Navigating the ACA Marketplace Year Round
Stay up to date on key dates, what's changed, and how to make sure you're not overpaying.
What’s Changed
A few real shifts are affecting what you'll pay and how you'll enroll. Here's what actually matters.
-
Cigna is exiting the ACA Marketplace for 2027, affecting about 369,000 members nationwide — with Mississippi and Tennessee among the states hit hardest. Texas is also losing a carrier, Baylor Scott & White Health Plan. If you're currently covered by either, you'll need to actively select a new plan during Open Enrollment — your coverage won't simply carry over. I can help you find a comparable replacement.
-
You may have heard that Open Enrollment was being shortened this year. A rule was going to end it on December 15, a federal judge vacated that rule in June, and CMS confirmed in August that HealthCare.gov states will use the usual schedule: November 1, 2026 through January 15, 2027. December 15 still matters — that's the cutoff for coverage that starts January 1. Enroll after that and your coverage begins February 1 instead. If you heard the earlier version, ignore it.
-
Expanded pandemic-era subsidies expired at the end of 2025 and weren't renewed, which brings back the original income cutoff. Earn above 400% of the federal poverty level and you lose your premium subsidy entirely — not gradually, but all at once, and going over by a single dollar does it. If your income is anywhere close to that line, it's worth running the numbers before you enroll rather than after. Send me your estimate and I'll tell you exactly where you stand.
-
After a steep jump in 2026, insurers have filed for another round of increases for 2027, with double-digit hikes proposed in many states. Rates vary enormously by state and by carrier, so the increase on your plan may look nothing like the national average. That's exactly why shopping instead of auto-renewing matters this year.
-
With subsidy eligibility and pricing shifting for so many people, staying on your current plan by default could mean overpaying, or missing a plan that fits you better. This is the year to actually compare, not coast.
Key Dates for 2027 Coverage
November 1, 2026
Open Enrollment begins! First day to enroll in, renew or change your 2027 plan.
December 15, 2026
First deadline. Enroll by this date for coverage that starts on January 1, 2027.
January 15, 2027
Final day to enroll or make changes to your 2027 plan, unless you have a qualifying life event.
Anytime - if you qualify
A qualifying life event — job change, marriage, new baby — opens a 60-day Special Enrollment Period, any time of year.
What Determines Your Subsidy
Two things decide what you pay: who's in your household and what your income is. People get these wrong all the time, and the mistake usually doesn't surface until tax season. Here's how they actually work.
-
Your Marketplace household is your tax household: you, your spouse if you file jointly, and everyone you'll claim as a dependent. That's true even for people who don't need coverage and even for people who already have insurance through a job — they still count toward your household size. A child away at college counts if you claim them. A roommate, or a partner you don't claim, doesn't. If you're expecting, the baby may count toward your household size, which can change what you qualify for, so tell me before you apply rather than after.
-
The Marketplace uses modified adjusted gross income, or MAGI. For most people it's identical or very close to the adjusted gross income on their tax return — it's AGI plus any non-taxable Social Security benefits, tax-exempt interest, and excluded foreign income. Two things trip people up. First, it's your estimated income for the year you'll be covered, not what you made last year. Second, it's everyone in the household, not just the people applying.
-
Count it: wages, self-employment income after business expenses, unemployment, Social Security including the portion that isn't taxed, IRA and 401(k) withdrawals, interest and dividends, net rental income.
Don't count it: SSI, workers' compensation, child support, gifts, and inheritances.
A dependent's income only counts if they're required to file their own return. Earning a little from a summer job usually doesn't change anything.
Your Subsidy and Your Tax Return
You Have to File and Reconcile
If you take a premium tax credit, you have to file a federal tax return and reconcile it on Form 8962 — even if your income is low enough that you wouldn't otherwise need to file at all. You'll get Form 1095-A from the Marketplace by early February with the numbers you need. Skip this step and two things happen: the IRS will reject your return, and the Marketplace can cut off your subsidy for the following year, leaving you paying full price. It's the single most common reason I see people lose their financial help.
If Your Income Was Higher Than You Estimated
Your subsidy is based on what you expect to earn. If you end up earning more, some or all of that credit has to be paid back when you file. The protections that used to cap how much you'd owe were eliminated starting with 2026 coverage, so the repayment is now the full difference. For anyone whose income moves around — self-employed, commission-based, seasonal — this is worth planning around rather than discovering in April.
Keep Your Subsidy! The fix is easier than the problem. Tell me whenever your income changes and I'll update your application. Your credit gets adjusted going forward, which means a smaller correction at tax time instead of a large one. A five-minute call in July is a much better outcome than a surprise the following spring.
Missed Open Enrollment? You May Still Qualify!
Open Enrollment isn't the only time you can get covered. A Special Enrollment Period gives you a 60-day window to enroll or change your plan outside the usual dates — triggered by a qualifying life event like:
Getting married or divorced
Having or adopting a baby
Losing other coverage (job loss, aging off a parent's plan, COBRA ending)
Moving to a new area
Income changes that affect your eligibility
Not sure if your situation qualifies? That's exactly the kind of question I can answer quickly — reach out and I'll check for you.
Let’s Make Sure You’re Covered - and Not Overpaying
Between subsidy rules, provider networks, and prices that shift every year, the Marketplace is a lot to sort through on your own. You don't have to. I'll help you figure out exactly where you stand and find a plan that actually fits — at no cost to you.
