exchange for the real numbers for your county.
Step 1: Calculate what a 15% jump means for you
Take your current monthly premium and multiply by 1.15. Then check whether your subsidy changes, since the premium tax credit depends on your income and the benchmark plan in your area.
| Current monthly premium | At +15% | Extra per year |
|---|---|---|
| $450 | $518 | $816 |
| $700 | $805 | $1,260 |
| $1,100 | $1,265 | $1,980 |
For a family paying $1,100 a month, that is nearly $2,000 a year, about the cost of a month’s rent in many mid-sized metros.
Step 2: Compare plans by total yearly cost
The cheapest premium is rarely the cheapest plan. Use this formula:
Total yearly cost = 12 × premium + deductible exposure + expected copays and coinsurance
Look at your past year’s claims and EOBs to estimate usage. A rough example for one adult:
| Bronze | Silver | |
|---|---|---|
| Monthly premium | $380 | $520 |
| Deductible | $7,500 | $4,500 |
| Low-use year (4 doctor visits, 2 Rx) | $4,560 + ~$600 = $5,160 | $6,240 + ~$400 = $6,640 |
| Bad year (hits out-of-pocket max of $9,200) | $4,560 + $9,200 = $13,760 | $6,240 + $8,000 = $14,240 |
Bronze wins in both scenarios here, but only if you can actually cover a bad-year bill. Check three things before choosing:
- Provider network: is your doctor or hospital in-network? Chase a plan’s price and lose your pediatrician, and the savings vanish.
- Drug formulary: look up your prescriptions by name.
- Cost-sharing reductions: these are available only on Silver plans if your income qualifies, and they can shrink the deductible dramatically.
If you’re eligible for an HSA-compatible plan, the account side matters too. We cover that in our HSA/FSA open enrollment planning guide.
Step 3: Turn the premium into a monthly budget line
A higher premium hits January’s cash flow just as holiday card balances and tax-prep costs show up. Two moves help:
- Recurring line item: list the premium alongside rent, car insurance, and utilities so you see the new monthly total at a glance.
- Deductible sinking fund: divide your deductible by 12. For a $4,500 deductible, that is $375 a month into a high-yield savings account such as Ally or Capital One 360. A full deductible takes time to build, so even half is a strong start. Our sinking funds guide walks through the setup.
Don’t forget that other insurance is also climbing. If your homeowner’s or renter’s policy renews soon, see how the home insurance cost spike is changing budgets.
Where Tefteri fits
Tefteri lets you add your premium as a recurring monthly entry, set up a “Medical deductible” sinking fund, and log every copay, pharmacy run, and lab bill by family member. Receipt photos stay on your iPhone. There’s no insurer account linking and no bank connection, so your health spending isn’t shared with anyone. At next year’s open enrollment you’ll have real usage data instead of guesses.
Your 30-minute pre-enrollment checklist
- Find your current plan’s summary of benefits and last year’s EOBs.
- Total premiums, copays, and Rx costs for the past 12 months.
- Preview 2027 plans on your exchange once rates are live.
- Calculate best-case and worst-case yearly cost for 2-3 plans.
- Set your new monthly premium and deductible fund in your budget.
Frequently Asked Questions
When is ACA open enrollment for 2027?
In most states it opens November 1, 2026. Enroll by December 15 for coverage starting January 1; the federal window runs through January 15, 2027. Some states have different deadlines, so check your state exchange.
How much will ACA premiums go up in 2027?
Insurers’ proposed median increase is about 15%, per KFF. Final rates vary by state, insurer, and plan, so your actual change could be higher or lower.
Is the cheapest ACA plan the best choice?
Not always. A low-premium Bronze plan has a high deductible, which is fine if you rarely use care and have savings for a bad year. Compare total yearly cost, not just the monthly premium.
How much should I save for a health insurance deductible?
Aim to build toward your full deductible, or at least your plan’s out-of-pocket maximum share you can reasonably cover. Dividing the deductible by 12 and saving that monthly is a simple start.
What if I miss open enrollment?
You generally need a qualifying life event, such as losing job-based coverage, marriage, a move, or a birth, to enroll through a special enrollment period. Otherwise you wait until the next open enrollment.
Tefteri is a personal finance app for iPhone that helps you track expenses, recurring bills, and sinking funds, with your data staying private on your device.
