Open enrollment for 2027 ACA marketplace coverage runs from November 1 to December 15, 2026, in most states. Miss that window and you cannot get coverage unless a qualifying life event triggers a Special Enrollment Period. This checklist covers the 10 things you need to do before the deadline closes.
Quick Answer: ACA open enrollment for 2027 coverage runs November 1 to December 15, 2026. To enroll, gather proof of income, Social Security numbers for household members, and current insurance details. Subsidies are available for incomes between 100% and 400% of the Federal Poverty Level, ranging from $15,650 to $62,600 for a single person in 2026.
Why 2026 Is a Critical Year for ACA Enrollment
For 2026 coverage, the enhanced premium tax credits that were in place from 2021 through 2025 have expired. The American Rescue Plan and Inflation Reduction Act provisions are no longer active, which means the "subsidy cliff" has returned. If your income exceeds 400% of the Federal Poverty Level, you no longer qualify for premium tax credits.
This makes reviewing your 2026 plan and actively enrolling for 2027 more urgent than in recent years. Premiums rose significantly for 2026 because of these changes, and millions of people who qualified for subsidies in 2025 may find themselves paying more or needing to reassess their options.
According to healthcare.gov, 2027 open enrollment begins November 1, 2026. Unlike past years, there is no February 1 start-date option. All plans selected during open enrollment take effect January 1, 2027.
2026 ACA Income Limits and Subsidy Thresholds
Before diving into the checklist, understand where your household income falls relative to the 2026 Federal Poverty Level. Subsidies for 2026 marketplace plans are based on the 2025 FPL guidelines. For 2027 plans enrolled during fall 2026 open enrollment, subsidies are based on the 2026 FPL guidelines.
2026 ACA Subsidy Eligibility: Income Limits by Household Size
| Household Size | 100% FPL (Medicaid floor) | 138% FPL (Medicaid ceiling) | 250% FPL (Cost-sharing reductions) | 400% FPL (Subsidy cliff) |
|---|
| 1 | $15,650 | $21,597 | $39,125 | $62,600 |
| 2 | $21,150 | $29,187 | $52,875 | $84,600 |
| 3 | $26,650 | $36,777 | $66,625 | $106,600 |
| 4 | $32,150 | $44,367 | $80,375 | $128,600 |
| 5 | $37,650 | $51,957 | $94,125 | $150,600 |
| 6 | $43,150 | $59,547 | $107,875 | $172,600 |
| 7 | $48,650 | $67,137 | $121,625 | $194,600 |
| 8 | $54,150 | $74,727 | $135,375 | $216,600 |
| Each additional | +$5,500 | +$7,590 | +$13,750 | +$22,000 |
Source: aspe.hhs.gov 2026 Federal Poverty Guidelines. Applies to contiguous 48 states and D.C. Alaska and Hawaii have higher thresholds.
If your income falls below 138% FPL and you live in a Medicaid expansion state, you likely qualify for Medicaid rather than a marketplace plan. Check your Medicaid eligibility at /medicaid-income-limits before enrolling in a marketplace plan.
If your income exceeds 400% FPL, you can still purchase marketplace coverage but without premium subsidies. Compare marketplace plans against off-exchange options in that case.
The 10-Item Open Enrollment Checklist
1. Confirm Your Enrollment Window
The federal marketplace at healthcare.gov runs open enrollment November 1 to December 15, 2026. Several states run their own exchanges with extended windows:
- California: November 1 to January 31, 2027
- New York: November 1 to January 31, 2027
- New Jersey: November 1 to January 31, 2027
- Pennsylvania: November 1 to January 15, 2027
- Rhode Island: November 1 to January 31, 2027
- Washington D.C.: November 1 to January 31, 2027
If you are in a state not listed above, treat December 15 as your hard deadline for 2027 coverage.
2. Gather Your Income Documents
Subsidies are calculated on your projected household income for the coming plan year. Collect:
- Most recent federal tax return (Form 1040)
- W-2 forms or 1099s from the past year
- Recent pay stubs (last 2 to 3 months)
- Documentation of self-employment income (Schedule C or profit/loss statement)
- Social Security award letters if applicable
- Unemployment benefit statements
- Alimony or rental income documentation
You will estimate your income for the upcoming year. If your actual income ends up higher or lower than estimated, you reconcile the difference on your tax return. Underestimating can lead to repaying part of your subsidy; overestimating means you may have paid more than necessary.
3. List Every Household Member
Your household size directly affects your FPL percentage and subsidy amount. List every person who will be on your tax return as a dependent, even if they do not need coverage. You will need:
- Full legal names
- Dates of birth
- Social Security numbers (SSNs) for every person enrolling
- Immigration documentation for non-citizen household members
- Medicare or Medicaid enrollment status for each person
Children already on CHIP or Medicaid do not need marketplace coverage, but they still count toward your household size for income calculations.
4. Verify Your Current Coverage Status
If you already have a 2026 marketplace plan, do not assume it auto-renews at the same premium. Plans change benefits, networks, and costs every year. Log into your account at healthcare.gov or your state exchange and review:
- Whether your current plan is still offered
- Any premium increases for the same plan
- Whether your doctors and prescriptions are still in-network
- Whether your subsidy amount has changed due to income changes
Even a small income change can shift your premium tax credit. A raise, a second job starting, or a household member aging off your plan all affect your eligibility amount.
5. Check Whether You Qualify for Medicaid or CHIP Instead
If your 2026 income falls below 138% FPL in a Medicaid expansion state, Medicaid is available year-round. You do not need to wait for open enrollment. If you have children under 19 with household income up to 200% to 300% FPL depending on the state, CHIP may cover them at low or no cost.
Medicaid and CHIP enrollment is not limited to the open enrollment window. You can apply any month of the year. Use the CoveredUSA screener at /screener to find out in two minutes whether Medicaid, CHIP, or a marketplace plan is the right fit for your household.
6. Review Metal Tier Options
Marketplace plans come in four metal tiers. Understanding them prevents you from selecting the wrong plan based on premium alone:
| Metal Tier | Average Premium | Deductible Range | Best For |
|---|
| Bronze | Lowest | $5,000 to $8,000+ | Healthy individuals, low expected usage |
| Silver | Moderate | $2,500 to $5,000 | Most people; required for cost-sharing reductions |
| Gold | Higher | $1,000 to $2,500 | Regular prescriptions, ongoing care |
| Platinum | Highest | $0 to $1,500 | High medical needs, frequent doctor visits |
If your income is between 100% and 250% FPL, you may qualify for cost-sharing reductions (CSRs) on a Silver plan. CSRs lower your deductible, copays, and out-of-pocket maximum significantly. You must select a Silver plan to get cost-sharing reductions. They are not available on Bronze, Gold, or Platinum.
7. Check Your Prescription Drug Formularies
Before selecting a plan, verify that your medications appear on the plan's drug formulary (covered drug list). This step prevents an expensive surprise in January.
Steps to check:
- List every prescription you take, including dosage
- Go to each plan's formulary lookup tool (accessible from the plan detail page on healthcare.gov)
- Verify the tier your drug is assigned to (Tier 1 generics cost least; Tier 4 or 5 specialty drugs cost most)
- Calculate estimated annual drug costs under each plan
A plan with a slightly higher premium may save hundreds of dollars per year if your prescriptions land in a lower tier.
8. Confirm Your Doctors Are In-Network
Switching plans can mean losing access to your current primary care doctor or specialist. Before enrolling:
- Write down the names and NPI numbers of your doctors
- Check the provider directory for each plan you are considering
- Verify that nearby hospitals you would use in an emergency are in-network
- Check whether the plan uses an HMO (requires referrals) or PPO (more flexibility) structure
Out-of-network care on an HMO plan can cost you the full billed amount. If continuity of care matters, this step is not optional.
9. Understand the Subsidy Reconciliation Rule
Premium tax credits are paid in advance to your insurer (called APTC, or Advanced Premium Tax Credit). When you file your federal taxes, you reconcile the credit against your actual income using IRS Form 8962.
For 2026 coverage, under Section 71305 of P.L. 119-21, the repayment caps that applied for tax years 2021 through 2025 have been eliminated. Every dollar of excess APTC must be repaid, regardless of household income. This is a major shift from prior years, when households below 400% FPL had repayment limited to a few hundred to a few thousand dollars depending on income and filing status.
This is another reason accurate income estimation matters. If you expect income fluctuation, report changes to the marketplace promptly during the year rather than waiting until tax time.
10. Set a Calendar Reminder and Complete Enrollment in One Session
Procrastination causes missed deadlines. The healthcare.gov system experiences heavy traffic in the days before December 15. Technical problems and call center wait times spike near the deadline.
Set a calendar reminder for November 1 (the day enrollment opens) rather than December 15. Give yourself the full window to compare plans, check drug formularies, verify providers, and confirm your income estimate. The application itself takes 30 to 60 minutes for most households. Starting early means you can call a navigator or licensed agent if you have questions. Those resources are less overloaded in early November than in mid-December.
How to Apply for ACA Coverage
Enrollment window: November 1 to December 15, 2026 (most states). Coverage starts January 1, 2027.
Step-by-step application process:
- Go to healthcare.gov (or your state exchange if your state runs its own marketplace)
- Create or log into your account
- Start a new application or update your existing one
- Enter household members, income, and coverage information
- Review subsidy eligibility results
- Compare available plans by premium, deductible, network, and drug formulary
- Select a plan and confirm enrollment
Documents to have ready:
- Social Security numbers for all household members enrolling
- Proof of income (pay stubs, W-2, 1099, or tax return)
- Current health insurance information (policy numbers, insurer name)
- Immigration documents if applicable
- Employer coverage details if you have an offer of employer insurance
Common reasons applications are delayed or denied:
- Income discrepancies between your estimate and IRS records
- SSN missing or mismatched for a household member
- Existing Medicare or Medicaid coverage that disqualifies from marketplace subsidy
- Employer coverage that meets minimum value and affordability standards (you are not eligible for marketplace subsidies if employer coverage is affordable)
- Citizenship or immigration status not verified
What Happens If You Miss the Deadline
If you miss December 15 (or your state's extended deadline), you cannot enroll in a marketplace plan until the next open enrollment period unless you experience a qualifying life event. Qualifying life events that trigger a 60-day Special Enrollment Period include:
- Loss of existing health coverage (job loss, COBRA expiring, aging off a parent's plan)
- Marriage or divorce
- Birth, adoption, or foster placement of a child
- Moving to a new state or county with different marketplace options
- Change in citizenship or immigration status
- Income change that affects subsidy eligibility
For detailed information on qualifying events, review the KFF health insurance FAQ.
Medicaid and CHIP have no enrollment deadline. You can apply any time of year if you meet income requirements.
Know Your Options Before You Enroll
Not everyone who visits the marketplace ends up on a marketplace plan. You may qualify for Medicaid, CHIP, or Medicare depending on your age, income, and household. Running an eligibility check first prevents you from enrolling in the wrong program or paying for a subsidized plan when free Medicaid coverage is available.
Check your eligibility now at CoveredUSA. It takes 2 minutes. Start the free screener at /screener.
Frequently Asked Questions
When does ACA open enrollment start and end in 2026?
Open enrollment for 2027 coverage starts November 1, 2026, and ends December 15, 2026, in most states using the federal marketplace at healthcare.gov. California, New York, New Jersey, Rhode Island, and Washington D.C. extend their deadlines to January 31, 2027.
What is the income limit to get a subsidy on the ACA marketplace in 2026?
For 2026 coverage, premium tax credits are available for incomes between 100% and 400% of the Federal Poverty Level. For a single person, that is $15,650 to $62,600 per year. For a family of four, the range is $32,150 to $128,600. Above 400% FPL, no subsidy is available. The enhanced credits that eliminated this cliff from 2021 through 2025 have expired.
What documents do I need to enroll in an ACA marketplace plan?
You need Social Security numbers for everyone enrolling, proof of income (pay stubs, W-2, 1099, or prior year tax return), and current insurance information if you have existing coverage. If any household member is not a U.S. citizen, you also need immigration documentation.
Can I enroll in a marketplace plan if I already have Medicaid?
No. If you qualify for Medicaid, you are not eligible for premium tax credits on the marketplace. If your income is below 138% FPL and you live in a Medicaid expansion state, apply for Medicaid instead. It is free or very low cost and available year-round without waiting for open enrollment.
What is the difference between a Silver and Bronze plan for subsidies?
Both Silver and Bronze plans are available with premium tax credits if your income qualifies. However, cost-sharing reductions (which lower your deductible, copays, and out-of-pocket maximum) are only available on Silver plans. If your income is between 100% and 250% FPL, a Silver plan is almost always the better value because cost-sharing reductions can reduce your out-of-pocket exposure by thousands of dollars per year.
What happens if I miss the open enrollment deadline?
You cannot enroll in a marketplace plan until the next open enrollment unless you have a qualifying life event such as job loss, marriage, birth of a child, or moving. If that happens, you have 60 days from the event to enroll in a Special Enrollment Period. Medicaid and CHIP have no enrollment deadline and can be applied for at any time.
Is 2026 the first year the subsidy cliff is back?
Yes. From 2021 through 2025, the American Rescue Plan and Inflation Reduction Act eliminated the 400% FPL subsidy cliff and made subsidies available at all income levels. Those provisions expired for 2026 coverage. As of 2026, if your income exceeds 400% FPL, you cannot receive premium tax credits on the marketplace. Congressional action could change this for future years, but no legislation has passed as of mid-2026.
How do I know if I qualify for Medicaid instead of a marketplace plan?
If your income is below 138% FPL and you live in one of the 41 states (including D.C.) that expanded Medicaid, you qualify for Medicaid regardless of whether open enrollment is active. The CoveredUSA screener at coveredusa.org/screener checks both Medicaid and marketplace eligibility at the same time so you know which path fits your situation.
