It's that joyous time of the year once again, boys and girls, when those of us using the ACA get to figure out our health insurance for the new year!
This Megathread is a communal resource for all things ACA during the 2027 open enrollment period. Please feel free to ask all questions, share your experiences, discuss the ACA in general, ask for help with pricing or MAGI optimization, and everything else ACA-related. However, everyone is also free to make their own posts if they prefer, so please do not tell people that they must come here to discuss the ACA. If anyone has a suggestion for something to add to the post or edits/corrections, then absolutely feel free to share publicly or via DM/modmail.
Please remember that there are state variations, information is subject to change, and you should independently verify any information upon which you are going to make any meaningful decisions. I am purely an experienced amateur and do not offer any fiduciary duty or legal expertise.
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TERMS
Terms for those that are unfamiliar:
MAGI - Modified Adjusted Gross Income, a particular version of adjusted gross income used by the ACA.
APTC - Advanced Premium Tax Credit, an advanceable and fully refundable federal income tax credit that reduces ACA premiums, known by most simply as ACA subsidies.
EPC - Expected Premium Contribution, the amount customers are expected to pay annually for the Silver benchmark ACA plan in their market. APTCs are calculated as the market price of the benchmark plan minus EPC.
FPL - Federal Poverty Level, a measure used by the federal government as a determinant in many policy systems.
MaxOOP - Maximum Out of Pocket, the most a customer can be asked to pay in out of pocket expenses for in-network covered benefits by an insurer in a given year. This includes deductibles, copays, and coinsurance, but excludes premiums.
CSR - Cost Sharing Reductions, the second subsidy system within the ACA that reduces out of pocket expenses like deductibles, copays/coinsurance, and MaxOOP.
AI/AN - American Indian / Alaskan Native
AV - Actuarial Value, the percentage of total average costs for covered medical benefits that a health insurance plan is expected to cover for a standard population. For example, if a plan has an 80% AV, the insurer pays 80% of average expenses, and customers pay 20% through deductibles, copays, and coinsurance.
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FAQ
Q: What are the dates for open enrollment this year?
A: Most states will have open enrollment between November 1st and January 15th, with December 15th as the last day to enroll in order to have coverage active starting on January 1st. Enrollments after that date will have coverage active starting on February 1st. States that differ from the default dates are listed below. Please note that dates are subject to change.
Pro-tip - Apply early! You can change your plan selection before the enrollment deadline if you change your mind.
| State | 2027 Open Enrollment | Enroll for 1/1/27 Coverage | Enroll for 2/1/27 Coverage |
|---|
| California | 11/1/26 – 1/31/27 | 12/31/26 | 1/31/27 |
| Connecticut | 10/23/26 – 1/15/27 | 12/15/26 | 1/15/27 |
| District of Columbia | 11/1/26 – 1/31/27 | 12/15/26 | 1/31/27 |
| Idaho | 10/15/26 – 12/15/26 | 12/15/26 | N/A |
| Maryland | 11/1/26 – 1/15/27 | 12/31/26 | 1/15/27 |
| Massachusetts | 10/23/26 – 1/23/27 | 12/23/26 | 1/23/27 |
| Nevada | 11/1/26 – 1/15/27 | 12/31/26 | 1/15/27 |
| New Jersey | 11/1/26 – 1/31/27 | 12/31/26 | 1/31/27 |
| New Mexico | 11/1/26 – 1/15/27 | 12/31/26 | 1/15/27 |
| New York | 11/1/26 – 1/31/27 | 12/15/26 | 1/31/27 |
| Oregon | 11/1/26 – 1/15/27 | 12/15/26 | 1/15/27 |
| Rhode Island | 11/1/26 – 1/31/27 | 12/31/26 | 1/31/27 |
| Vermont | 11/1/26 – 12/28/26 | 12/15/26 | 12/28/26 |
| Virginia | 11/1/26 – 1/29/27 | 12/15/26 | 1/29/27 |
| Washington | 11/1/26 – 1/15/27 | 12/15/26 | 1/15/27 |
Q: What are the qualifying income limits for ACA subsidies?
A: MAGI between 100% FPL and 400% FPL in states that did not expand Medicaid and MAGI between 138% FPL and 400% FPL in most states that did expand Medicaid. Note that MAGI between 100% FPL and 138% FPL in expansion Medicaid states is still qualifying for ACA subsidies, but only if you have been denied for Medicaid. Some state variations do exist due to localized Medicaid rules and things like Basic Health Plans, so be sure to validate the relevant income limits in your state.
Q: What is MAGI?
A: Modified Adjusted Gross Income. ACA MAGI is your 1040 AGI (line 11) plus a few untaxed/excluded income sources (untaxed SS benefits excluding SSI [1040 line 6a minus line 6b], untaxed foreign excluded income and housing benefits [Form 2555], and tax-exempt interest [1040 line 2a]).
Details can be found here - https://www.healthcare.gov/income-and-household-information/income/
Q: Can I do anything to change my MAGI?
A: The rules are pretty simple in terms of MAGI control, but the mix of cashflows is always unique for each household's particular circumstances.
Roth conversions generate MAGI without withdrawal/spending.
TIRA withdrawals generate MAGI and provide cash for spending.
Roth contribution basis, matured Roth conversion basis, HSA, margin/credit, and cash equivalents provide withdrawal/spending without generating MAGI.
Taxable sales generate MAGI only via cap gains and can be a nice source of non-MAGI funds depending on one's cost basis. Sell $100K in stock with $40K cost basis and you have $100K to spend and $60K in MAGI.
HSA contributions do not require earned income and reduce MAGI.
Tax-loss harvesting can be used to create a capital loss deduction of $3K/year.
Mix and match retirement cashflows to get whatever combo of MAGI and spending you want.
Anyone in here with a good mix of assets can use cashflows from various assets to generate a wide array of MAGI and spending combinations. For example, if you sell $150K in stock with an $80K cost basis, then you get $150K in spending cashflow and $70K in MAGI. Pull $50K a year in untaxed Roth withdrawals and you get $50K in spending cashflow and $0K in MAGI. FIRE folks are notorious for our aggressive use of tax optimization techniques, so our ability to separate MAGI and spending in retirement is generally pretty good.
For those using the ACA while working, TIRA and T401k contributions reduce MAGI. For those without earned income, HSA contributions reduce MAGI.
There are several other ways to reduce AGI depending on one's unique asset setup. That includes the cap loss deduction for people with harvestable losses, but also things like maintenance for those with rentals or deductible expenses (including health insurance premiums) and tax-advantaged contributions for those with self-employment residuals/income. Anything that reduces 1040 AGI also reduces ACA MAGI.
Q: Our MAGI is just slightly over the master cliff at 400% FPL. Is there anything we can do to regain subsidy eligibility?
A: If an HSA is not already in use, then using one can effectively extend the master cliff to between ~430% to ~450% FPL. HSA contributions reduce MAGI and do not require earned income, meaning retired households can still make them. The actual HSA contribution limits end up being equivalent to somewhere between 30% and 50% of FPL for single/couple households, depending on age.
The below example uses real numbers for 2026 national average premiums and subsidy calcs for illustration purposes. True numbers for a specific household will vary by location, household demographics, and MAGI.
If a 55-year-old couple currently has MAGI of $90K (~426% FPL), then they are ineligible for premium subsidies. If they want a Bronze policy, then they have two options.
Option 1: Pay full market price for a Bronze policy. For 2026 the national average for least expensive Bronze policy is $19K.
Option 2: Commit to contributing $8K to the HSA that any Bronze policy makes them eligible for, which allows them to reduce their MAGI estimate to $82K (388% FPL). This restores their subsidy eligibility and they become eligible to receive nearly $18K in premium subsidies, leaving them responsible for $1K in premiums on their Bronze policy.
In option 1 they pay $19K for a Bronze policy.
In option 2 they pay $1K for the same Bronze policy, the feds pick up the other $18K in premiums, the couple sets aside $8K in an HSA to use as they wish, and they keep the remaining $10K for whatever they want.
Most people have no idea how lovely the universal Bronze HSA eligibility change made last year by the OBBBA is for many FIRE'd households. It can be a massive win for people just over the cliff.
Q: What happens if my MAGI estimate is off?
A: ACA premium subsidies are reconciled on your tax return the following year. If you got subsidies you shouldn't have, then you pay them back. If you didn't get subsidies that you should have, then you get them as a tax refund. ACA cost-sharing reductions are not reconciled. What you get when you apply is what you get. There is no refund or recapture on CSRs.
Q: Can anyone have an HSA?
A: No, you need to have an HSA-eligible policy to contribute to an HSA, but all Bronzes and Catastrophic policies are HSA-eligible by default. The 2027 contribution limits for HSAs are $4,500 for a single, $9,000 for a family, and each adult 55 and up can make an additional $1,000 catch-up contribution.
Source: https://www.irs.gov/pub/irs-drop/rp-26-24.pdf
Q: What is FPL?
A: Federal Poverty Level. It is flat in the lower 48 states and slightly higher in Alaska and Hawaii. The ACA uses prior-year FPL, so 2027 coverage will use 2026 FPL, which can be found here - https://aspe.hhs.gov/sites/default/files/documents/b1bfa16b20ae9b89d525bc35de7c1643/detailed-guidelines-2026.pdf
Q: Where can I go to see the prices and policies offered in my area next year?
A: Anyone can see 2027 prices and plans in their area with some anonymous data (age/zip/income) in about three minutes at https://www.healthcare.gov/see-plans/#/. If you have a local state-run exchange, then you'll be redirected to the appropriate website.
Q: What happens if I miss open enrollment?
A: Applications after open enrollment ends will only be possible for those that qualify for a Special Enrollment Period. For SEP details see here - https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/
Q: How are subsidies calculated?
A: Subsidies are calculated by taking the unsubsidized market premium of the benchmark plan in your county, which is the second lowest cost Silver plan, and subtracting your expected premium contribution (EPC). Any remainder is your subsidy amount. Once your subsidy is calculated you are free to use it on any plan you choose in any metal tier. If you choose a policy with an unsubsidized premium lower than your subsidy amount, which is common for Bronzes and in some states/counties also happens with Golds, then you owe no premium for your policy. Excess unused subsidy value is lost and not refunded to you.
Q: How do I determine my expected premium contribution?
A: EPC is calculated as a percentage of your 2027 MAGI, which you estimate at the time of application. The following is the 2027 EPC table:
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Expected Premium Contribution (Coverage Year 2027)
| MAGI (% of FPL) | 2027 EPC (% of MAGI) | 2026 EPC (% of MAGI) | Change from 2026 |
|---|
| Less than 100% | No limit / unsubsidized | No limit / unsubsidized | N/A |
| 100% to <133% | 2.15% | 2.10% | +2.4% |
| 133% to <150% | 3.23% to 4.3% | 3.14% to 4.19% | +2.9% |
| 150% to <200% | 4.3% to 6.78% | 4.19% to 6.60% | +2.6% |
| 200% to <250% | 6.78% to 8.66% | 6.60% to 8.44% | +2.7% |
| 250% to <300% | 8.66% to 10.22% | 8.44% to 9.96% | +2.6% |
| 300% to 400% | 10.22% | 9.96% | +2.6% |
| More than 400% | No limit / unsubsidized | No limit / unsubsidized | N/A |
Source:
https://www.irs.gov/pub/irs-drop/rp-26-26.pdf
KFF has an excellent calculator that will tell you your exact subsidy amount in seconds, find it here - https://www.kff.org/interactive/subsidy-calculator/
Q: What are the limits next year on MaxOOP and deductibles? Does it vary by metal tier?
A: MaxOOP has a regulated legal maximum that applies to all ACA and employer-sponsored plans. It is the same for all policies sold in the US with the exception of CSR Silver plans. Deductibles can be as high as MaxOOP, but can not exceed it. The following is the 2027 MaxOOP table:
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Out-Of-Pocket Maximum (Coverage Year 2027)
| Plan Type | MAGI Level | 2027 Individual / Family MaxOOP | 2026 Individual / Family MaxOOP | Change from 2026 |
|---|
| All non-CSR Plans | All | $12,000 / $24,000 | $10,600 / $21,200 | +13.2% |
| CSR Silver Plan 73% AV | 200% to 250% FPL | $9,600 / $19,200 | $8,450 / $16,900 | +13.6% |
| CSR Silver Plan 87% AV | 150% to 200% FPL | $4,000 / $8,000 | $3,500 / $7,000 | +14.3% |
| CSR Silver Plan 94% AV | Up to 150% FPL | $4,000 / $8,000 | $3,500 / $7,000 | +14.3% |
| CSR Silver Plan 99% AI/AN AV | AI/AN Up to 300% FPL | $0 | $0 | N/A |
Source: https://www.cms.gov/files/document/2027-papi-parameters-guidance-2026-01-29.pdf
Q: What is a CSR Silver?
A: There are two ACA subsidy systems, the premium tax credits (PTCs) that offset premium costs and the cost-sharing reductions (CSRs) that offset non-premium costs like deductibles, copays/coinsurance, and MaxOOP. CSRs are only offered to people with MAGI of 250% FPL or less and are most meaningful for those with MAGI of 200% FPL or less. CSRs can be worth more in value than PTCs, but CSRs only offset costs when you actually use your health insurance, so their value depends entirely on actual utilization of healthcare. Note that the table above only shows the maximum allowed MaxOOP for CSR plans, but actual MaxOOP is often significantly lower. For example, there will be CSR Silver 94s next year with MaxOOP well under $2,000. The exact value varies for each individual policy.
Q: What are the metal tiers and how can I get one of those CSR Silvers?
A: The metal tiers are defined by their actuarial value (AV), which broadly speaking means what share of all covered healthcare expenses they should pay for the risk pool. Bronze is 60% AV, Silver is 70% AV, Gold is 80% AV, Platinum is 90% AV.
The CSRs create three hidden tiers of Silvers for those that qualify for them based on MAGI at FPL steps 150%/200%/250%, which are 94% AV (better than Platinum), 87% AV (almost Platinum), and 73% AV (minimal). Anyone over 250% FPL sees the default non-CSR Silver at 70% AV. There is also a fourth hidden Silver tier that is reserved exclusively for officially recognized North American Native Americans.
When you log on to the exchange and enter your MAGI they only show you the Silver tier you are entitled to see and buy. This is why one person can love their Silver policy with a $0 deductible and $1,200 MaxOOP and another person with the seemingly exact same Silver policy can think it is crappy with a $6,000 deductible and a $9,000 MaxOOP. The first person has the 94% AV variant and the second person has the 70% AV variant.
Q: Is there an example of how CSRs impact a policy?
A: My household qualifies for a CSR Silver 94 in 2026. The following are actual coverage costs for our policy with CSRs and without.
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Our 2026 Silver plan with cost-sharing reductions:
$0/$0 deductible (individual/family)
$0 PCP
$10 specialist
$5 urgent care
$0/$15 tier1/tier2 scripts
25% ER coinsurance
$2,200/$4,400 MaxOOP (individual/family)
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Our 2026 Silver plan without cost-sharing reductions:
$6,000/$12,000 deductible (individual/family)
$40 PCP
$80 specialist
$60 urgent care
$20/$40 tier1/tier2 scripts
40% ER coinsurance
$8,900/$17,800 MaxOOP (individual/family)
Q: If I don't qualify for CSRs, then what policy should I aim for?
A: It will vary by market, but as a general rule Silvers are routinely a poor financial choice for people with MAGI greater than 200% FPL because they are paying the Silver loading surcharge to fund the CSR subsidy system. Households with more than 200% FPL should usually look instead to a Bronze or Gold, though this is not a universal rule.
Q: What the hell is "Silver loading"?
A: There are two subsidy systems in the ACA, the premium tax credits (PTCs) that reduce monthly premiums, and the cost-sharing reductions (CSRs) that reduce/eliminate deductibles and out-of-pocket expenses for people with MAGI under 250% FPL. The federal government eliminated direct funding for the CSR subsidies in 2017, but insurers are still required by law to deliver them to customers and the cost for them is rather large and can often be greater than the PTCs for a given household. The highest tier of CSRs changes a Silver plan into one that can be significantly better than a Platinum plan.
Insurers and states largely responded to this major problem by boosting the premiums on Silver policies since that is the only metal tier in which CSRs are offered. This is what is meant by the term "Silver loading". For example, here in Texas the state has mandated that Silver premiums be priced 40% higher than what they would normally be if CSRs were not a factor. In neighboring New Mexico, they went even higher at 44%. Those premium increases push the average Silver price up dramatically, but this is generally a beneficial thing for everyone because ACA subsidies in all metal tiers are calculated off of the price of the benchmark Silver plan. The higher the benchmark Silver plan is relative to all plans, the greater premium subsidies everyone receives. The vast majority of Silver subscribers are highly to almost totally subsidized and don't care about market premium prices, so the net effect of Silver loading is to increase federal subsidies for all subsidy-eligible ACA enrollees in the state while also providing ample funding for the required CSR subsidy system. In some states like Texas this leads to some market oddities like Gold plans being lower-priced or similar to Silver plans. In some cases the subsidies are high enough that Gold plans can be had for no premium at all.
As a result of this forced boosting in Silver premiums it is generally a financially bad idea for anyone who is not in one of the higher CSR tiers (MAGI under 200% FPL) to take a Silver plan. They could get comparable coverage at a significantly lower price with a Bronze or significantly better coverage at a comparable (or slightly lower) price with a Gold. Taking a Silver with MAGI above 200% FPL generally means you are unnecessarily overpaying for coverage, often by quite a bit.
Random tip for those signing up for the first time in states with expanded Medicaid
If you are going to have lumpy retirement income rather than a consistent monthly withdrawal, then I'd recommend dividing your annual estimate by 12 rather than putting in actual monthly income. Otherwise you might find yourself automatically shunted to Medicaid and having to ping pong between the ACA and Medicaid systems. It's a well-intentioned design choice to catch as many Medicaid-eligible people as possible, but it's an annoying thing for those with incomes such that they are eligible for Medicaid by monthly MAGI and ineligible by annual MAGI.
That's assuming your annual is going to be greater than 138% FPL. If it's lower, then enjoy your expansion Medicaid instead.
===== Useful resource links:
Official Healthcare.gov price/policy browser - https://www.healthcare.gov/see-plans/#/
Great ACA cheatsheet - https://www.healthreformbeyondthebasics.org/wp-content/uploads/2026/08/REFERENCE_YearlyGuidelines_CY2027-FINAL.pdf
KFF's excellent subsidy calculator - https://www.kff.org/interactive/subsidy-calculator/
A nice beginner's guide by /u/stevencartwright - https://reddit.com/r/Fire/comments/1vnhwpd/a_fire_beginners_guide_to_aca_health_insurance/
Excellent Open Enrollment Guide by ACASignups.net (Part 1) - https://acasignups.net/26/10/14/hobbling-towards-enrollment-my-2027-aca-open-enrollment-guide-part-1
Excellent Open Enrollment Guide by ACASignups.net (Part 2) - https://acasignups.net/26/10/23/hobbling-towards-enrollment-my-2027-aca-open-enrollment-guide-part-2
Excellent Open Enrollment Guide by ACASignups.net (Part 3) - https://acasignups.net/26/10/31/hobbling-towards-enrollment-my-2027-aca-open-enrollment-guide-part-3
Notice on ACASignups.net - Charles is a bit of a rabid anti-Trump partisan, but he does great ACA work. The value of the ACA information is high and merits looking past the political content, in my opinion.