How to Use the Health Insurance Marketplace for 2027: Dates, the 400% Line and the Credit Math

Michael Whitman · Trading since 2017, full-time since 2020 · YouTube creator, 137K subscribers · Published 2026-11-08

To use the health insurance marketplace well, treat it as two jobs: picking a plan, and making an income estimate the IRS will check against your tax return. The plan decides what care costs you. The income estimate decides your tax credit, and from 2026 any credit paid on a low estimate is owed back in full.

The window for 2027 coverage is open. HealthCare.gov’s Open Enrollment runs from November 1, 2026 to January 15, 2027; a plan picked by December 15 starts January 1, and one picked from December 16 starts February 1. States that run their own exchange set their own dates, so check yours.

Before you start: what the application asks for

• Your expected 2027 household income: modified adjusted gross income for everyone on your tax return, from last year’s return adjusted for raises, job changes and self-employment swings.
• Social Security numbers or immigration documents for everyone applying. HealthCare.gov warns that from January 1, 2027 only certain immigration statuses qualify for savings, while other statuses can still buy coverage.
• Any job-based coverage offer for anyone in the household, with the employee’s cost for self-only coverage and for family coverage. If that offer is affordable and meets minimum value, the person it covers cannot get the credit. The employee is tested on the self-only cost; since 2023, family members are tested on the cost of covering the family.

What changed for 2026 and 2027

The larger credits ended after 2025. From 2021 through 2025, temporary rules from the American Rescue Plan Act, extended by the Inflation Reduction Act, removed the 400% income limit and capped the benchmark plan at 8.5% of income. They expired at the end of 2025. The IRS tables for 2026 and 2027 follow the original formula, which stops at 400% of the poverty line.

Repayment caps are gone. The IRS says that beginning with tax year 2026 you repay the full amount of any excess advance credit, where the law used to cap the bill for many households.

Bronze plans pair with an HSA. CMS says every bronze and catastrophic Marketplace plan is HSA-eligible from 2026. How the account works is on health savings account.

The 2027 contribution table, next to 2026

Inside each band the percentage rises in a straight line from its starting to its ending value.

The credit equals the second-lowest-cost silver plan for your household minus that share of income, and you can spend it on any bronze, silver, gold or platinum plan. The same 10.22% is the 2027 test for whether a job-based offer is affordable.

The steps: from income estimate to tax return

1. Estimate 2027 household income from your latest tax return

Start from last year’s modified adjusted gross income and add or subtract only the changes you already know.

2. Check every job-based offer against the 10.22% test

For the employee, compare the yearly cost of self-only coverage with 10.22% of household income; for a spouse or child, use the yearly cost of family coverage.

3. Open your application at HealthCare.gov or your state exchange before December 15

Returning enrollees should update the application rather than letting the old income roll over.

4. Enter the household exactly as it will appear on your tax return

The credit is measured on the tax household, so a mismatch shows up at tax time.

5. Compare plans on premium after credit, deductible and out-of-pocket maximum

Add twelve months of premium to the out-of-pocket maximum to see each plan’s worst-case year. If the application says you qualify for cost-sharing reductions, they come only with a Silver plan.

6. Search each plan’s directory for your doctors and prescriptions

A low premium does not help if your doctor is out of network.

7. Pay the first premium to the insurer by its due date

HealthCare.gov ties the coverage start to that first payment.

8. Report income and household changes within the year

Updating the Marketplace mid-year resets the advance credit, which is the only protection now that repayment is uncapped.

9. Reconcile Form 1095-A on Form 8962 when you file

The 1095-A shows the advance credit paid; Form 8962 compares it with the credit your final income earns.

A worked example: a couple, both 40, at the 400% line

The setup: a household of two in the 48 states, both 40, for 2027. The 2026 poverty guideline for two is $21,640, so 400% is $86,560. The benchmark is KFF’s 2027 US average of $703 a month each (weighted by county plan selections), $1,406 for the couple or $16,872 a year. Real benchmarks vary by county; this is an illustration, not a quote.

The cliff in plain numbers. One extra dollar of income at $86,561 costs the couple $8,025.57 of credit, 9.3% of their income, and their benchmark cost rises to 19.49% of income. Below the line, the expected share never passes 10.22%. A single 40-year-old meets the same edge at $63,840, where the credit is $1,911.55 a year. For comparison, the 2021-2025 rules would have capped the couple’s benchmark at 8.5% of income, $7,357.69, above the line. The rows are in the 2027 credit file.

Income near the line is the part you control. Pre-tax retirement and HSA contributions lower modified adjusted gross income, which is why the HSA investing page matters here.

The original data: what 2026 enrollees did

CMS publishes a state-level file of every Open Enrollment. Comparing the 2025 and 2026 files shows the first year without the larger credits.

Plan selections fell 1,188,853, or 4.89%, the average premium after credits rose 57.5%, and enrollees reporting income above 400% fell 34.7%. Selections fell in 41 of 51 states. The steepest drops were North Carolina (21.9%), Ohio (19.5%) and West Virginia (16.7%); New Mexico (up 18.1%), DC (up 7.5%) and Texas (up 5.2%) grew. Illinois moved from HealthCare.gov to its own exchange between the two years.

People traded down to bronze. Bronze selections rose by 1,880,369 and silver fell by 3,829,807, so bronze went from 29.9% to 39.6% of plans while silver fell from 56.2% to 42.6%; gold rose from 13.2% to 17.2%. Bronze cuts the premium and raises the deductible, which is why step 5 adds the out-of-pocket maximum. State figures are in the enrollment by state file and the metal counts in the metal level file.

How to tell it worked: five checks before January 15

Your enrollment is in good shape if:

• Your plan was picked by December 15 for a January 1 start, or by January 15 for February 1, and the first premium is paid.
• The application’s income is within 5% of the household income on your latest return, or you can name the change that explains the gap.
• You compared at least 3 plans on twelve months of premium plus the out-of-pocket maximum.
• Every regular doctor and prescription shows as in network for the plan you chose.
• If your income sits within 10% of the 400% line, you have a plan to report changes within 30 days.

When it fails: the tax-time and coverage traps

The income estimate is low. Credit paid on a low estimate is repaid in full at tax time from tax year 2026. A raise that is never reported can turn into a tax bill.

Income crosses 400% late in the year. In the worked example, $1 over $86,560 means repaying all $8,025.57 of advance credit, because the test is the full year’s income.

The premium hides the deductible. A bronze plan with a low premium can cost more than silver in a year with a hospital stay; the 2026 shift to bronze makes this the common trap.

Auto re-enrollment carries old numbers. CMS counted 8,812,187 automatic re-enrollments for 2026. An old income or plan carried forward can be wrong for 2027.

The deadline is missed. After January 15 you need a Special Enrollment Period, which HealthCare.gov generally ties to an event in the past 60 days, such as a move, a birth or losing other coverage.

Questions people ask

When is open enrollment for 2027?

On HealthCare.gov, November 1, 2026 to January 15, 2027. Pick by December 15 for coverage from January 1. State-run exchanges set their own windows.

What is the income limit for the premium tax credit in 2027?

400% of the 2026 poverty guideline: $63,840 for one person, $86,560 for two and $132,000 for four in the 48 states. The floor is 100%.

Did the enhanced premium tax credits expire?

Yes. They ran from 2021 through 2025. As of November 8, 2026, the IRS 2027 table (Rev. Proc. 2026-26) uses the original rules, with no credit above 400%.

Do I have to pay back the premium tax credit?

You repay any advance credit above what your final income earns, in full, starting with tax year 2026.

Can I get a Marketplace credit if my job offers insurance?

Only if the offer is unaffordable or does not meet minimum value. For 2027, unaffordable means the employee’s cost for self-only coverage is above 10.22% of household income; for family members, the test uses the employee’s cost for family coverage.

Related

Health savings account explains the account a bronze plan now opens, and HSA investing covers what to hold in it. Building the premium and deductible into a monthly plan is the job of budgeting, and an emergency fund sized to your plan’s out-of-pocket maximum keeps a bad year from becoming debt. If cover for your family is the next question, see how to choose a life insurance amount.

This page is educational, not financial advice. Test every idea on your own charts before risking money.