By JC Moreno
Consumers choosing health coverage for 2027 may face higher premiums or changes in available plan costs. The plan they want may no longer fit comfortably within their budget.
The pressure is already showing. In 2026, the average monthly premium paid by ACA Marketplace consumers increased 58%, while more people moved toward lower-premium coverage. Bronze selections rose from 30% of Marketplace enrollment in 2025 to 40% in 2026.
Costs could climb again next year. Marketplace insurers have proposed a median premium increase of 15% for 2027.
Higher premiums can leave consumers weighing monthly affordability against the coverage and financial protection they need. Licensed insurance agents can bring clarity to those decisions by looking beyond a single plan or premium and considering the broader range of options available in the under-65 market.
Look at the full cost of coverage
A manageable premium is important, but the monthly payment tells only part of the story.
Deductibles, copays, coinsurance, prescription costs, provider networks, and out-of-pocket limits can significantly affect what a consumer pays for healthcare throughout the year. Moving to a lower-premium option could reduce the monthly expense while leaving the consumer responsible for more costs when care is needed.
Marketplace coverage and available financial assistance should remain part of the review. Some eligible consumers may also have access to catastrophic Marketplace plans. CMS expanded its hardship exemption guidance beginning with the 2026 plan year, allowing more eligible consumers to access catastrophic coverage.
Looking at the full financial picture can help consumers understand the tradeoffs before making a change based on premium alone.
Know the role of alternative coverage
A consumer who still faces a coverage or affordability gap may have additional choices in the under-65 market. For example:
- Short-term medical coverage can address certain temporary gaps, but plans are subject to significant federal and state requirements and limitations. Availability, duration, renewal and eligibility vary by state and plan.
- Hospital indemnity insurance can provide fixed benefits for covered hospital events.
- Critical illness and accident insurance can provide benefits for certain covered diagnoses or injuries.
- Dental insurance and prescription drug programs can address other healthcare expenses.
Each option has a specific purpose, along with its own benefits, limitations, exclusions, and eligibility requirements. Availability can vary by state.
Clear explanations matter here. Supplemental and limited-benefit products provide different protection than comprehensive major medical coverage. Consumers need to understand both the benefits they’re adding and the expenses they could still face.
Build the conversation around the consumer
Coverage decisions become more useful when they reflect how someone really uses their healthcare.
A consumer taking several prescriptions every month may prioritize different benefits than someone primarily concerned about an unexpected hospital stay. A person between jobs could need temporary coverage. Someone who is self-employed may be looking for a solution that can fit both ongoing healthcare needs and a monthly budget.
Reviewing current coverage, healthcare needs, prescriptions, household finances, and potential out-of-pocket expenses can give licensed insurance agents a clearer view of where the greatest financial exposure lies.
Make the tradeoffs easier to understand
Rising costs could put more pressure on coverage decisions for 2027. Looking beyond the monthly premium can give consumers a clearer picture of what each choice means for their healthcare needs and finances.
A broader coverage review can show where a consumer has strong protection, where financial exposure remains, and which available options could address a specific need.
Licensed insurance agents can bring those pieces together, helping consumers understand their options and make coverage decisions that better reflect their needs, priorities, and budgets.
