ACA shoppers face 15% premium hikes and stricter identity checks as 2027 enrollment begins

Average health insurance premiums are set to rise by 15 percent for 2027 coverage, a figure that remains in double digits despite being lower than the 26 percent surge experienced in the previous year. Open enrollment for plans starting next year began on November 1 in most states, though Idaho, Connecticut, and Massachusetts opened their markets earlier. This timing coincides with a period of reduced overall enrollment, a trend policy experts attribute to the expiration of enhanced subsidies at the end of 2025.

The Trump administration views the drop in enrollment numbers as a victory, citing efforts to reduce fraud. In August, officials canceled policies for 760,000 enrollees suspected of being improperly signed up, though a small number have since regained coverage. As shoppers navigate this changed landscape, the Centers for Medicare & Medicaid Services has introduced new identity verification requirements that will affect consumers using agents in the federal marketplace, which serves 29 states.

These new rules mandate that consumers obtain a one-time confirmation code via text, email, or phone call to authorize a specific agent. Additionally, individuals classified as high-risk must verify their identity before an agent can act on their behalf. CMS defines high-risk applicants as first-time enrollees, those changing states, those switching agents, or those with monthly premiums of $30 or less. Joshua Brooker, an insurance agency owner in Pennsylvania, noted that the $30 cutoff targets plans where low bills might go unnoticed, allowing bad agents to profit from commissions without detection.

Brooker expressed concern that up to one in five consumers may need to undergo this extra proofing process. Those who fail initial verification checks may be required to submit documents such as driver's licenses, passports, or immigration papers directly through healthcare.gov. Stacey Pogue, a senior research fellow at the Center on Health Insurance Reforms at Georgetown University, warned that these hurdles could exclude people who lack credit files or have recently changed names, even if they are legitimate applicants.

Compounding these challenges is a September rule that pauses the registration of new brokers. Agents not registered with the federal marketplace in 2026 are barred from assisting with 2027 enrollments until February. Jason Fine, a Florida broker, said the move protects consumers in the long run but creates short-term chaos. He expects to struggle in hiring the up to 10 additional agents he planned to add to his core staff of five, as many available candidates lack the required 2026 registration status.

The restriction has prompted legal action from industry groups. The National Association of Benefits and Insurance Professionals filed a lawsuit on October 15, arguing the moratorium unfairly targets 19,000 agents. On October 21, Health Agents for America sought a temporary restraining order. Ronnell Nolan, the group's president, stated that the rule penalizes agencies that invested thousands of dollars in training new staff who can no longer work.

Subsidies for 2027 will be less generous than in recent years, as Congress did not renew the enhanced funding. Most consumers will still receive aid, but higher earners have lost subsidies entirely. Subsidy eligibility for households earning more than four times the federal poverty rate has ended, a threshold of $63,840 for a single person and $109,280 for a family of three this year. The One Big Beautiful Bill Act also strips subsidy eligibility from many lawfully present immigrants, including H-1B visa holders and refugees.

Out-of-pocket maximums are also increasing by 13 percent, rising to $12,000 for individual plans and $24,000 for family plans in 2027. Health policy analysts advise consumers to compare premiums and deductibles rather than allowing plans to auto-renew, as several major insurers have exited certain markets.