Health insurance has become the most stressful bill for many self-employed workers, early retirees and families without employer coverage. After the enhanced federal subsidies expired at the end of 2025, millions of ACA marketplace enrollees saw their monthly payments jump. Now open enrollment for 2027 has started, and shoppers want to know what coverage will cost next year.
This guide explains current marketplace prices, how premium tax credits work after the subsidy changes, why deductibles keep climbing and how to choose a plan that fits both your health needs and your budget. It also covers the key enrollment dates you must not miss.
What Happened to Marketplace Prices
KFF reports that insurers raised benchmark marketplace premiums by an average of 26% for 2026, the steepest increase since the marketplaces opened. At the same time, the enhanced premium tax credits created in 2021 expired on January 1, 2026, so subsidized enrollees lost part of their financial help at the worst possible moment.
The combination hit household budgets hard. KFF found that average monthly premium payments rose 58%, from $113 in 2025 to $178 in 2026. For 2027, KFF’s October analysis shows benchmark silver premiums rising another 13% on average before subsidies, so shoppers should expect higher sticker prices again this year.
Average Premiums Before and After Subsidies
The Peterson-KFF Health System Tracker reports that the average monthly gross premium for a benchmark silver plan reached $625 in 2026, while the average lowest-cost bronze plan cost $456 a month. Those gross prices apply to people who receive no subsidy, including many households earning above 400% of the federal poverty level.
Most enrollees still receive a premium tax credit that lowers their payment. The credit ties your contribution to a percentage of your income for the benchmark silver plan, so your net price depends on household income and size. Lower-income households may still pay very little, while middle-income families above the cutoff pay full price.
| Measure | 2025 | 2026 | 2027 outlook |
|---|---|---|---|
| Change in benchmark premium | n/a | +26% | about +13% |
| Average monthly payment after subsidy | $113 | $178 | likely higher |
| Average deductible | $2,759 | $3,786 | likely higher |
| Gross benchmark silver, monthly | n/a | $625 | about $700 |
Deductibles Keep Climbing
To cope with higher premiums, many enrollees switched to plans with lower monthly costs and higher out-of-pocket costs. KFF found that average marketplace deductibles rose 37%, or more than $1,000 per person, from $2,759 in 2025 to a record $3,786 in 2026. That shift lowers monthly bills but raises the cost of actually using care.
A high deductible can work if you rarely see a doctor and keep an emergency fund. It becomes risky if you have chronic conditions, regular prescriptions or a planned surgery. Before choosing a bronze plan, estimate your yearly medical spending and compare the total cost, not just the premium.
Who Qualifies for Help
Premium tax credits now go to households earning between 100% and 400% of the federal poverty level, roughly $15,650 to $62,600 for an individual based on 2025 guidelines. People below the lower limit may qualify for Medicaid in states that expanded the program, while those above the upper limit pay the full premium.
Households earning between 100% and 250% of the poverty level may also qualify for cost-sharing reductions if they choose a silver plan. These reductions lower deductibles and copays, sometimes dramatically, which can make a silver plan a better deal than a bronze plan for lower-income families.
Choosing the Right Metal Tier
Marketplace plans come in four metal tiers: bronze, silver, gold and platinum. Bronze plans charge the lowest premiums but the highest out-of-pocket costs, while gold and platinum plans cost more each month and less when you need care. Silver plans sit in the middle and unlock cost-sharing reductions for eligible households.
Healthy adults with savings often choose bronze plans paired with a health savings account, which lets them set aside pre-tax money for medical costs. People who expect regular care usually save money with silver or gold plans. Check that your doctors and prescriptions fall within each plan’s network and formulary before you enroll.
Key Dates for 2027 Coverage
Open enrollment for 2027 runs from November 1, 2026 to January 15, 2027 on HealthCare.gov, although some state-run marketplaces set different deadlines. Enroll by December 15 if you want coverage to start on January 1. Signing up between December 16 and January 15 usually starts coverage on February 1.
Outside open enrollment, you can only enroll after a qualifying life event, such as losing job-based coverage, getting married, having a baby or moving to a new area. Because missing the window can leave you uninsured for months, put the deadline on your calendar now and compare plans early.
Coverage That Marketplace Plans Do Not Include
Marketplace health plans cover pediatric dental care for children but usually exclude adult dental benefits. Adults who want cleanings, fillings and crowns covered need a separate plan, which we explain in our guide to dental insurance cost per month.
Health insurance also does nothing for your family’s income if you die. Self-employed parents in particular should pair their marketplace plan with affordable term coverage, as shown in our guide to term life insurance rates by age. Older adults may also want small permanent coverage like the policies in our guide to final expense insurance cost.
Frequently Asked Questions
How much does ACA health insurance cost per month? The average enrollee paid about $178 a month after subsidies in 2026, according to KFF. Without subsidies, the average benchmark silver plan cost about $625 a month and the cheapest bronze plan about $456. Your price depends on age, location, income and household size.
Did the enhanced ACA subsidies expire? Yes, the enhanced premium tax credits expired on January 1, 2026. Standard subsidies still exist for households earning between 100% and 400% of the federal poverty level, but many enrollees now pay a larger share of their income, and households above 400% receive no federal help.
When is the deadline for 2027 marketplace coverage? Open enrollment on HealthCare.gov runs from November 1, 2026 through January 15, 2027. Enroll by December 15 for coverage that starts January 1. Some state-run marketplaces set later deadlines, so check your state’s exchange if it does not use HealthCare.gov.
Final Thoughts
Marketplace coverage costs more than it did two years ago, but careful shopping still makes a big difference. Comparing total yearly costs, checking subsidy eligibility and choosing the right metal tier can save a family thousands of dollars while keeping access to the doctors they trust.
Update your income estimate, review every plan in your area and enroll before the December 15 deadline if you want coverage on January 1. The Peterson-KFF Health System Tracker explains the trade-offs between premiums and deductibles in detail, which can help you choose wisely this year.