What changed

2026 against 2027, line by line

Most year-over-year comparisons in this category are vague. This one is specific, sourced, and honest about which items are settled and which are still in front of a judge.

Money

20262027Direction
Top applicable percentage9.96%10.22%Worse
Out-of-pocket max, one person$10,600$12,000Worse
Out-of-pocket max, family$21,200$24,000Worse
Affordability exemption threshold8.05%8.5%Worse
Median rate change filed+20% approved+15% proposedWorse
Out-of-pocket maximums rose 13.2% in one year. The applicable percentage increase means everyone at the top of the eligible range contributes a larger share of income before any premium change is applied.

Poverty levels and the cliff

Subsidies use the prior year’s poverty guidelines. 2026 coverage used the 2025 figures; 2027 coverage uses the 2026 figures, published in January 2026.

2026 coverage2027 coverageDirection
100% of poverty, one person$15,650$15,960Better
Each additional person$5,500$5,680Better
Cliff, one person$62,600$63,840Better
Cliff, family of four$128,600$132,000Better
Higher poverty guidelines raise the cliff in dollar terms, which genuinely helps households near the line. It is the only column on this page moving in the consumer's favour.

Contribution percentages

Income band20262027
Under 133%2.10% to 2.10%2.15% to 2.15%
133% to 150%3.14% to 4.19%3.23% to 4.30%
150% to 200%4.19% to 6.60%4.30% to 6.78%
200% to 250%6.60% to 8.44%6.78% to 8.66%
250% to 300%8.44% to 9.96%8.66% to 10.22%
300% to 400%9.96% to 9.96%10.22% to 10.22%
Every band rose. Sources: IRS Rev. Proc. 2025-25 for 2026 and Rev. Proc. 2026-26 for 2027.

Rules and deadlines

20262027
Open enrollment opensNovember 1, 2025November 1, 2026
Deadline for January 1December 15, 2025December 15, 2026
Final deadlineJanuary 15, 2026January 15, 2027 (under appeal)
Monthly low-income special enrollmentRepealedPermanently gone
Excess subsidy repayment capsEliminatedEliminated
Enhanced premium tax creditsExpiredStill expired

Changes that are not currently in effect

Several restrictive rules finalised for 2027 were struck down or enjoined by a federal court in Maryland during 2026, and the government has appealed. As things stand, these are not operating:

RuleStatus
Shortened open enrollment ending December 15Vacated, on appeal
$5 monthly premium for auto-reenrolled zero-premium enrolleesNot in effect for 2027
Expanded pre-enrollment verification for special enrollment periodsEnjoined
Denying advance credits for failure to reconcileEnjoined
Expanded income verification producing extra data-matching issuesEnjoined
Bronze plans allowed a 130% out-of-pocket maximumEnjoined
Elimination of standardised plan optionsEnjoined
Status as of August 8, 2026. The appeal is pending before the Fourth Circuit. Anything here could change during open enrollment.

Changes that are settled

RuleEffect for 2027
Monthly special enrollment period at or below 150% of povertyPermanently repealed by statute
DACA recipientsNot eligible for marketplace coverage or subsidies
Immigrant eligibilityNarrowed to permanent residents, Cuban-Haitian entrants, and COFA migrants
Routine adult dental as an essential health benefitProhibited
Marketplace user fee1.9% of premium on the federal platform
These come from statute or from unchallenged parts of the rulemaking, so litigation does not affect them.

The short version

You will contribute a slightly larger share of income, your worst-case year costs 13% more, premiums are rising again, and the credit that used to absorb all of that is still gone. Against that, the poverty thresholds moved up a little and several restrictive enrollment rules are not currently operating. Read the enrollment guide for what to do about it, and run your own numbers rather than the averages.

Common questions

Is 2027 better or worse than 2026?

Slightly worse on every axis that can be measured. The share of income you are expected to contribute rose, out-of-pocket maximums rose 13%, and insurers filed another median 15% increase. Poverty guidelines also rose, which nudges the cliff thresholds up and marginally helps people near the edge.

Did anything improve?

The poverty guidelines increased, so the 400% cliff sits about 2% higher in dollar terms, which helps households near the line. Several restrictive 2027 enrollment rules were struck down by a federal court in 2026 and are not currently in effect, which also works in consumers' favour while the appeal is pending.

What is still uncertain for 2027?

The end date of open enrollment, several verification and eligibility rules, and whether Congress restores the enhanced credits. Any of these could change the picture materially before or during open enrollment.

Sources

  1. 1.IRS Rev. Proc. 2026-26 (2027 applicable percentages)
  2. 2.IRS Rev. Proc. 2025-25 (2026 applicable percentages)
  3. 3.CMS 2027 Payment Parameters Guidance
  4. 4.HHS 2026 Poverty Guidelines, 91 FR 1797
  5. 5.CMS 2025 Marketplace Integrity and Affordability final rule
  6. 6.CMS legal statement on the City of Columbus litigation
  7. 7.CMS 2027 Notice of Benefit and Payment Parameters
  8. 8.KFF: How the 2025 budget reconciliation law affects the ACA

Marketplace rules change through legislation, rulemaking, and litigation. Confirm anything you are about to act on, or call and ask.

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