New identity rules and higher premiums define 2027 ACA open enrollment

Open enrollment for 2027 health insurance coverage began on November 1 in most states. The period follows a sharp drop in total enrollment numbers, a trend policy experts attribute to the expiration of enhanced federal subsidies at the end of 2025. While the administration views the decline as a success in reducing fraud, consumers now face a more complex process to secure coverage.

The Centers for Medicare and Medicaid Services introduced new identity verification rules for shoppers using agents in the federal marketplace, which serves 29 states. All consumers working with an agent must now receive a one-time confirmation code via text, email, or phone call to authorize the agent's actions. This step is designed to prevent unauthorized changes to insurance policies.

Stricter scrutiny applies to individuals classified as high-risk. This category includes first-time applicants, those changing states, and consumers using a new agent. It also includes anyone paying a monthly premium of $30 or less. These shoppers must verify their identity through a third-party service like Experian before authorizing an agent. Joshua Brooker, an insurance agency owner in Pennsylvania, noted that the low premium threshold targets plans where policyholders might not notice billing errors.

Brooker warned that up to one in five consumers may face these extra hurdles. He expressed concern that some shoppers might abandon the process if the identity proofing proves too difficult. Stacey Pogue, a senior research fellow at Georgetown University, agreed that while the measures target fraud, they also create new barriers for people without established credit files or recent name changes.

A second major change limits the number of available brokers. The federal government issued a rule in September pausing new broker registrations for the 2027 season. Agents not registered with the marketplace in 2026 cannot assist with enrollments until February. Jason Fine, a Florida brokerage owner, said this rule makes it hard for small agencies to hire staff. He plans to add up to 10 agents but struggles to find candidates registered in the previous year. He suggested the rule may unintentionally benefit larger call centers that maintain year-round staff.

Costs will rise for most shoppers. Premiums are expected to increase by 15%, a lower rate than the 26% jump seen last year. However, the average out-of-pocket maximum for an individual will rise from $10,600 to $12,000. For family plans, the cap will increase from $21,200 to $24,000. Subsidies remain available for those earning below four times the federal poverty rate, which is set at $63,840 for a single person and $86,560 for a couple in 2026.

The One Big Beautiful Bill Act has also removed subsidy eligibility for many lawfully present immigrants. Groups affected include holders of H-1B visas, refugees, asylees, and those with pending green-card applications. Eligibility remains for green-card holders, certain Cuban and Haitian immigrants, and citizens of Micronesia, the Marshall Islands, or Palau.

Experts advise shoppers to compare plans actively rather than allowing automatic renewals. Louise Norris, a health policy analyst, said that premiums and coverage details can change annually, and new insurers may enter the market. She noted that out-of-pocket caps are increasing, making it essential to review deductibles and other costs to find the most affordable option.