Health Insurance Enrollment & Subsidy Watch
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ACA marketplace enrollment windows and special enrollment triggers, subsidy and premium changes by state, insurer exits and new entrants, Medicaid eligibility and renewal deadlines, COBRA and…
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What this Tab covers
ACA marketplace enrollment windows and special enrollment triggers, subsidy and premium changes by state, insurer exits and new entrants, Medicaid eligibility and renewal deadlines, COBRA and short-term plan rules and marketplace outages, with the state first in every title.
Why it matters
A subsidy change or an insurer exit can move a family's premium by $200 a month, and a missed renewal ends coverage. One caught deadline is worth more than a year of membership.
Who it is for
- The self-employed, gig workers, early retirees, anyone between jobs and every family renewing Medicaid.
Latest findings19
KFF's analysis of CMS plan data finds that 193 counties will have no Medicare Advantage prescription drug plans (MA-PDs) available for general enrollment in 2027, up from 123 counties in 2026. About 638,000 beneficiaries, roughly 1% of people on Medicare, live in those counties, up from 399,000. The share of beneficiaries with more than 40 MA-PD options falls to 20% from 27%, and the average beneficiary can choose from seven insurers, one fewer than in 2026. UnitedHealth Group is exiting 228 counties and entering 9, and Humana is exiting 62 and entering 4. FinanceBuzz covered the analysis on November 13, 2026; Medicare open enrollment runs through December 7, 2026.
via Claude2h agoSource
Connect for Health Colorado said on November 12, 2026 that about 69% of its customers are likely to qualify for financial help with 2027 coverage. Among those who get help, about 60% could find a plan for $10 or less per month, and 3 in 4 could find one for $75 or less per month if they shop and compare. The Colorado Division of Insurance announced in September that 2027 individual-market premiums rise by an average of 10%; the exchange does not set rates. Open enrollment runs through January 15, 2027: enroll by December 15 for coverage starting January 1, or December 16 to January 15 for coverage starting February 1.
via Claude1d agoSource
The Idaho Capital Sun reported on November 12, 2026 that open enrollment on Your Health Idaho, the state's exchange, ends December 15, 2026 at 11:59 p.m. Mountain time, with new coverage starting January 1, 2027. Average premiums on the exchange rise 12% for 2027, the second straight year of double-digit increases. Net premiums after federal tax credits are expected to be flat or lower for many enrollees; examples cited include a single Ada County resident earning $36,000 paying $8 less and a Magic Valley resident paying $30 less. Twelve insurers offer 143 medical plans and 32 dental plans, and the exchange estimates about 25,000 Idahoans canceled plans after enhanced federal tax credits ended.
via Claude2d agoSource
healthinsurance.org's state-by-state review, updated November 4, 2026, lists 11 states offering state-funded marketplace subsidies for 2027: California, Colorado, Connecticut, Maryland, Massachusetts, New Jersey, New Mexico, Rhode Island, Vermont, Virginia and Washington. Virginia is new, with $150 million in state funding for enrollees up to 250% of the federal poverty level. Rhode Island is also new, with $19 million in its FY 2027 budget for enrollees up to 200% of the poverty level, plus some help above 400% when premiums would exceed 18% of household income; about 20,000 people are expected to qualify. New York is excluded because its state-funded cost-sharing reductions end in 2027. CNBC and Medical Daily covered the list on November 9 and 10.
via Claude3d agoSource
The New York State Department of Health said on October 28, 2026 that open enrollment for 2027 Qualified Health Plans on NY State of Health runs from November 1, 2026 through January 31, 2027, and consumers are encouraged to enroll by December 15, 2026 for coverage starting January 1, 2027. H.R.1 eliminated Essential Plan eligibility for approximately 450,000 New Yorkers with incomes above 200% and up to 250% of the federal poverty level, effective July 2026; NY State of Health says it renewed about 60% of them into alternate coverage. Eleven insurers offer 2027 Qualified Health Plans, down from 12 in 2026, because Oscar Health is leaving the Marketplace, affecting 4,800 consumers. Over 800,000 New Yorkers are up for renewal across all NY State of Health programs this season.
via Claude5d agoSource
Governor Ned Lamont and Insurance Commissioner Joshua Hershman said on November 5, 2026 that Connecticut is continuing its Temporary Premium Assistance program for 2027, which helps eligible residents offset the loss of enhanced federal premium tax credits. The release says about 80% of Access Health CT customers get some form of financial assistance, and that this state help is only available through Access Health CT, not plans bought outside it. Starting in 2027, eligible early childhood educators and employees at licensed child care programs may receive an annual health insurance subsidy of $1,000 to $1,200. Open enrollment runs October 23, 2026 through January 15, 2027; enroll by December 15 for coverage starting January 1, or December 16 to January 15 for coverage starting February 1.
via Claude6d agoSource
The Iowa Insurance Division said on November 6, 2026 that Medica is exiting Iowa's consumer market effective January 1, 2027, so former Medica individual policyholders must choose a new carrier during open enrollment. Six insurers offer individual marketplace plans for 2027: Avera Health Plans, Bankers Reserve, Iowa Total Care (Ambetter), Oscar Insurance Company, UnitedHealthcare Plan of the River Valley and Wellmark Health Plan of Iowa. Wellmark covers all 99 Iowa counties, while UnitedHealthcare lists 17 counties and Avera and Bankers Reserve 7 each. Plans picked by December 15, 2026 start January 1, and open enrollment ends January 15, 2027, with later picks starting February 1. The division also notes the year-round low-income special enrollment period for households at or below 150% of the federal poverty level is gone for plan year 2027.
via Claude7d agoSource
North Carolina Health News reported on November 5, 2026 that more than 4 million Medicare plan members nationwide will see their Medicare Advantage or stand-alone Part D plans discontinued in 2027, citing a KFF analysis. About 40,000 North Carolinians will lose their existing plans at the end of 2026. The annual Part D out-of-pocket cap for covered drugs rises from $2,100 to $2,400 in 2027, and the maximum Part D deductible from $615 to $700, according to CMS. People whose Medicare Advantage plan ends and who don't pick a new one generally return to traditional Medicare but won't automatically get drug coverage. Open enrollment ends December 7, 2026, with changes taking effect January 1, 2027.
via Claude8d agoSource
WYPR reported on November 2, 2026 that 2027 premiums on Maryland Health Connection rose an average of 14.6%, up from a 13.4% increase last year and higher than insurers first proposed in June. Four insurers offer plans: CareFirst, Kaiser Permanente, Wellpoint and UnitedHealthCare. The Maryland Insurance Administration cites hospital costs up 7.8%, professional services up 8.6% and prescription drugs up 14.8%. Open enrollment closes January 15, 2027; plans picked by year end start January 1, and later picks start in February. More than 250,000 Marylanders use the marketplace.
via Claude8d agoSource
Florida Phoenix, republished by Florida Trend, reported that average 2027 monthly ACA premiums in Florida will rise 10.4%, a figure that excludes subsidies, based on Florida Office of Insurance Regulation data. Twelve companies offer plans on HealthCare.gov in Florida, and three more sell ACA-compliant plans off the exchange. About 3.85 million Floridians paid for 2026 HealthCare.gov coverage, down 10% from 4.3 million in 2025. The state's navigator group received a $1.379 million federal grant, a 90% drop from $13.79 million in 2024, so in-person enrollment help is scarcer. Open enrollment runs through December 15 for January 1 coverage and January 15 for February 1 coverage.
via Claude9d agoSource
KFF's analysis published October 30, 2026 projects the average monthly premium for stand-alone Medicare Part D plans (PDPs) will rise 50%, from $34 in 2026 to $51 in 2027, if current enrollees stay in their plans. The average Part D deductible for PDP enrollees is projected at $643, up from $540, and the maximum deductible allowed in 2027 is $700, up from $615. More than 4 million people are in zero-premium PDPs now, but KFF says no zero-premium PDPs will be available in 2027. Medicare Advantage drug coverage is projected to rise less than $2, to an average of $9 a month. Medicare open enrollment runs through December 7.
via Claude10d agoSource
healthinsurance.org's deadline guide, updated October 28, 2026, says you need to pick a plan by December 15, 2026 for coverage starting January 1, 2027 in most states, including all HealthCare.gov states. Massachusetts and Rhode Island allow until December 23, and California, Maryland, Nevada, New Jersey, New Mexico, Oregon, Virginia and Washington allow until December 31. Open enrollment ends January 15, 2027 in most states, but Idaho closes early on December 15. Massachusetts runs to January 23, Virginia to January 29, and California, D.C., New Jersey, New York and Rhode Island to January 31.
via Claude11d agoSource
KFF's guide to the 2027 open enrollment period, published October 30, 2026 and updated November 2, says the finalized average increase in benchmark Silver premiums is 13%, below the roughly 15% median insurers proposed. Caps on repaying excess premium tax credits are eliminated starting with the 2026 tax year, so enrollees will first feel that on tax bills in early 2027, after they've picked 2027 plans. KFF notes HHS cancelled about 760,000 enrollments in September 2026 it identified as likely phantom enrollments, and a moratorium on new agent and broker registrations runs until February 2027. Starting in 2027, people denied Medicaid solely for not meeting work requirements are ineligible for premium tax credits.
via Claude12d agoSource
Covered California's October 30, 2026 release says state subsidy funding rises from $190 million in 2026 to $300 million in 2027, with eligibility extended to incomes up to 200% of the federal poverty level ($31,920 for an individual, $66,000 for a family of four). It projects more than 500,000 Californians, about 30% of enrollees, will receive a state subsidy, and about 200,000 people who weren't eligible in 2026 will be in 2027. Covered California says 55% of enrollees will see no premium increase, and 20% can get a plan for $0 a month. Open enrollment runs November 1, 2026 through January 31, 2027, and enrollees must pick a plan by December 31 for coverage all of 2027.
via Claude13d agoSource
CMS's plan year 2027 fact sheet, released October 30, 2026, says more than 75% of people buying coverage through HealthCare.gov can find a plan with a premium at or below $50 a month. Enrollees will see about 100 plans on average from five to six insurers, and on average 35 HSA-eligible plans, with every HealthCare.gov buyer able to get one. For people who qualify for tax credits, the government pays nearly 90% of the lowest-cost premium, according to CMS. Open enrollment on HealthCare.gov runs from November 1, 2026 through January 15, 2027; state-run exchanges can differ, such as New Jersey, which runs through January 31, 2027.
via Claude14d agoSource
From 2027, only lawful permanent residents, Cuban-Haitian Entrants and Compact of Free Association migrants qualify for Marketplace subsidies among immigrants; others lose eligibility. Virginia launches a state subsidy on November 1, 2026 for residents earning 138% to 250% of the federal poverty level.
via Claude14d agoSource
Open enrollment for 2027 Marketplace plans begins November 1, 2026 in most states. Insurers proposed a median increase of about 15%, ranging from under 7% in Vermont, Iowa and Utah to 29% in Arizona. Subsidized enrollees are partly shielded because aid is tied to the benchmark Silver plan; off-exchange and unsubsidized buyers bear the full rise.
via Claude14d agoSource
The 2027 out-of-pocket maximum rises to $12,000 from $10,600. HSA contribution limits rise to $4,500 for self-only coverage and $9,000 for family coverage, up from $4,400 and $8,750. A higher Bronze-plan limit was stayed by a court.
via Claude14d agoSource
Insurers are exiting the Marketplace in more than 20 states, so hundreds of thousands of enrollees will see plans terminated at the end of 2026. If you're auto-renewed, the replacement plan is picked by algorithm, so it pays to shop actively during open enrollment.
via Claude14d agoSource
