Shopping for a 2027 health plan? State aid and 4 smart moves can cut your health costs

by Ellyn Vohnoutka

edited by Gaby Clark, reviewed by Andrew Zinin

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Residents of at least 11 states who buy coverage through the Affordable Care Act (ACA) marketplace can get extra state help paying their premiums in 2027.

ACA health plans are for anyone under 65 who doesn't have access to affordable job-based health insurance or isn't eligible for Medicaid.

States helping to blunt the cost of ACA coverage include California, Colorado, Connecticut, Maryland, Massachusetts, New Mexico, New Jersey, Rhode Island, Vermont, Virginia and Washington state, CNBC reports. All run their own marketplaces rather than using HealthCare.gov.

These state programs aim to soften the loss of enhanced federal premium tax credits, which expired at the end of 2025. Without them, members saw average marketplace premiums rise 58% in 2026, according to KFF, a nonpartisan health policy research group.

Enrollment fell as costs climbed.

As of February, about 19.2 million people had marketplace plans, according to the U.S. Department of Health and Human Services. That's a 13% drop from a year earlier.

State aid comes on top of the federal tax credits that remain. Amounts and eligibility vary, and many programs focus on lower-income enrollees.

California, for example, is opening its program to people earning up to 200% of the federal poverty level, or about $31,920 for a single adult. That change will make roughly 200,000 more residents eligible, CNBC reports.

New Mexico is the only state fully replacing the lost federal aid. Elsewhere, help can be modest. In Washington state, some enrollees can get up to $35 a month.

States that offered aid in 2026 saw smaller enrollment drops, experts say.

"If the previous pattern continues, we will also see possibly better enrollment retention in states that are more generous with their subsidies," Justin Lo, a senior researcher at KFF, told CNBC.

Whether states can keep funding these programs depends on their budgets, Louise Norris, a health policy analyst at healthinsurance.org, told CNBC.

Norris also shared tips with WCVB in Boston for picking a 2027 plan:

Check the network. A doctor who took someone's old plan may not accept a new one, even from the same insurer. Also, look beyond the monthly premium and compare deductibles and out-of-pocket limits.

Update household and income details. Subsidies are pegged to a midpriced "benchmark" plan in each area, so costs will likely change in 2027 even for people keeping the same plan. A child aging off coverage or an income shift can also change the subsidy. Shopping around each year beats automatic renewal.

Don't assume income is too high. Eligibility rests on modified adjusted gross income, a specific tax calculation. Pretax retirement savings and health savings account contributions can lower it, which matters most for people just over the cutoff.

Get free help. Trained navigators and licensed brokers can compare plans for free. "You are not saving any money by not getting help," Norris said.

A key deadline for enrolling is Dec. 15 for coverage starting Jan. 1.

Most states keep enrollment open into mid-January, but dates vary. Keep in mind that switching plans in January could mean paying toward two deductibles in one year, since the new plan would start in February.

Who's behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →

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Citation: Shopping for a 2027 health plan? State aid and 4 smart moves can cut your health costs (2026, November 12) retrieved 12 November 2026 from https://medicalxpress.com/news/2026-11-health-state-aid-smart.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.