Open enrollment for 2027 health coverage starts November 1, 2026. If you are self-employed, a 1099 contractor, a realtor, or you run a small business, this is the one window each year where you can change your marketplace plan without a qualifying event — and this year there is more riding on it than usual.
Premiums are going up again, the enhanced subsidies are gone, and the subsidy cliff is back. That combination means a lot of self-employed people who were fine on autopilot last year are going to open a renewal notice in October and not like what they see. Here is how to get ahead of it.
The 2027 Open Enrollment Dates
For the majority of states, which use HealthCare.gov, the schedule looks like this:
| Date | What Happens |
|---|---|
| Late October 2026 | Renewal notices go out. Your current plan's 2027 premium and any plan changes are in this letter — read it. |
| November 1, 2026 | Open enrollment opens. You can shop, switch, or enroll for the first time. |
| December 15, 2026 | Deadline for January 1 coverage. Miss this and your new plan starts February 1 instead. |
| January 15, 2027 | Open enrollment closes in most states. After this, you need a qualifying life event to change marketplace plans. |
A few state-run exchanges run their own calendars. Idaho opens October 15; Connecticut and Massachusetts open October 23; California, New York, New Jersey, and D.C. stay open through January 31. If you are in one of those states, check your state exchange for the exact dates.
What's Different This Year
The enhanced subsidies are gone
The extra premium tax credits that started in 2021 expired on December 31, 2025. They did two things that mattered for self-employed people: they made subsidies bigger at every income level, and they removed the income cap. Both are gone for 2026 and 2027.
The subsidy cliff is back
This is the one that catches 1099 earners. Under the original ACA rules, if your household income is above 400% of the federal poverty level, you get no premium tax credit at all. Not a smaller one — zero. For 2027 coverage, that line is drawn using the 2026 poverty guidelines:
| Household Size | 400% FPL (2027 Coverage) | Above This Line |
|---|---|---|
| 1 person | $63,840 | No subsidy |
| 2 people | $86,560 | No subsidy |
| 3 people | $109,280 | No subsidy |
| 4 people | $132,000 | No subsidy |
If you earn one dollar over the line, you pay full price. If you earn under it, you pay a set percentage of your income for the benchmark silver plan — for 2027 that ranges from about 2.15% to 10.22% depending on where you land. Near the top of that range, the subsidy is often small enough that it barely moves the needle anyway.
Premiums are up again
Insurers proposed a median 15% increase for 2027 marketplace plans, on top of an 18% median increase for 2026. The drivers are what you would expect: hospital and physician prices, prescription costs, and a sharp rise in GLP-1 drug spending. If you are paying full price with no subsidy, that increase lands entirely on you.
Auto-renewal is on borrowed time
For 2027, if you do nothing, most marketplace enrollees will still be auto-renewed into the same or a similar plan. But federal legislation passed in 2025 is expected to end that after the 2027 plan year. Get in the habit now of actively re-enrolling every fall — and actually looking at what you are re-enrolling in.
Step 1: Estimate Your 2027 Income Honestly
Everything about the marketplace hinges on the income number you enter, and self-employed income is the hardest kind to predict. The marketplace asks for your expected 2027 modified adjusted gross income — for most 1099 earners that means net profit after business expenses, plus any other household income (a spouse's W-2, investment income, rental income).
Two things to know:
- Net, not gross. If you gross $95,000 as a realtor but write off $30,000 in expenses, your income for subsidy purposes is closer to $65,000. A lot of people over-report and lose subsidies they were entitled to.
- It reconciles at tax time. If you estimate $60,000, take a subsidy all year, then have a great year and finish at $90,000, you will pay the entire subsidy back on your 2027 return. Under the current rules, there is no cap on that repayment once you cross 400% FPL.
If your income swings a lot year to year — commission-based, project-based, seasonal — the cliff makes the marketplace a gamble. That is not a reason to skip it, but it is a reason to look at the alternative before you commit.
Step 2: Decide Whether the Marketplace Is Even the Right Place
Here is the part most open enrollment guides skip: the marketplace is not the only way to buy health insurance, and for a healthy self-employed person above the subsidy line, it is frequently the most expensive one.
Private underwritten health insurance — PPO plans sold outside the exchange — prices you on your health, not on your income. That means:
| ACA Marketplace | Private PPO | |
|---|---|---|
| When you can enroll | Nov 1 – Jan 15 only (or with a qualifying event) | Any month of the year |
| What sets your price | Age, zip code, income (for subsidies) | Age, zip code, health history |
| Above 400% FPL, healthy | Full price, rising ~15% this year | Often 30–50% less for similar coverage |
| Below 400% FPL | Subsidy can make this the better deal | No subsidy applies |
| Pre-existing conditions | Always accepted | Underwritten — may be declined or rated up |
| Network | Often narrow HMO/EPO | Nationwide PPO is common |
The rule of thumb we use with clients: if you are under the 400% line and your income is stable, the marketplace with a subsidy is hard to beat. If you are over the line and reasonably healthy, get a private PPO quote before you enroll in anything — it takes a couple of hours and it is frequently the difference of several hundred dollars a month. If you have a serious ongoing condition, the marketplace's guaranteed acceptance is worth the premium.
We walked through this comparison in more detail in Private Health Insurance vs Marketplace.
Step 3: Get Your Paperwork Together Before November 1
Whichever route you take, having these ready means you can enroll in one sitting instead of three:
- Your 2025 tax return (Schedule C or K-1) and a rough 2026 year-to-date profit-and-loss
- Your best estimate of 2027 household income, including a spouse's income
- Social Security numbers and dates of birth for everyone being covered
- Your current plan's renewal notice with the 2027 premium
- A list of the doctors and hospitals you actually use, so you can check networks
- Your prescriptions, with dosages — formularies differ by plan and by carrier
- For a private PPO quote: your zip code, ages, tobacco use, and a quick summary of any health conditions or medications
Step 4: Do Not Let It Auto-Renew Without Looking
Even if you stay on the marketplace, do not assume last year's plan is still the right one. Carriers reprice every year, networks change, and the "benchmark" silver plan that your subsidy is calculated against can shift to a different insurer — which means the plan you are in might quietly become much more expensive relative to the subsidy.
At minimum, every fall: check that your doctors are still in network, check that your prescriptions are still covered at the same tier, and compare your renewal premium against at least two other plans at the same metal level. Fifteen minutes of comparison regularly saves a thousand dollars over the year.
Mistakes We See Every Year
Waiting until January
Enrolling after December 15 means no coverage until February 1. If your old plan ends December 31, that is a full month uninsured — and a full month where a private PPO could have already been in force.
Reporting gross instead of net income
Self-employed people routinely overstate their income on the application and either lose subsidies they qualified for or push themselves over the cliff on paper when they are actually under it.
Assuming the marketplace is the only option
It is the only option with a subsidy. For everyone above the line, it is one option among several — and usually not the cheapest.
Picking a plan by premium alone
A $400 bronze plan with a $7,500 deductible and a narrow local network is not cheaper than a $550 PPO with a $3,000 deductible if you use your coverage at all. Look at the total: premium plus deductible plus out-of-pocket max plus whether your doctor is actually in it.
The Short Version
Open enrollment runs November 1, 2026 through January 15, 2027, with December 15 as the deadline for January 1 coverage. Estimate your 2027 net income carefully, because the 400% FPL cliff is back and there is no safety net above it. If you are under the line, the marketplace subsidy is probably your best deal. If you are over it and healthy, get a private PPO quote before you enroll in anything — and remember that private plans do not care about the open enrollment calendar at all.
Either way, the worst move is doing nothing and letting a 15% increase land on autopilot.
Find Out Where You Land Before November 1
Text or call with your ages and zip code and we'll run both sides — marketplace with your subsidy estimate, and private PPO — so you can see real numbers before open enrollment starts. Licensed in 30+ states.