ACA Marketplace Premiums Rise 15% for 2027; Immigrants Lose Subsidies
Open enrollment for 2027 ACA coverage begins November 1, with median premiums rising 15% nationwide and major changes to subsidies for visa holders, refugees, and asylees. Lawfully present immigrants without green cards will no longer qualify for federal premium tax credits.
Starting November 1, 2026, Americans buying individual health insurance through the ACA Marketplace face the second consecutive year of double-digit premium increases. Insurers have proposed a median rate hike of 15% for 2027 across 276 carriers nationwide, according to analysis by the Kaiser Family Foundation. While that headline sounds dire, most Marketplace enrollees receive federal subsidies that partially absorb the increases.
But there's a major catch for foreign-born residents: the enhanced premium tax credits that have kept costs down since 2021 have expired. Households earning above 400% of the federal poverty level no longer qualify for any subsidy at all. More significantly, lawfully present immigrants who are not green card holders—including visa holders, refugees, asylees, and people on temporary protected status—have been stripped of subsidy eligibility entirely under 2025 federal law.
What's Changing and Why
- Median premium increase: 15% nationwide (range: 1% decrease in some areas to 54% increase in others)
- Enhanced subsidies that ran 2021–2025 are gone; original ACA subsidy formula applies
- Subsidies now capped at 400% of the federal poverty level (~$64,000 for an individual)
- Immigrants without green cards—visa holders, refugees, asylees, people with TPS status—no longer qualify for premium tax credits
- Seven insurers are exiting the Marketplace, forcing some enrollees to switch plans
- Open enrollment runs November 1, 2026, through January 15, 2027; enroll by December 15 for January 1 coverage
Open enrollment also brings stricter repayment rules: if you underestimate your income in 2027, you now repay every dollar of excess subsidy at tax time, with no cap on repayment amount—a change from prior years that capped repayment for lower-income earners.
If you're on a work visa, student visa, or have refugee/asylee status but no green card: you will no longer receive a premium tax credit in 2027. Your full premium cost will be significantly higher. You can still enroll in a Marketplace plan, but you'll pay the unsubsidized rate—potentially $600–$800+ per month depending on your state and age. If you have an employer offering health coverage at a reasonable cost, your income will now be tested against that offer before you qualify for Marketplace assistance. Review your options carefully during the open enrollment window.
Sources
Independent app, not a government. General information, not advice. The official source:
