ACA Open Enrollment 2027: 15% Premium Hikes and Strict ID Checks

Average health insurance premiums are set to rise by 15% for 2027 coverage, a figure that represents a decrease from the 26% average increase seen last year. Open enrollment for the federal marketplace begins today in most states, marking the start of the annual period when consumers must select their health plans. Idaho, Connecticut, and Massachusetts began the process earlier this month.

The Centers for Medicare & Medicaid Services introduced new identity verification rules for 2027 to reduce fraud. Consumers who use agents or brokers in the 29 states served by the federal marketplace must now receive a one-time confirmation code via text, email, or phone to authorize their agent. This step does not apply to state-based exchanges. Additionally, CMS designated certain groups as high-risk, including first-time applicants, those changing states, and consumers with monthly premiums of $30 or less. These individuals must verify their identity through third parties such as Experian before authorizing an agent.

Joshua Brooker, an insurance agency owner in Pennsylvania, noted that the $30 monthly premium threshold targets plans that may lack billing visibility. He expressed concern that up to one in five consumers may face extra identity proofing. Stacey Pogue, a senior research fellow at Georgetown University, said the changes might create extra hurdles for people without credit files or recent name changes.

A September CMS rule also imposes a moratorium on new brokers. Agents not registered with the federal marketplace in 2026 cannot assist with 2027 enrollments until February. Jason Fine, a Florida brokerage owner, said the rule complicates staffing for small agencies that hire seasonal workers. He argued that larger call centers with permanent staffs of 25 to 40 people benefit from the directive. The National Association of Benefits and Insurance Professionals filed a lawsuit on Oct. 15 against the administration over the moratorium. Health Agents for America filed a separate suit on Oct. 21 seeking a temporary restraining order.

Subsidies for 2027 will be less generous than in previous years because enhanced subsidies expired at the end of 2025. Income-based subsidies cut off for households earning more than four times the federal poverty rate. This threshold is $63,840 for a single person and $86,560 for a couple. Louise Norris, a health policy analyst for HealthInsurance.org, said overall affordability will remain similar for most shoppers who managed premiums this year. However, Anne Petry, who owns Jaggi Petry Insurance & Investments in Illinois, called affordability the biggest issue consumers will face.

The One Big Beautiful Bill Act removes subsidy eligibility for many lawfully present immigrants, including H-1B visa holders, refugees, and asylees. Green-card holders, certain Cuban and Haitian immigrants, and citizens of Micronesia, the Marshall Islands, and Palau remain eligible. Out-of-pocket maximums for 2027 will increase by 13% to $12,000 for individuals and $24,000 for families. Experts advise consumers to compare plans rather than allowing auto-renewal, as deductibles and coverage details change annually.