The changes come after enhanced federal subsidies expired at the end of 2025, leaving many households paying more for insurance. New restrictions on financial assistance, additional identity checks and tighter rules for insurance brokers are also changing how consumers obtain coverage through the marketplaces, commonly known as Obamacare.
Higher Insurance Premiums Add Pressure As Federal Subsidies Shrink
Health insurance purchased through Affordable Care Act marketplaces is expected to cost 13% more on average in 2027, according to an analysis of new Centers for Medicare & Medicaid Services data by KFF, a nonprofit health policy research organization.
The increases reflect several pressures on the healthcare system. Cynthia Cox, vice president and director of KFF’s Affordable Care Act program, identified rising medical costs and hospital market concentration among the main factors. Other possible contributors include the No Surprises Act, which took effect in 2022, and the growing availability of GLP-1 medications.
Consumers who do not qualify for federal subsidies are expected to face the greatest financial pressure. Cox noted that many have already switched to bronze plans, which generally carry the lowest premiums.
The expiration of enhanced subsidies introduced during the COVID-19 pandemic has further complicated affordability. Those subsidies, established through legislation signed by former President Joe Biden, had helped reduce monthly insurance payments for millions of Americans.
According to KFF Health News, most marketplace customers will continue receiving financial assistance, although the subsidies are less generous than those available before 2026.
Eligibility now ends for households earning more than four times the federal poverty level. During the current enrollment period, that threshold is $63,840 for an individual, $86,560 for a couple and $109,280 for a family of three.
Consumers also face higher potential out-of-pocket expenses. The annual maximum will rise to $12,000 for individuals and $24,000 for families in 2027, compared with $10,600 and $21,200 in 2026.
Stricter Enrollment Checks and Immigration Rules Reshape Access to Coverage
Beyond affordability, consumers will encounter additional administrative requirements when applying for marketplace insurance.
According to KFF Health News, people using agents or brokers through the federal marketplace, which serves 29 states, must now authorize those representatives through a one-time confirmation code or link.
Certain applicants must also undergo additional identity verification. These include first-time applicants, people changing states or brokers, and consumers whose monthly premiums are $30 or less.
Federal officials describe the measures as part of efforts to prevent fraudulent enrollments and unauthorized changes to insurance policies. The administration has also restricted new broker registrations for the 2027 enrollment season, potentially reducing access to enrollment assistance.
Immigration-related eligibility changes introduce another barrier. New regulations limit federal subsidies for several categories of lawfully present immigrants, including refugees, asylum recipients and certain temporary visa holders.
Meanwhile, approximately 19.2 million Americans were actively enrolled in marketplace plans as of February, according to the Department of Health and Human Services.
The administration has announced efforts to remove 760,000 enrollments it considers improper, citing an estimated $2.2 billion in savings. The combined effects of higher costs and stricter eligibility rules leave the number of people who will retain coverage in 2027 uncertain.
