ACA Open Enrollment for 2027: health insurance for U.S. freelancers and the self-employed

Open Enrollment for 2027 Marketplace health insurance runs from November 1, 2026 to January 15, 2027 on HealthCare.gov. To have coverage from January 1, pick a plan by December 15. States that run their own marketplace can set different dates, so check your state's site if you don't apply through HealthCare.gov.

For freelancers, the application is also a tax decision. Your premium tax credit is based on the income you expect to earn in 2027, and from the 2026 tax year onward any credit you receive in advance beyond what you qualify for must be repaid in full when you file.

Disclaimer: This is educational information for U.S. freelancers, not tax, legal, or insurance advice. Plan options, prices, and state rules vary. Confirm your figures on HealthCare.gov or your state marketplace, and ask a qualified tax professional or a certified enrollment assister about your situation.

The 2027 enrollment dates

CMS confirmed the full November 1-January 15 window in its October 30, 2026 fact sheet. KFF notes that a rule which would have shortened Open Enrollment to nine weeks was vacated in court, so the longer window stands for this cycle.

If you already have a Marketplace plan, your plan, price, and credit can all change for 2027. KFF reports that several insurers are leaving at least one state for 2027, so log in and compare options rather than assuming this year's plan still fits. If you are leaving a job with health coverage at another time of year, losing that coverage usually opens a 60-day Special Enrollment Period.

Where premium tax credits stand

The enhanced premium tax credits that applied through 2025 have expired, and 2027 is the second plan year without them. KFF's October 30, 2026 brief sets out what that means for buyers this autumn:

• The 400% cliff is back. Households with income above 400% of the federal poverty level no longer qualify for any premium tax credit and pay the full premium.
• Benchmark prices are up. The average benchmark silver premium rises 13% for 2027, after a double-digit increase for 2026.
• Some states help. New Mexico continues to fully replace the lost federal help, and a few other states offer partial state subsidies, mostly for lower incomes.

2027 Marketplace savings are figured with the poverty levels HealthCare.gov lists for 2026: $15,960 for one person and $33,000 for a family of four (higher in Alaska and Hawaii). That puts the 400% line at $63,840 for a single freelancer and $132,000 for a family of four.

Estimating freelance income

The Marketplace wants your expected household income for 2027, not last year's. For self-employment, that means net income: what you expect to report as profit on Schedule C, after business expenses. The figure used is modified adjusted gross income (MAGI), which for most people is the same as or close to adjusted gross income (AGI). MAGI adds back untaxed foreign income, non-taxable Social Security benefits, and tax-exempt interest.

1. Start from your 2026 run rate. Use year-to-date net profit, not gross invoices, and adjust for clients you know are starting, ending, or changing scope in 2027.
2. Include the household. Add a spouse's wages and other taxable income for everyone in your tax household.
3. Account for adjustments. Above-the-line deductions on Schedule 1, such as the deductible part of self-employment tax and the self-employed health insurance deduction, lower AGI. Planned retirement contributions can too, so ask your tax preparer which ones apply to you.
4. Be careful near 400%. Just under the line you may get a credit; just over it you get none. If your estimate is close, an optimistic number can turn into a large repayment.

When income changes mid-year

HealthCare.gov asks you to update your application as soon as possible when your expected income or household changes. Freelance income moves, so treat this as a routine check rather than a one-off.

• Income going up: report it, and your monthly credit drops. If you don't, you repay the difference when you file, and the IRS says there is no longer a cap on that repayment from the 2026 tax year.
• Income going down: report it, and you may qualify for more help now, or for Medicaid or CHIP.
• Unsure: you can use all, some, or none of your credit in advance each month. Taking less now means a smaller repayment risk, with any unused credit counted when you file.

Reconciling on Form 8962

If you had Marketplace coverage with advance credit payments, you must file a federal return and reconcile them on Form 8962, using the Form 1095-A the Marketplace sends you. The form compares the credit paid to your insurer during the year with the credit your actual income supports. If you were paid too much, the difference is added to your tax bill or taken out of your refund; if too little, you get the difference.

This applies first to 2026 coverage on the return due April 15, 2027, which will be the first filing season without repayment caps. If you had 2026 Marketplace coverage, include any expected repayment when you size your year-end reserve. The Q4 2026 estimated tax checkpoint covers the January 15 payment that comes before it, and the U.S. federal tax return guide for 2026 walks through the return where Form 8962 is filed.

The self-employed health insurance deduction

If you have a net profit from self-employment, you may be able to deduct premiums for medical, dental, and vision insurance for yourself, your spouse, and your dependents on Schedule 1 (Form 1040), line 17. The IRS Form 7206 instructions set the main limits:

• No deduction for any month you were eligible for a subsidized employer plan, including through your spouse's employer, even if you did not enroll.
• The deduction is limited by the earnings of the business the plan is set up under, and it does not reduce self-employment tax.
• With a Marketplace plan and a premium tax credit, the deduction and the credit affect each other. IRS Publication 974 has special instructions for claiming both.

One more change worth knowing when you compare plans: from 2026, the IRS treats bronze and catastrophic plans available through an Exchange as compatible with a health savings account.

What to do before December 15

1. Write down your 2027 estimate. Net self-employment profit plus other household income, and note where it falls against the 400% line for your household size.
2. Compare plans, not just premiums. Check deductibles, networks, and whether your doctors and prescriptions are covered.
3. Decide how much credit to take upfront. If your income is hard to predict, taking less in advance lowers the risk of a bill next spring.
4. Set a review date. Put a monthly or quarterly reminder next to your estimated tax dates to update the application if income moves.

The freelance tax calendar for November 2026 to April 2027 lists those estimated tax dates alongside the 1099 and filing deadlines, so the enrollment dates can sit in the same reminder list.

For the full money system behind these numbers, read money, tax and bookkeeping for freelancers.

Sources

• HealthCare.gov: Dates and deadlines for 2027 health insurance
• CMS: Plan Year 2027 Marketplace plans and prices fact sheet (October 30, 2026)
• KFF: 9 things to watch for the 2027 ACA Open Enrollment period (October 30, 2026)
• HealthCare.gov: Federal poverty level (FPL)
• HealthCare.gov: Estimating income if you're self-employed
• HealthCare.gov: How to estimate your expected income
• HealthCare.gov: Reporting income, household, and other changes
• HealthCare.gov: How to save money on monthly premiums
• HealthCare.gov: How to reconcile your premium tax credit
• IRS: Repayment caps eliminated for excess advance payments of the Premium Tax Credit
• IRS: Instructions for Form 7206, Self-Employed Health Insurance Deduction
• IRS Publication 974, Premium Tax Credit (PTC)
• IRS: Guidance on new tax benefits for health savings account participants
• HealthCare.gov: Special Enrollment Period