WASHINGTON — Open enrollment for 2027 health coverage through HealthCare.gov opened on Nov. 1 with another sharp rise in prices, and shoppers have until Dec. 15 to pick a plan that starts on Jan. 1.
Premiums for the benchmark silver plan will rise 13 percent on average for 2027, according to a KFF analysis of federal plan data published on Oct. 30. The benchmark plan is the second-lowest-cost silver plan in an area, and it is the plan used to set the size of federal help with premiums.
This is the second large rise in a row. Premiums rose 26 percent from 2025 to 2026, according to KFF, so the two years add up to about 42 percent. It is 11 percent on average in HealthCare.gov states, and 16 percent in states that run their own marketplaces, according to the analysis.
It is also the second year without the enhanced premium tax credits that expired at the end of 2025. Those larger credits had lowered what many people paid each month. Without them, more of the full price of a plan falls on the household, even before this year’s increase in the underlying premium is counted.
Insurers point to rising medical care costs as the main reason, according to KFF. Changes in the risk pool — who signs up, and how much care they are expected to need — account for about 4 percentage points of the rise, according to the analysis. When fewer healthy people sign up, the cost is spread across a smaller and sicker group, and prices go up again.
The Centers for Medicare and Medicaid Services put out a fact sheet on Oct. 30. It did not give an average premium change. CMS said more than 75 percent of HealthCare.gov shoppers can find coverage options, a claim the agency made about the choices on offer, not about what each person will finally pay.
Fewer people are buying this coverage. Paid marketplace enrollment fell to 19.2 million by February 2026, down 12 percent, according to KFF. That drop followed the end of the enhanced credits and the earlier rise, which is why this season is being watched closely.
State figures show how wide the range is. In North Carolina, approved increases for individual plans range from 8.35 percent to 27.36 percent for 2027, according to the North Carolina Department of Insurance. A statewide average can hide a much bigger rise, or a smaller one, for a given family, plan and county.
What shoppers can do
The practical step is to check your own price rather than rely on an average. Help based on income may still apply for some people, even without the enhanced credits, so it is worth entering your current income and household size and seeing the real figure. Compare plans on total cost, not just the monthly premium: a cheaper premium can come with a much higher deductible. Check that your doctors and medicines are covered, and note the dates. Open enrollment runs from Nov. 1, 2026 to Jan. 15, 2027. Enroll by Dec. 15 for coverage from Jan. 1, 2027. If you enroll between Dec. 16 and Jan. 15, coverage starts Feb. 1. State rate details are in the North Carolina Department of Insurance release.
