Losing Your Health Insurance in 2027? Who Is Affected and What to Do
Insurer exits, the subsidy cliff, Medicaid changes and new immigrant rules are all ending coverage for people this fall. Here is what applies to you and what to do before January 1.
Who is losing coverage going into 2027
Most people losing coverage this fall fit one of five situations. Each has a different deadline and a different fix, so find yours first.
| What happened | When | Your window |
|---|---|---|
| Your insurer is leaving your state's Marketplace | Plan ends Dec 31, 2026 | Open Enrollment, or 60 days after coverage ends |
| Your income is over 400% of the poverty level, so no credit | Since Jan 1, 2026 | Open Enrollment |
| You are a Medicaid expansion adult facing work requirements or 6-month checks | From Jan 1, 2027 (some states earlier) | 60 days after Medicaid ends |
| You are lawfully present but not in an eligible immigration category | From Jan 1, 2027 | Open Enrollment (at full price) |
| You relied on the year-round low-income enrollment window | Ends after 2026 | Open Enrollment only |
Your insurer is leaving the Marketplace
Nine insurers are pulling out of at least one state for 2027. The largest is Cigna, which is exiting the Marketplace in all 11 of its states, including Florida, where it covered about 97,000 people. Others include CareSource (Indiana, Ohio, West Virginia), Baylor Scott & White (Texas), PacificSource (Idaho, Montana, Oregon) and ConnectiCare (Connecticut).
If your insurer is leaving, you will get a discontinuance notice. If you do nothing, the Marketplace may place you in a plan from another insurer, chosen on price and plan type, not on your doctors. Choose your own plan during Open Enrollment instead, and check your doctors and prescriptions on it before you enroll.
Missed the deadline?
A plan ending because it was discontinued counts as a loss of coverage, which opens a 60-day Special Enrollment Period. Do not count on it, though: enrolling by December 15 is the only way to guarantee no gap on January 1.
Priced out by the subsidy cliff
With the enhanced credits gone, a single person earning more than about $63,840, a couple above about $86,560 or a family of four above about $132,000 gets no credit in 2027. Florida saw roughly 443,000 people leave the Marketplace between 2025 and 2026, much of it from that change.
Dropping coverage is the expensive way out. A single hospital stay can cost more than several years of premiums. Before you let a plan lapse:
- Check whether pre-tax retirement or HSA contributions bring your income back under the line. See the 2027 income limits.
- Price a bronze plan with an HSA, or a catastrophic plan, which anyone above 250% of the poverty level can request through a hardship exemption.
- If you are self-employed, use your net profit, not gross revenue. Over the cliff as a self-employed person.
Our guide to lowering a 2027 premium has all eleven options.
Medicaid work requirements and 6-month renewals
Under the 2025 budget law, states must start work and community engagement requirements on January 1, 2027 (some can start sooner or get an extension). They apply to adults aged 19 to 64 covered through Medicaid expansion, who must show 80 hours a month of work, job training, school or community service unless exempt. Expansion adults also move to eligibility checks every six months, starting with renewals due on or after December 31, 2026.
Florida did not expand Medicaid, so most Floridians on Medicaid are not in the expansion group. If you live in an expansion state and lose Medicaid, you generally have 60 days to enroll in a Marketplace plan, often with a sizable credit.
Immigrant eligibility changes on January 1, 2027
From January 1, 2027, premium tax credits are limited to lawful permanent residents (green card holders), Cuban and Haitian entrants, and people here under a Compact of Free Association. Other lawfully present immigrants, such as many people with work visas, TPS or pending asylum cases, can still buy a Marketplace plan but without a credit. If that is you, compare Marketplace plans at full price with job-based coverage and catastrophic options. Guía en español.
The year-round low-income window is closing
Since 2022, people at or below 150% of the poverty level could enroll any month. That window ends after plan year 2026, and people who enroll through an income-based special enrollment period no longer get a credit. For 2027, if your income is low, Open Enrollment is the time to enroll.
What to do next, in order
- Read every letter from your insurer, the Marketplace or Medicaid. Note the date your coverage ends.
- Estimate your 2027 income honestly. Since tax year 2026, any excess credit is repaid in full.
- Compare plans by your doctors and drugs, not just premium. Six things to check on any 2027 plan.
- Enroll by December 15 for January 1 coverage. Open Enrollment closes January 15, 2027.
- If you miss it, act within 60 days of losing coverage. Check whether you qualify for a Special Enrollment Period.
Losing your plan? We will find the next one
Tell us your ZIP, income and doctors. We line up the replacement before your coverage ends, at no cost to you.
Get my free 2027 quote →Sources: KFF analysis of 2027 ACA rate filings (Aug 2026); Florida Office of Insurance Regulation filings as reported by WLRN (Sep 2026); KFF insurer participation tracker for 2027 (Sep 2026); CMS 2027 Notice of Benefit and Payment Parameters; IRS Rev. Proc. 2026-24 and Notice 2026-5; 2026 HHS poverty guidelines. Figures checked 4 October 2026. Rates are proposals until each state finalizes them.
Frequently asked
Is Cigna leaving the ACA Marketplace in 2027?
Yes. Cigna is exiting the ACA Marketplace in all 11 states where it sold individual plans, including Florida, for 2027. Members should receive a discontinuance notice. You can choose a new plan from another insurer during Open Enrollment, November 1, 2026 to January 15, 2027; choose by December 15 to have coverage start January 1.
What do I do if my health insurance company leaves the Marketplace?
Pick a new plan yourself during Open Enrollment rather than waiting to be reassigned, and check that your doctors and prescriptions are covered on the new plan. Losing a plan because it was discontinued also counts as a loss of coverage for a Special Enrollment Period, so if you miss Open Enrollment you generally have 60 days from the date the coverage ends to enroll.
When do Medicaid work requirements start?
Federal law requires them starting January 1, 2027, although states can start sooner and some can get extensions. They apply to adults aged 19 to 64 covered through Medicaid expansion, who need 80 hours a month of work, job training, school or community service unless they qualify for an exemption. Florida did not expand Medicaid, so most Floridians on Medicaid are not in the group these rules target.
I lost Medicaid. Can I get a Marketplace plan?
Yes. Losing Medicaid is a qualifying event, and you generally have 60 days to enroll in a Marketplace plan, with a premium tax credit if your income is in range. In states that did not expand Medicaid, including Florida, adults below 100% of the poverty level usually do not qualify for a credit, but may qualify for a low-cost catastrophic plan through a hardship exemption.
Can I still enroll any month if my income is low?
Not after 2026. The monthly Special Enrollment Period for people at or below 150% of the poverty level ends after plan year 2026, and people who enroll through an income-based Special Enrollment Period no longer receive a premium tax credit. For 2027, Open Enrollment is the window to use.
Which immigrants can still get ACA subsidies in 2027?
From January 1, 2027, premium tax credits are limited to lawful permanent residents, Cuban and Haitian entrants, and people living in the U.S. under a Compact of Free Association. Other lawfully present immigrants can still buy a Marketplace plan, but at full price.