Consumers purchasing health insurance through the Affordable Care Act (ACA) can expect various changes as open enrollment for 2027 coverage begins. These changes include premium increases, additional identity checks, potential broker delays, and new limits on subsidies for immigrants. Planning ahead is essential. Open enrollment starts Nov. 1 in most states, with Idaho, Connecticut, and Massachusetts starting earlier.
Enrollment Decline Continues
Overall enrollment is expected to decline further due to the expiration of enhanced subsidies at the end of 2025. Experts indicate the loss of subsidies led millions to drop or lose coverage earlier this year. The Trump administration views the enrollment decline as a victory, attributing it to efforts to combat fraud, including cancelling policies for 760,000 enrollees in August suspected of improper enrollments.
Increased Scrutiny in Enrollment
For 2027, heightened scrutiny on consumers and agents will aim to prevent fraud and improper enrollments. This process might slow down for those needing assistance from agents or brokers in the federal marketplace. Consumers using agents must receive a confirmation code or link for authorization, sent via text, email, or automated call. High-risk consumers must verify their identity through third parties like credit companies.
“People may face challenges in proving their identity, particularly if they lack a credit file, have moved, or changed names,” notes Stacey Pogue from Georgetown University.
Brokers Facing Restrictions
New restrictions limit brokers’ ability to offer ACA coverage. A moratorium on new brokers aims to manage compliance issues observed in 2026. Established brokers express concern over staffing difficulties caused by these restrictions, possibly leading to fewer agents available during enrollment.
Agent associations, including the National Association of Benefits and Insurance Professionals, are suing over the moratorium, arguing it unfairly impacts new agents. Consumers relying on brokers should schedule appointments early as fewer brokers may be available.
Rising Costs
The absence of renewed subsidies and double-digit premium increases will result in higher costs for many consumers. While subsidies remain income-based, higher earners lose access completely. Despite challenges, most ACA consumers will still receive subsidies.
Premiums increased significantly last year, influenced by fears regarding healthy individuals leaving the market post-subsidy expiration. These trends persist with projected premium increases of 15%, slightly below last year’s 26% spike.
Impact on Immigrants
The One Big Beautiful Bill Act affects subsidy eligibility, excluding many lawfully present immigrants like those on H-1B visas, refugees, and asylees. However, green-card holders, certain Cuban and Haitian immigrants, and citizens of specific Pacific islands retain eligibility.
KFF Health News, a prominent source of health policy research, provides analysis on issues impacting the ACA.
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