Auto-Renew Could Leave You Uncovered in January — and 2027 Benchmark Premiums Are Up 13%
Here is the trap waiting for anyone who had Marketplace coverage in 2026: you do nothing, your plan renews, and in January you discover the price jumped, your doctor left the network, or your subsidy vanished. None of that is a glitch. The rules behind your 2026 price changed, and the plan that was right last year may be the wrong plan this year. This post is about the one decision that protects you — actively re-shopping before December 15 — and the 2027 rule changes that make auto-renewal unusually dangerous.
The dates that decide everything
Open enrollment for 2027 coverage on HealthCare.gov runs from November 1, 2026, through January 15, 2027, according to KFF's 2027 open enrollment guide. But there are two deadlines inside that window, and they do different jobs:
| Date | What it decides |
|---|---|
| November 1, 2026 | Open enrollment opens for 2027 coverage |
| December 15, 2026 | Last day to enroll or change plans for coverage starting January 1, 2027 |
| January 1, 2027 | Coverage starts for people who enrolled by December 15 and paid their first premium |
| January 15, 2027 | Open enrollment ends on HealthCare.gov |
| February 1, 2027 | Coverage starts for people who enrolled December 16 through January 15 and paid their first premium |
The December 15 date is confirmed as the cutoff for January 1 coverage by SubsidyCalc's 2027 dates guide, citing HealthCare.gov, and the January 15 end date is confirmed by Medicare.tools' 2027 enrollment guide, citing HealthCare.gov's current enrollment guide. A 2025 federal rule would have ended enrollment on December 15, but a federal court vacated that rule in June 2026, and the Centers for Medicare & Medicaid Services (CMS) confirmed the window runs through January 15, 2027, as reported by GLP Winner, citing CMS's July 31, 2026 statement. Treat December 15 as your real deadline anyway: it is the only date that protects January coverage under any version of the rules.
Two more date facts matter. First, your plan only takes effect once you pay the first premium, according to SubsidyCalc, citing HealthCare.gov. Enrolling without paying is not coverage. Second, if your state runs its own exchange, your dates may differ: for example, California and Washington list December 31 as the cutoff for a January 1 start, and Massachusetts lists December 23, according to SubsidyCalc's state dates guide. Check your state's own marketplace before you count on the federal dates.
Why auto-renewal is riskier than usual in 2027
1. Benchmark premiums jumped again. Finalized benchmark Silver premiums rise 13% on average for 2027, according to KFF. The increase is 11% in states that use the HealthCare.gov platform and 16% in states that run their own enrollment platforms, according to the same KFF analysis. Insurers had proposed a median increase of 15% for 2027, according to KFF. This follows a 26% rise in benchmark premiums from 2025 to 2026, according to KFF — 30% in HealthCare.gov states and roughly 17% in state-based Marketplaces, according to the same KFF analysis. Taken together, benchmark Silver premiums have increased 42% on average between 2025 and 2027, according to KFF. Insurers cite higher underlying care costs and the expiration of the enhanced premium tax credits, and KFF's analysis of insurer filings found that insurers estimated risk-pool changes added about 4 percentage points on average to premiums in 2026 and expect a similar, additional effect in 2027, according to KFF.
2. Your insurer may be gone. As of October 29, 2026, 11 carriers had announced plans to exit at least one state for 2027, while 7 carriers had announced plans to enter a new state, according to KFF. Cigna, for example, is leaving the individual market in all 11 states where it currently participates, according to KFF. An auto-renewed plan from an exiting carrier means a forced switch later, on someone else's timetable.
3. Enrollment is falling, which feeds back into prices. During the 2026 open enrollment period, Marketplace plan selections fell by 1.2 million from 2025, according to KFF. By February 2026, effectuated Marketplace enrollment — people who pay their premiums and remain enrolled — was down 12%, or 2.6 million people, from the previous year, to 19.2 million people, according to KFF. The Congressional Budget Office estimated ACA Marketplace enrollment would fall from a peak of 22.4 million in 2025 to 13.1 million in 2027, according to KFF, citing CBO. When healthier enrollees drop coverage, the remaining pool gets sicker on average, which puts further upward pressure on premiums, according to KFF.
4. The subsidy cliff is back — and it is a cliff, not a slope. The enhanced premium tax credits expired December 31, 2025, according to KFF. The House passed a three-year extension in January 2026 by a vote of 230 to 196, but the Senate has not passed it, and S.3385 failed cloture by 51 to 48 in December 2025, according to Taxpayers for Common Sense's 2027 subsidy status tracker, citing KFF. Under the original premium tax credit rules that now apply, households above 400% of the federal poverty level get no premium tax credit at all, according to KFF. From 2021 through 2025, the enhanced credits had capped what anyone paid for a benchmark plan at 8.5% of household income and removed the old income ceiling, according to Taxpayers for Common Sense, citing KFF. Both protections are gone for 2027.
The dollar consequences are already visible. After tax credits, the average enrollee paid $113 a month in 2025 and $178 in 2026, according to SuperMoney, citing CMS — a 58% jump in one year, or $780 more over twelve months, according to the same SuperMoney analysis. KFF estimated that for enrollees who still qualify for help, the amount coming out of their own pockets could more than double on average once the enhanced credits lapsed, rising about 114%, from roughly $888 a year to roughly $1,904, according to SeniorSite, citing KFF. KFF also estimated that a 64-year-old with income just over the 400% line could pay roughly $11,000 more a year for coverage without the enhanced credits, and a 60-year-old in the same position roughly $9,600 more, according to SeniorSite, citing KFF. People above 400% of poverty are hit hardest because they must pay the full cost of coverage, according to KFF.
5. Overestimating your income no longer has a safety net. Beginning in the 2026 tax year, limits that previously capped how much some Marketplace enrollees had to repay in excess premium tax credits were eliminated through the 2025 budget reconciliation law, according to KFF. Because the first tax filings under the new rules will not happen until early 2027, enrollees choose 2027 plans without having seen how uncapped repayment works in practice, according to KFF. If your income ends up higher than projected, your tax bill can be larger than you expect — which is why the income estimate you enter this fall deserves real attention, not a guess carried over from last year.
6. Two eligibility doors narrowed. For 2027, premium tax credits are limited to certain groups of lawfully present immigrants, including lawful permanent residents, Cuban and Haitian entrants, and lawful residents living in the United States under the Compact of Free Association, according to KFF. Other lawfully present immigrants, such as refugees, victims of human trafficking, and asylees, can still purchase Marketplace coverage but will no longer be eligible for premium tax credits, according to KFF. The Congressional Budget Office estimates that 1 million more individuals will be uninsured as a result of this provision by 2035, according to KFF, citing CBO. Separately, starting in 2027, in states required to implement Medicaid work requirements, consumers who lose or are denied Medicaid coverage solely for not meeting work requirements will also be ineligible for premium tax credits, according to KFF. The law now requires 43 states and the District of Columbia to implement work requirements by the start of 2027, according to KFF.
7. Fraud crackdowns changed the enrollment experience. In September 2026, the Department of Health and Human Services reported it cancelled coverage for approximately 760,000 individuals that CMS described as "phantom" enrollees, according to KFF. HHS sent a list of about 1.2 million people to insurers to review, according to KFF. HHS also temporarily paused the registration of new agents and brokers in the federally facilitated Marketplace until February 2027, and CMS estimated that approximately 19,000 new agents and brokers would have registered absent the restriction, according to KFF. Practical consequence: enrollment help may be harder to reach, and you should expect identity and income checks to be taken seriously.
One piece of genuinely good news from the courts: for plan year 2027, consumers will not be disqualified from receiving premium tax credits if they fail to file and reconcile prior years' premium tax credits, according to KFF. And some states are cushioning the federal cuts themselves: New Mexico fully backfilled the lost federal assistance for Marketplace enrollees in 2026 and is continuing its assistance in 2027, according to KFF. California is continuing state-funded premium subsidies and expanding its program to partially backfill lost enhanced tax credits for households with incomes between 165% and 200% of poverty, after previously covering only households between 138% and 165% of poverty, according to KFF. New Jersey, Rhode Island, and Virginia have also maintained or created state-specific subsidies for 2027, according to KFF.
Subsidy basics: how the credit is figured in 2027
The premium tax credit is built around a benchmark: the second-lowest-cost Silver plan in your area, which sets subsidy amounts, according to SmartMoneyGuide, citing KFF's analysis. The credit covers the gap between that benchmark premium and the share of your income the law expects you to pay. That expected share comes from the IRS applicable percentage table for 2027, published in Revenue Procedure 2026-26. The table runs from 2.15% of household income at the bottom to 10.22% at the top, and it stops at 400% of the federal poverty level, according to Revenue Procedure 2026-26, via PartnerTax:
| Household income as a share of poverty | Expected share of income (initial) | Expected share of income (final) |
|---|---|---|
| Less than 133% | 2.15% | 2.15% |
| 133% to less than 150% | 3.23% | 4.30% |
| 150% to less than 200% | 4.30% | 6.78% |
| 200% to less than 250% | 6.78% | 8.66% |
| 250% to less than 300% | 8.66% | 10.22% |
| 300% to 400% | 10.22% | 10.22% |
| Above 400% | No credit | No credit |
The separate required contribution percentage used for the employer-coverage affordability test is also 10.22% for 2027, according to ClearMoneyGuide, summarizing Revenue Procedure 2026-26. The table is the reason the cliff matters so much: a household at 400% of poverty is expected to pay 10.22% of income toward the benchmark plan and gets a credit for the rest, while a household one dollar over the line gets nothing.
The poverty figures behind the table come from the 2026 federal poverty guidelines, which are the figures 2027 Marketplace plans are priced off, according to Wealthvieu, citing HHS. The 2026 guideline for one person in the 48 contiguous states and the District of Columbia is $15,960, and $33,000 for a family of four, with $5,680 added for each additional household member, according to BenefitsUSA, citing HHS ASPE. The 400% cutoff therefore lands at the following incomes, according to LegalClarity, citing the 2026 HHS guidelines:
| Household size | 100% of poverty | 400% of poverty (subsidy cutoff) |
|---|---|---|
| 1 person | $15,960 | $63,840 |
| 2 people | $21,640 | $86,560 |
| 4 people | $33,000 | $132,000 |
If your projected income sits near one of those lines, your estimate is the most valuable number in this whole process. A small raise, a bonus, or a year of freelance income that lands you just over the line does not shrink your credit — it erases it. And with repayment caps gone, an income underestimate can also come back as a tax bill. Update your income estimate when circumstances change during the year, and keep the documents that support it.
How to compare plans: premium vs. deductible vs. network
Every Marketplace plan falls into a metal category, and the category has nothing to do with the quality of care you get, according to HealthCare.gov's plan categories page. The categories describe how you and the plan split the cost of covered services, on average:
| Category | Plan pays (average) | You pay (average) |
|---|---|---|
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Silver with extra savings | 73% to 94% | 6% to 27% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
Those percentages are averages across a large group of people, not a promise about any single bill, according to HealthCare.gov. All Marketplace plans in every category must cover the same 10 essential health benefits, including preventive services, according to HealthCare.gov. So the comparison is not about what is covered in principle — it is about what you pay, which doctors you can see, and what happens when you actually need care.
Start with total yearly cost, not the monthly premium. A low premium with a high deductible can cost more over a year than a higher premium with a low deductible if you use care regularly. Compare the premium across twelve months plus the deductible and the out-of-pocket maximum, then check the copays for the services you actually use. For 2027 plans, CMS set the maximum annual limitation on cost sharing at $12,000 for self-only coverage and $24,000 for other-than-self-only coverage, up from the 2026 limits of $10,600 and $21,200, according to CoveredUSA, citing CMS. That limit covers in-network essential health benefits only, so premiums, out-of-network care, and services the plan does not cover never count toward it, according to CoveredUSA, citing HealthCare.gov.
The Silver trap is the single most expensive mistake in this section. Cost-sharing reductions — extra savings that lower deductibles, copays, and the out-of-pocket maximum — are available only on Silver plans and only for incomes from 100% to 250% of the poverty level, according to RedHealth Advisors, checked against CMS, IRS, and federal rules. For 2027, CMS set reduced out-of-pocket limits of $4,000 for household income up to 200% of the poverty level and $9,600 for income above 200% up to 250%, with family limits of $8,000 and $19,200 respectively, according to CoveredUSA, citing CMS. The 250% line for 2027 coverage is $39,900 for one person and $82,500 for a family of four, according to Peterson-KFF Health System Tracker. If you qualify for cost-sharing reductions and pick Bronze instead, you walk away from that entire benefit — and unlike excess premium tax credits, the cost-sharing reduction itself is not paid back, according to RedHealth Advisors. Premium tax credits are only available on Marketplace plans and cannot be applied to catastrophic plans, according to Peterson-KFF Health System Tracker, and plans bought directly from insurers outside the Marketplace never include cost-sharing reductions, according to HealthCostTools, citing HealthCare.gov.
Then check the network before the price. A plan that does not include your doctors or your prescriptions is not cheaper — it is a different product. Confirm that your regular doctors, your hospital, and your prescriptions are in-network, and check whether referrals are required. Networks changed this year in places where carriers exited, so last year's network answer is not this year's answer.
Re-shop checklist: do this before December 15
- Confirm your projected 2027 household income and compare it with the 400% cutoff for your household size in the table above.
- If you are near the cutoff, treat the income estimate as the decision that matters most — crossing it erases the credit entirely.
- Check whether your 2026 carrier is still selling in your state for 2027, and whether your doctors and prescriptions are still in-network.
- If your income is at or below 250% of poverty, compare Silver plans first — cost-sharing reductions exist only on Silver.
- Compare total yearly cost (twelve months of premiums plus deductible plus out-of-pocket maximum), not the monthly premium alone.
- Enroll by December 15, 2026 for coverage starting January 1, 2027, and pay the first premium by the insurer's deadline.
- If your state runs its own exchange, confirm its dates on the state's own site — do not assume the federal dates apply.
- Save your enrollment confirmation and your income documents, and update your income estimate on the Marketplace if it changes during the year.
Common mistakes to avoid
1. Letting the plan auto-renew untouched. If you already have a Marketplace plan and do nothing by December 15, you may be renewed automatically for January 1, but HealthCare.gov says that in some cases you will not be, and that you should update your application either way, according to BlackHealth, citing HealthCare.gov. Auto-renewal also locks in last year's subsidy math against this year's prices, networks, and rules.
2. Treating December 15 as the end of enrollment. December 15 is the deadline for January 1 coverage, not the end of open enrollment. Enrolling December 16 through January 15 is still possible, but coverage starts February 1 instead, according to SubsidyCalc, citing HealthCare.gov. If your current coverage ends December 31, that gap month is uninsured time.
3. Picking Bronze while eligible for Silver extra savings. See the Silver trap above: cost-sharing reductions exist only on Silver plans for incomes from 100% to 250% of poverty, according to RedHealth Advisors. A cheaper Bronze premium can be the most expensive choice of the year.
4. Guessing your income. With repayment caps eliminated beginning in the 2026 tax year, according to KFF, an underestimate can return as an uncapped tax bill, and an overestimate near the 400% line can cost the whole credit. Project carefully, and update the estimate when income changes.
5. Buying off-Marketplace to "keep it simple." Premium tax credits are only available on Marketplace plans, according to Peterson-KFF Health System Tracker, and off-Marketplace Silver plans never carry cost-sharing reductions, according to HealthCostTools. The same plan bought in the wrong place can cost the full subsidy.
6. Assuming January 15 saves you. After January 15, you generally cannot enroll in a Marketplace plan until next fall unless you qualify for a Special Enrollment Period, according to BlackHealth, citing HealthCare.gov. A Special Enrollment Period usually runs within 60 days of a life change such as losing other coverage, moving, getting married, or having a baby, according to BlackHealth, citing HealthCare.gov. Medicaid and CHIP, by contrast, take applications any time of year, according to SubsidyCalc, citing HealthCare.gov.
7. Forgetting the first premium. Your plan only takes effect once you pay the first premium, according to SubsidyCalc, citing HealthCare.gov. Enrollment without payment is not coverage, and January 1 will arrive without it.
Save this: your 2027 re-shop summary
- Real deadline: December 15, 2026 for coverage starting January 1, 2027. Open enrollment itself ends January 15, 2027.
- The cliff is back: above 400% of poverty — $63,840 for one person, $132,000 for a family of four — the premium tax credit is zero.
- The Silver rule: at or below 250% of poverty ($39,900 for one person), compare Silver first. Cost-sharing reductions exist only on Silver.
- The repayment change: excess premium tax credits are no longer capped on repayment. Estimate income carefully and update it when it changes.
- The auto-renewal rule: never let a plan roll over untouched in a year when premiums, carriers, networks, and subsidy rules all moved. Re-shop, confirm the network, enroll by December 15, and pay the first premium.
Sources
- KFF, 9 Things to Watch for the 2027 ACA Open Enrollment Period (updated November 2, 2026):
KFF: 2027 ACA open enrollment - IRS Revenue Procedure 2026-26, applicable percentage table and required contribution percentage for 2027:
Revenue Procedure 2026-26 (full text) - HealthCare.gov, Health plan categories: Bronze, Silver, Gold, and Platinum:
HealthCare.gov: plan categories - HHS 2026 poverty guidelines, via BenefitsUSA (ASPE table) and LegalClarity:
BenefitsUSA: 2026 federal poverty level chart · LegalClarity: 400% of poverty, 2026 - 2027 dates and deadlines, citing HealthCare.gov:
SubsidyCalc: 2027 dates and deadlines by state · Medicare.tools: 2027 ACA enrollment guide - 2027 subsidy status, citing KFF:
Taxpayers for Common Sense: 2027 ACA subsidy status - 2027 out-of-pocket limits and cost-sharing reductions, citing CMS and HealthCare.gov:
CoveredUSA: comparing plans for 2027 · RedHealth Advisors: cost-sharing reductions 2027 - Cost-sharing reductions and the 250% line, via Peterson-KFF Health System Tracker:
Peterson-KFF: HSAs in the ACA Marketplaces - Average enrollee costs after credits, citing CMS:
SuperMoney: 2027 open enrollment, don't auto-renew - KFF subsidy-cliff estimates for older enrollees:
SeniorSite: ACA subsidy cliff 2027, citing KFF - Special enrollment periods and auto-renewal, citing HealthCare.gov:
BlackHealth: 2027 open enrollment guide - CMS July 31, 2026 statement on the January 15 end date:
GLP Winner: 2027 open enrollment dates, confirmed - Benchmark Silver definition, citing KFF:
SmartMoneyGuide: benchmark premiums rise 13% for 2027 - Photo: Pavel Danilyuk on Pexels (page verified November 3, 2026):
Pexels photo page
This post is educational only, not personalized advice. It makes no predictions about your premiums or eligibility. Confirm your figures with HealthCare.gov or your insurer before you enroll, and check your state's own marketplace if your state runs its own exchange.
By Daniel Kim — practical knowledge for your wallet and everyday life.
---About the author: Daniel Kim
Daniel Kim writes practical guides to household money decisions and the economy around you, in plain English.
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