ACA Benchmark Up 13%: Do the Subsidy Cliff Math Now

Open enrollment for 2027 marketplace coverage opened yesterday, Sunday, November 1, and it opened with a number worth sitting down for: benchmark Silver premiums, the plans that subsidies are pegged to, are up 13 percent on average for 2027, according to the KFF analysis of the newly released federal plan data published October 30. Insurers had filed for a median increase of about 15 percent, per the Peterson-KFF filing analysis summarized in the 2027 enrollment dates reporting. This is the second enrollment season without the enhanced premium tax credits that expired at the end of 2025, which means the old subsidy cliff is not background knowledge. It is the math that decides your bill.

The dates, once, clearly

On HealthCare.gov, enrollment runs November 1, 2026 through January 15, 2027. Enroll by December 15 and coverage starts January 1; enroll after that and it starts February 1. A 2025 federal rule would have cut the window at December 15, a federal court vacated that rule in June 2026, and the Centers for Medicare and Medicaid Services confirms the January 15 end date in its Plan Year 2027 fact sheet, as covered in the open enrollment guide. December 15 is still the date that matters if you cannot afford a gap month.

The cliff, in exact dollars

Premium tax credits now stop completely at 400 percent of the federal poverty level. For 2027 coverage, the cutoffs in the contiguous United States are $63,840 for a household of one, $86,560 for two, $109,280 for three and $132,000 for a family of four, built from the HHS poverty guidelines (100 percent is $15,960, $21,640, $27,320 and $33,000 respectively) as laid out in the 2027 cliff guide. Alaska and Hawaii cutoffs are higher. One dollar of modified adjusted gross income over your line and the credit is not reduced. It is zero.

Premium tax credit cutoffs for 2027 coverage at 400% of the federal poverty level, by household size. Source: HHS poverty guidelines as applied to 2027 marketplace coverage.

A worked example, labeled as one

Premium levels vary by age and county, so treat this as arithmetic practice with stated inputs, not a quote. Take a single applicant whose unsubsidized benchmark Silver plan costs $612 a month, $7,344 a year, a mid-range illustrative figure. At a MAGI of $63,500, just under the $63,840 line, this household is still inside the credit system and pays an income-capped share of that premium, with the credit covering the rest. At a MAGI of $64,500, just $1,000 a year more in income, the credit is $0 and the same plan costs the full $7,344. A $1,000 raise that removes a credit worth several thousand dollars is a pay cut wearing a costume. This is why I told readers in the October ACA prep piece to estimate income conservatively; now the estimate has consequences you can compute before December 15 instead of discovering at tax time.

The second number to check while you shop is the ceiling on what a bad year costs: the ACA out-of-pocket maximum rises to $12,000 for an individual and $24,000 for a family in 2027, up from $10,600 and $21,200, per the CMS figures in the 2027 dates reporting. A cheap premium attached to a $12,000 ceiling is not cheap insurance. It is a bet.

What to do this week

Log in, update your income estimate before you look at plans, and write your household's cliff number at the top of the page: $63,840, $86,560, $109,280 or $132,000. If your expected 2027 income sits within about $5,000 of that line, the plan comparison is secondary to the income question, because lawful MAGI reducers, retirement contributions chief among them, can be worth more than any plan switch; our Roth conversion piece covers the adjacent year-end levers. Then pick the plan, and pick it by December 15. The 13 percent headline is an average. Your cliff is personal, exact, and already published.