Obamacare 2027: How a $1,000 Raise Can Cost a Couple $27,000

Open enrollment for 2027 health coverage started on November 1, and it is the second year in a row of double-digit premium increases. For most people a tax credit absorbs much of that. But for anyone near the income cutoff, and especially for older shoppers, the same plan can cost thousands of dollars more depending on one number: the income you estimate on your application.

Below: what changed for 2027 in dollars, exactly how the tax credit is calculated, four example shoppers from $25,000 to $87,000 of income, the fine print that can cost you at tax time, and a checklist before December 15.

What changed for 2027

KFF's analysis finds the average benchmark silver premium, the plan your tax credit is based on, rose 13 percent for 2027. For a 40-year-old the national average monthly premiums before tax credits are:

• 2025 benchmark: about $497
• 2026 benchmark: about $624
• 2027 benchmark: about $704 (up about 42 percent in two years)
• 2027 bronze: about $511; silver: about $689; gold: about $716

States that use HealthCare.gov saw benchmark premiums rise 11 percent on average, while states running their own exchanges saw 16 percent, according to KFF. An Edit USA analysis of the HealthCare.gov plan files found the largest median-county increases for a 40-year-old in Delaware (+26.7 percent, $692 to $876 a month), South Carolina (+25.0 percent), Alaska (+24.8 percent), Montana (+23.5 percent) and Arizona (+22.2 percent). Florida rose about 4.5 percent and Arkansas fell 2.2 percent.

Choice is thinning. KFF counts 11 insurers exiting at least one state and seven entering a new one; Cigna is leaving the individual market in all 11 states where it sells. Counties served by a single insurer nearly doubled, from 57 to 112, in the same plan-file analysis. CMS, for its part, says more than 75 percent of HealthCare.gov shoppers can still find a plan for $50 a month or less after tax credits, with about 100 plans and 35 HSA-eligible plans available on average.

How the tax credit is calculated

Your credit equals the price of the benchmark silver plan for your age and ZIP code, minus an expected contribution set as a share of your income. For 2027, IRS Revenue Procedure 2026-26 sets that share from 2.15 percent of income (below 133 percent of the poverty line) up to 10.22 percent (300 to 400 percent). You can apply the credit to any metal level.

The poverty line for 2027 coverage is $15,960 for one person, $21,640 for two and $33,000 for a family of four. Because the enhanced credits of 2021 to 2025 expired, the cutoff at 400 percent of the poverty line is back: $63,840 for one person, $86,560 for a couple and $132,000 for a family of four. One dollar above it, the credit is zero.

Four example shoppers

• These use KFF's national-average 2027 premiums. Your local prices will differ, so treat them as a map, not a quote.
• Shopper 1, age 40, income $25,000 (about 157 percent of poverty): expected share about 4.6 percent, or $96 a month toward the benchmark. Tax credit about $608 a month, more than the average $511 bronze premium, so a bronze plan could cost $0.
• Shopper 2, age 40, income $45,000 (about 282 percent): expected share about 9.7 percent, or $362 a month. Credit about $342 a month; average bronze about $169.
• Shopper 3, single, age 40: at $63,000 the benchmark costs about $537 a month; at $64,000, above the line, it costs the full $704. A $1,000 raise adds about $2,005 a year.
• Shopper 4, a couple, both 60: under the federal default age curve a 60-year-old's premium is about 2.1 times a 40-year-old's, so the average benchmark is about $1,495 a month each. At $86,000 of income they pay 10.22 percent, about $8,789 a year. At $87,000 they pay full price, about $35,891, or 41 percent of income. The difference is about $27,100.

The fine print

No more repayment cap. The credit is paid in advance based on your estimated income. KFF notes that, starting with 2026 tax years, the limits on paying back excess credit were eliminated. A couple that estimates $86,000 and ends at $87,000 could owe back the entire credit at tax time.

The $0 bronze trap. Cost-sharing reductions, which lower deductibles and copays for incomes up to 250 percent of the poverty line, come only with silver plans. A $0 bronze plan carries a much higher deductible; if you expect regular care or prescriptions, a cost-sharing silver plan can be cheaper over the year.

Out-of-pocket maximums. The standard 2027 limit is $12,000 for one person and $24,000 for a family (CMS guidance), and the final 2027 federal payment rule allows some bronze plans to exceed it. Check each plan's out-of-pocket maximum, not just its premium.

The money saver. The credit uses modified adjusted gross income. KFF notes that contributions to a health savings account (with an HSA-eligible plan) or a traditional IRA can lower it. In our example, a deductible contribution of about $440 or more could bring the $87,000 couple back to $86,560. Confirm with a tax professional.

Checklist before December 15

• Preview plans with your real ZIP code, ages and income at HealthCare.gov or your state exchange.
• Update your 2027 income estimate, especially if you are near 400 percent of the poverty line.
• Compare total yearly cost: 12 months of premium plus the deductible and copays you expect to use.
• Check that your doctors, hospitals and prescriptions are in network and on the formulary.
• Do not rely on auto re-enrollment, especially if your insurer is leaving your area.
• Key dates on HealthCare.gov: November 1 open enrollment starts; December 15 deadline for January 1 coverage; January 15 open enrollment ends. State exchanges can set their own dates.

Watch the video

Sources

1. KFF, 9 Things to Watch for the 2027 ACA Open Enrollment Period, October 30, 2026: kff.org
2. KFF average Marketplace premiums by metal level, 2025-2027 (data table): datawrapper.dwcdn.net
3. CMS, Plan Year 2027 Marketplace Plans and Prices Fact Sheet, October 30, 2026: cms.gov
4. IRS Revenue Procedure 2026-26 (2027 applicable percentage table): irs.gov
5. HealthCare.gov, federal poverty levels: healthcare.gov
6. CMS, 2027 premium adjustment percentage and maximum cost-sharing guidance, January 29, 2026: cms.gov
7. Edit USA, HealthCare.gov's 2027 prices are out, October 30, 2026: editusa.com