ACA open enrollment begins November 1, and the price tags for 2027 marketplace plans are coming into focus state by state. On August 31, the Georgia Recorder reported that insurers selling plans to about 900,000 Georgians are seeking increases as high as 29 percent. On September 4, New York regulators announced they had cut insurers’ requests sharply. And a running tally updated by healthinsurance.org on September 8 shows a wide spread from state to state.

For Black families who buy their own coverage, especially in the South, this is the second hard year in a row. Here is what is driving the increases, what is still up in the air, and the steps to take before you pick a plan.

Why ACA Premiums Are Rising Again in 2027

A KFF review of filings from 276 insurers across all 50 states and Washington, D.C., found a median proposed premium increase of 15 percent for 2027. That follows a finalized median increase of 20 percent for 2026. Insurers point to rising prices for medical care, and to the end of the enhanced federal premium tax credits after 2025, which pushed healthier people out and left a sicker pool of enrollees.

KFF’s Cynthia Cox called it a “triple whammy” for consumers: higher premiums in 2026, higher again in 2027, and smaller subsidies. The damage is already visible. KFF found that marketplace enrollment fell 12 percent, from 21.8 million to 19.2 million people, between February 2025 and February 2026, as average premium payments after tax credits rose 58 percent.

2027 ACA Rates Look Very Different by State

Where you live matters a great deal. According to healthinsurance.org’s tracker, finalized average increases include 3 percent in Vermont, 17.5 percent in Indiana, 21.6 percent in Oregon, 24.4 percent in New Mexico and 25 percent in Alabama. Arizona insurers proposed 29 percent.

New York shows what aggressive review can do. The state’s Department of Financial Services approved a 6 percent increase for individual plans, down from the 20.6 percent insurers requested, saving consumers an estimated $324 million.

Georgia is on the other end. The Georgia Recorder reported proposed 2027 increases ranging from 10 percent to 29 percent among insurers on Georgia Access, the state’s marketplace. Cigna and UnitedHealthcare are leaving. Georgia saw roughly 350,000 plan cancellations between spring 2025 and spring 2026, among the largest drops in the country, and the state has not fully expanded Medicaid.

Cigna’s exit reaches well beyond Georgia. KFF reports the company is leaving the individual market in all 11 states where it sells plans, affecting more than 350,000 people enrolled through the marketplaces.

Why This Hits Black Households Hard

Black Americans were already more likely to go without coverage. In 2024, 10.1 percent of Black people under 65 were uninsured, compared with 6.8 percent of white people, according to KFF.

Geography deepens the gap. Ten states have not expanded Medicaid, and KFF estimates 1.2 million uninsured adults fall into the coverage gap, earning too much for Medicaid in their state but too little for marketplace subsidies. Hispanic and Black adults make up 56 percent of that group.

In a February analysis, the Economic Policy Institute projected that losing the enhanced credits could leave tens of thousands of Black residents uninsured in each of several major metros, including more than 40,000 in metro Atlanta and more than 39,000 in metro Houston. Those are projections, but the direction matches what the enrollment numbers now show.

Court Fights That Could Change the Rules

A 2025 federal rule would have shortened open enrollment and added hurdles, including a $5 charge for some people who are automatically reenrolled and tougher income checks. In June, a federal judge in Maryland threw out those provisions. HHS appealed to the Fourth Circuit on July 22, and Congress wrote some similar restrictions into the 2025 tax and spending law, so more changes may still come.

For now, HealthCare.gov lists these dates: open enrollment runs November 1 through January 15. Enroll by December 15 for coverage starting January 1, or between December 16 and January 15 for coverage starting February 1. States that run their own marketplaces can set different deadlines, so check your state’s site.

What This Means for You

• Put two dates on your calendar. November 1 to start shopping and December 15 to lock in January coverage.
• Update your income. Subsidies are based on your expected income. For 2027, help is available only below 400 percent of the poverty level, about $63,840 for a single person and $132,000 for a family of four, according to healthinsurance.org.
• Do not auto renew blindly. Your subsidy is tied to the benchmark Silver plan in your area, not to the plan you have, so the best deal may have changed. If your insurer is leaving, you must choose a new plan.
• Look hard at Silver plans if money is tight. If your income qualifies for extra savings called cost-sharing reductions, you must pick a Silver plan to get them, and they lower what you pay out of pocket.
• Check Medicaid if your income dropped. New Medicaid work rules are also on the way, which we explained in our guide to Medicaid work requirements.
• Get free help. HealthCare.gov’s local help finder connects you with community groups and assisters who help at no cost.
• Have a backup for care. If you end up uninsured, federally funded community health centers serve everyone, even people who cannot pay, and adjust fees based on income.

Going without coverage can lead straight to medical bills you cannot control. If that has already happened, our explainer on medical debt and your credit walks through your options.

Nobody should have to become an insurance expert to stay covered, but this year a little homework pays off. Final 2027 prices will land before November 1. When they do, sit down with your numbers, compare at least three plans, and ask for help if anything is unclear.